Medicare procedure market data by CPT code & state

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Market snapshot

TX CY2024

Medicare Part B FFS · CY2024 · as published by CMS

78227 Nuclear medicine study of liver and bile duct system with use of drugs CPT · Nuclear imaging

Classification Imaging › Nuclear (CMS RBCS)

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

National scale 20,176 services ▲ 4.6% YoY · 19,999 beneficiaries (CY2024, Medicare FFS)

Medicare paid $1.3M · $64.14 avg / service, national

CMS descriptor · RBCS classification · Medicare Part B physician/supplier claims, 12-year window · National figures — the TX market is below

Market analyticsPlatform Methods →

The structure and trend panels below are live for everyone — free to look at. The rank & score analytics, baskets, and export are the platform.

The read

What am I looking at, in one breath?

The read Platform

In Texas, 10 groups bill 78227 — 667 fee-for-service services, and volume is roughly flat year over year.

The orienting line is free; the comparative synthesis — growth rank, concentration, and $/service against the national figure — unlocks with Platform.

The snapshot

The honest, real numbers — free, always.

Billing groups

Named groups billing this code in TX

Named-group FFS services

667

Attributable volume · fee-for-service

FFS of Medicare

46%

Payer-mix frame

Named-group coverage

51%

Of Texas’s disclosed Part B services (2024). The rest is billed by clinicians whose volume isn’t attributed to any group — they belong to several groups, or none. How attribution works →

Services · year over year

Services YoY

-0.1%

FFS enrollment -1.5%

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

Estimated all-Medicare volume estimate

FFS + estimated MA

~1,432 services

667 observed fee-for-service (47%) · ~765 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

The market

How big, moving which way, worth how much.

Billed → allowed → paid

Named-group submitted charges

$164K

Named-group allowed amount

$32K

Named-group Medicare payments

$25K

Avg charge / svc

$246

Avg allowed / svc

$48

Avg payment / svc

$37

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

Per-service vs national + the payments trend unlock with Platform

Market trend — 12-year view

services 2013–2024

Year	Services	Services per 1,000 Part B FFS beneficiaries	Medicare payments
2013 (introduction year)	4,821	2.2	$321,117
2014	3,079	1.4	$265,262
2015	3,230	1.5	$281,005
2016	3,515	1.6	$252,682
2017	3,046	1.4	$277,731
2018	2,340	1.1	$247,338
2019	2,677	1.3	$262,190
2020 (2020)	1,732	0.8	$182,391
2021	1,677	0.8	$192,826
2022	1,385	0.7	$143,838
2023	1,581	0.9	$132,202
2024	1,580	0.9	$127,556

CAGR 2014–2024: -6.5%/yr · CAGR excludes 2020 and the introduction year.

Rates are per 1,000 Part B fee-for-service beneficiaries in the market's geography. See Methods.

The structure

Who's in this market and how it's shaped.

Average charge per group

$140–224

$224–308

$308–392

$392–476

$476–559

$559–643

$643–727

$727+

$140 10 groups · avg submitted charge / service $915

Market structure

Concentration is not shown for markets under 11 billing groups.

Of volume attributable to named groups, independents account for 0%; hospital-affiliated 100%.

Disclosed setting mix: 2% office · 98% facility.

HHI trend: 2020: 1,003 · 2021: 1,412 · 2022: 1,511 · 2023: 1,441 · (group rosters begin 2019)

Provider-setting count 2013 → 2024: 237 → 68 (-71%).

Named groups cover 42% of disclosed volume. CMS suppresses provider-code rows under 11 beneficiaries at the source; suppressed volume is excluded and cannot be estimated from this file. Volume shares describe the volume attributable to named groups; the coverage line above states how much of disclosed Medicare fee-for-service volume that is.

Market position

Where this market sits on volume and growth among all state markets, and its rank.

National benchmarks

Where each group's volume sits nationally and within its specialty.

The opportunity

So where do I act?

Worth a look

Every state market for this search, ranked by a published score: size, growth, fragmentation, below-expected volume. The cross-market compare view sits alongside.

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 78227 services, highest first, CY2024
#	Physician group locked column	City locked column	Specialty locked column	Providers locked column	78227 svcs	Submitted charges locked column	Avg charge locked column	Medicare $ locked column	Share* locked column	Phone
1	RADIOLOGY ASSOCIATES OF NORTH TEXAS PA	FORT WORTH	DIAGNOSTIC RADIOLOGY	340	268	$47,376	$177	premium	17.0%	(817) 321-0470
2	UT PHYSICIANS	HOUSTON	NURSE PRACTITIONER	1758	137	$38,299	$280	premium	8.7%	(713) 566-5000
3	HOUSTON RADIOLOGY ASSOCIATED	HOUSTON	DIAGNOSTIC RADIOLOGY	103	106	$30,412	$287	premium	6.7%	(281) 206-9020
4	CRAWFORD ANDREWS AND DAVIS PTR	BEAUMONT	DIAGNOSTIC RADIOLOGY	46	47	$6,580	$140	premium	3.0%	(409) 892-7171
5	SCOTT AND WHITE CLINIC	TEMPLE	PHYSICIAN ASSISTANT	2435	27	$5,427	$201	premium	1.7%	(254) 724-2663

That's the top 5 of 10 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 →