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

76604 Ultrasound scan of chest 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 62,928 services ▲ 9.9% YoY · 55,915 beneficiaries (CY2024, Medicare FFS)

Medicare paid $1.5M · $23.33 avg / service, national

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

Billing groups

393

Named groups billing this code

Named-group all-Medicare svcs · est.

71,284

Scaled from 34,810 observed FFS services.

FFS of Medicare

49%

Payer-mix frame

Services · year over year

Services YoY

+13.9%

All-Medicare est. · observed FFS +9.9%

Volume, not care. A shrinking fee-for-service denominator is not a shrinking market.

Estimated all-Medicare volume estimate

FFS + estimated MA

~71,284 services

34,810 observed fee-for-service (49%) · ~36,474 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 — 76604 (CY2024)

CA 13,882 NY 8,045 FL 6,136 TX 5,965 MA 2,855

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

Billed → allowed → paid

Named-group submitted charges

$6.6M

Named-group allowed amount

$1.0M

Named-group Medicare payments

$811K

Avg charge / svc

$190

Avg allowed / svc

$30

Avg payment / svc

$23

Totals are named-group (attributable) sums. Allowed is Medicare’s fee-schedule recognized price — what CMS recognizes, before the 80% Medicare pays.

Average charge per group

$46–85

$85–124

$124–163

$163–203

$203–242

$242–281

$281–320

$320+

$46 393 groups · avg submitted charge / service $924

Market analyticsPlatform Methods →

Search a single state to see that market's full analytics — the free tier previews every panel, gated.

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 →

Data year: CY2024 CY2023 CY2022 CY2021 CY2020

Physician groups ranked by 76604 services, highest first, CY2024
#	Physician group locked column	City locked column	St locked column	Specialty locked column	Providers locked column	76604 svcs	Submitted charges locked column	Avg charge locked column	Medicare $ locked column	Share of state* locked column	Phone
1	PHYSICIANS REFERRAL SERVICE	HOUSTON	TX	NURSE PRACTITIONER	2696	2,347	$664,509	$283	premium	39.3%	(713) 592-5433
2	NORTH SHORE-LIJ MEDICAL PC	MANHASSET	NY	PHYSICIAN ASSISTANT	6294	1,938	$292,526	$151	premium	24.1%	—
3	MONTEFIORE MEDICAL CENTER	BRONX	NY	PHYSICAL THERAPIST IN PRIVATE PRACTICE	2796	1,320	$752,400	$570	premium	16.4%	(866) 633-8255
4	STONY BROOK INTERNISTS UNIVERSITY FACULTY PRACTICE CORPORATION	STONY BROOK	NY	HOSPITALIST	414	1,002	$249,780	$249	premium	12.5%	(631) 444-1560
5	CEP AMERICA - CALIFORNIA	MORENO VALLEY	CA	EMERGENCY MEDICINE	1230	738	$147,504	$200	premium	5.3%	(651) 243-0811

That's the top 5 of 393 groups. The platform ranks the whole market — code baskets, benchmarks, and the full ranked list. the full ranking is part of the market analytics platform — built, not launched yet. Notify me at launch →

*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 →