Medicare procedure market data by CPT code & state

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Market snapshot

Nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS

76516 Ultrasound scan to determine eye length CPT · Ultrasound imaging

Classification Imaging › Ultrasound › Ultrasound - Nonspecific (CMS RBCS)

First observed 2013 — start of our 12-year window; the code predates it

National scale 1,266 services ▲ 12.1% YoY · 1,157 beneficiaries (CY2024, Medicare FFS)

Medicare paid $41K · $32.41 avg / service, national

CMS descriptor · RBCS classification · Medicare Part B physician/supplier claims, 12-year window

Billing groups

Named-group FFS services

420

FFS of Medicare

49%

Services YoY

+12.1%

FFS enrollment -2.2%

Estimated all-Medicare volume FFS + estimated MA estimate

~849 services

420 observed fee-for-service (49%) · ~429 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 — 76516 (CY2024)

CA 342 MO 223 MA 166 NJ 88 MI 87

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

Named-group submitted charges

$83K

Named-group allowed amount

$15K

Named-group Medicare payments

$11K

Avg charge / svc

$197

Avg allowed / svc

$35

Avg payment / svc

$26

Average charge per group

$55–105

$105–155

$155–205

$205–255

$255–305

$305–355

$355–405

$405+

$55 11 groups · avg submitted charge / service $660

Market analyticsPlatform

a taste of the twelve-year trend layer

Market position — where this market sits on volume and growth among all state markets, and its rank.
Worth a look — every state market for this search, ranked by a published score: size, growth, fragmentation, below-expected volume.
Lookalike opportunities — groups billing below what peers of the same specialty, size, and state predict, with the expected figure shown.
National benchmarks — where each group's volume sits nationally and within its specialty.
Market structure — how concentrated this market is, and who owns the volume.
Medicare-wide scaling — the payer split, and this market total scaled to all of Medicare, labeled as an estimate.

Or just look at it: nuclear heart imaging (78452) in Arizona is open as a live example — the full paid view, real data.

View the live example →

Nevvi's market analytics platform — code baskets, market structure and share, the twelve-year trend layer — is built and not launched yet. We're gathering interest in it.

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Data year: CY2024 CY2023 CY2022 CY2021 CY2020

Physician groups ranked by 76516 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	76516 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	MASSACHUSETTS EYE AND EAR ASSOCIATES, INC	BOSTON	MA	OPHTHALMOLOGY	406	102	$9,718	$95	premium	61.4%	(617) 523-7900
2	REGENTS OF THE UNIVERSITY OF MICHIGAN	ANN ARBOR	MI	INTERNAL MEDICINE	3330	59	$11,210	$190	premium	67.8%	(734) 763-5459
3	SCRIPPS HEALTH	LA JOLLA	CA	PHYSICIAN ASSISTANT	1431	45	$10,055	$223	premium	13.2%	(858) 455-9100
4	UNIVERSITY OF CONNECTICUT HEALTH CENTER	FARMINGTON	CT	NURSE PRACTITIONER	630	37	$7,215	$195	premium	100.0%	(860) 679-3692
5	JULES STEIN EYE INSTITUTE MEDICAL GROUP	ARCADIA	CA	OPHTHALMOLOGY	116	31	$20,460	$660	premium	9.1%	(323) 442-7122
6	M. HANIF PERACHA , M.D. , P.C.	MONROE	MI	OPHTHALMOLOGY	5	28	$3,500	$125	premium	32.2%	(734) 242-2727
7	SCRIPPS HEALTH	LA JOLLA	PA	PHYSICIAN ASSISTANT	1431	27	$6,615	$245	premium	100.0%	(858) 455-9100
8	VANDERBILT UNIVERSITY MEDICAL CENTER	NASHVILLE	TN	NURSE PRACTITIONER	3394	26	$3,406	$131	premium	61.9%	(615) 322-5000
9	UMASS MEMORIAL MEDICAL GROUP INC	WORCESTER	MA	PHYSICIAN ASSISTANT	2483	20	$2,740	$137	premium	12.0%	(508) 334-1000
10	UNIVERSITY OF MARYLAND EYE ASSOCIATES, P.A.	BALTIMORE	MD	OPHTHALMOLOGY	24	16	$3,760	$235	premium	59.3%	(667) 214-1111
11	TULLAHOMA VISION ASSOCIATES P C	TULLAHOMA	TN	OPTOMETRY	2	16	$880	$55	premium	38.1%	(931) 455-0654
12	DRS FINE HOFFMAN AND SIMS LLC	EUGENE	OR	OPHTHALMOLOGY	4	13	$3,250	$250	premium	100.0%	(541) 687-2110

*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 →