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Market snapshot

78268 nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS

78268 — Nuclear medicine study to assess exhaled breath samples

Billing groups
6
Named-group FFS services
201
FFS of Medicare
49%
Services YoY
-34.7%
FFS enrollment -2.2%
Estimated all-Medicare volume FFS + estimated MA estimate
~442 services

201 observed fee-for-service (45%) · ~241 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 — 78268 (CY2024)

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

Named-group submitted charges
$56K
Named-group allowed amount
$18K
Named-group Medicare payments
$18K
Avg charge / svc
$280
Avg allowed / svc
$92
Avg payment / svc
$92
Average charge per group
$165 6 groups · avg submitted charge / service $617
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Data year: CY2024 CY2023 CY2022 🔒 CY2021 🔒 CY2020 🔒
Physician groups ranked by 78268 services, CY2024
#Physician group City St Specialty Providers 78268 svcs Submitted charges Avg charge Medicare $ locked column Share* Phone
1 MARK A NAGRANI MD PA NEW SMYRNA BEACH FL ANESTHESIOLOGY 3 60 $12,000 $200 premium 100.0% (386) 423-5500
2 EASTERN CAROLINA MEDICAL CENTER, PC BENSON NC PHYSICIAN ASSISTANT 5 51 $9,435 $185 premium 75.0% (919) 894-5787
3 NORTH VALLEY GASTROENTEROLOGY MEDICAL GROUP INC YUBA CITY CA GASTROENTEROLOGY 3 39 $24,063 $617 premium 75.0% (530) 671-3671
4 GUT PC DOTHAN AL GASTROENTEROLOGY 52 20 $3,300 $165 premium 100.0% (334) 836-1212
5 CAROLINAS PHYSICIANS NETWORK INC CHARLOTTE NC PHYSICIAN ASSISTANT 2360 17 $4,420 $260 premium 25.0% (704) 667-1000
6 GASTROENTEROLOGY CENTER OF THE MIDSOUTH PLLC GERMANTOWN MS GASTROENTEROLOGY 154 14 $3,076 $220 premium 100.0% (901) 755-9110

*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 →