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Market snapshot

Nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS
78597 Nuclear medicine study of lung ventilation and blood flow to lung CPT · Nuclear imaging
Classification Imaging Nuclear (CMS RBCS)
First observed 2013 — start of our 12-year window; the code predates it
National scale 569 services ▼ 14.8% YoY · 566 beneficiaries (CY2024, Medicare FFS)
Medicare paid $15K · $26.81 avg / service, national
CMS descriptor · RBCS classification · Medicare Part B physician/supplier claims, 12-year window
Billing groups
7
Named-group FFS services
273
FFS of Medicare
49%
Services YoY
-14.8%
FFS enrollment -2.2%
Estimated all-Medicare volume FFS + estimated MA estimate
~552 services

273 observed fee-for-service (49%) · ~279 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 — 78597 (CY2024)

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

Named-group submitted charges
$42K
Named-group allowed amount
$9K
Named-group Medicare payments
$7K
Avg charge / svc
$153
Avg allowed / svc
$34
Avg payment / svc
$27
Average charge per group
$98 7 groups · avg submitted charge / service $300
Market analyticsPlatform
a taste of the twelve-year trend layer

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

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Data year: CY2024 CY2023 CY2022 locked column CY2021 locked column CY2020 locked column
Physician groups ranked by 78597 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 78597 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 NEW YORK UNIVERSITY NEW YORK CO DIAGNOSTIC RADIOLOGY 5704 107 $9,951 $93 premium 72.8% (212) 263-9700
2 STONY BROOK RADIOLOGY, UNIVERSITY FACULTY PRACTICE CORPORATION STONY BROOK AR DIAGNOSTIC RADIOLOGY 59 32 $9,600 $300 premium 100.0% (631) 638-2121
3 OSU RADIOLOGY LLC COLUMBUS OH DIAGNOSTIC RADIOLOGY 174 31 $4,030 $130 premium 100.0% (614) 293-8315
4 NORTH SHORE-LIJ MEDICAL PC MANHASSET NY PHYSICIAN ASSISTANT 6294 25 $4,237 $169 premium 18.7%
5 SJHMC PHYSICIAN SERVICES PHOENIX AZ NURSE PRACTITIONER 690 20 $1,960 $98 premium 62.5% (602) 406-6017
6 NORTHWESTERN MEDICAL FACULTY FOUNDATION CHICAGO IL NURSE PRACTITIONER 4339 17 $3,196 $188 premium 48.6%
7 TEMPLE FACULTY PRACTICE PLAN INC PHILADELPHIA PA PHYSICIAN ASSISTANT 1330 16 $1,920 $120 premium 50.0%
8 NEW YORK UNIVERSITY NEW YORK NY DIAGNOSTIC RADIOLOGY 5704 14 $3,500 $250 premium 10.4% (212) 263-9700
9 STONY BROOK RADIOLOGY, UNIVERSITY FACULTY PRACTICE CORPORATION STONY BROOK MD DIAGNOSTIC RADIOLOGY 59 11 $3,300 $300 premium 100.0% (631) 638-2121

*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 →