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Market snapshot

Nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS
41100 Biopsy of front 2/3 of tongue CPT · Other Organ Systems procedure
Classification Procedure Other Organ Systems (CMS RBCS)
First observed 2013 — start of our 12-year window; the code predates it
National scale 240 services ▲ 37.1% YoY · 217 beneficiaries (CY2024, Medicare FFS)
Medicare paid $28K · $115.28 avg / service, national
CMS descriptor · RBCS classification · Medicare Part B physician/supplier claims, 12-year window
Billing groups
7
Named-group FFS services
141
FFS of Medicare
49%
Services YoY
+37.1%
FFS enrollment -2.2%
Estimated all-Medicare volume FFS + estimated MA estimate
~304 services

141 observed fee-for-service (46%) · ~163 estimated Medicare Advantage. Scaled from the observed floor by each state’s fee-for-service share (FFS share as of 2024) — scaled estimate — assumes MA utilization mirrors FFS; not an observation. How we scale

Top states — 41100 (CY2024)

Disclosed Medicare fee-for-service services by billing state; open a bar for that state's ranked market.

Named-group submitted charges
$90K
Named-group allowed amount
$21K
Named-group Medicare payments
$15K
Avg charge / svc
$636
Avg allowed / svc
$148
Avg payment / svc
$109
Average charge per group
$300 7 groups · avg submitted charge / service $2,203
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Data year: CY2024 CY2023 CY2022 locked column CY2021 locked column CY2020 locked column
Physician groups ranked by 41100 services, highest first, CY2024
# Physician group activate to sort City activate to sort St activate to sort Specialty activate to sort Providers activate to sort 41100 svcs sorted descending — activate to reverse Submitted charges activate to sort Avg charge activate to sort Medicare $ locked column Share* activate to sort Phone
1 UNIVERSITY OTOLARYNGOLOGISTS INC COLUMBUS OH OTOLARYNGOLOGY 58 64 $19,200 $300 premium 100.0% (614) 538-2424
2 UNIVERSITY OF WISCONSIN MEDICAL FOUNDATION INC MADISON WI PHYSICIAN ASSISTANT 2523 15 $13,710 $914 premium 100.0% (608) 287-2050
3 TEXAS ONCOLOGY PA DALLAS TX PHYSICIAN ASSISTANT 995 15 $9,240 $616 premium 100.0%
4 TRUSTEES OF BOSTON UNIVERSITY BOSTON OR PHYSICAL THERAPIST IN PRIVATE PRACTICE 44 13 $10,127 $779 premium 100.0% (617) 358-3700
5 ASSOCIATED ORAL AND MAXILLOFACIAL SURGEONS, PC MARTINSBURG MD MAXILLOFACIAL SURGERY 3 12 $8,280 $690 premium 100.0% 3042630991205
6 UNIVERSITY OF MIAMI MIAMI FL NURSE PRACTITIONER 2331 11 $4,895 $445 premium 26.2% (305) 689-5437
7 NEW YORK UNIVERSITY NEW YORK NY DIAGNOSTIC RADIOLOGY 5704 11 $24,233 $2,203 premium 100.0% (212) 263-9700

*Share of the state's disclosed Medicare-FFS services for the primary code, counted once per clinician. "St" is the state the volume was billed from: a group appears in each state where its clinicians bill Medicare, with that state's volume and share ("City" is the group's registered location). Group figures sum clinicians affiliated with exactly one group; clinicians in several groups are listed in each group's drill-down but not volume-attributed to any single group, so shares reflect attributable volume. See Methods.

Comparing against an all-payer estimate?

These are exact counts from Medicare fee-for-service claims — roughly a third to half of most procedure markets, depending on payer mix. Modeled all-payer databases project the remainder statistically; we publish the audited floor and label it as such. Same market, different denominator. How the numbers reconcile →