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

80197 Tacrolimus level CPT · General Laboratory test

Classification Test › General Laboratory › Clinical Chemistry (CMS RBCS)

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

National scale 343,872 services ▼ 1.1% YoY · 73,338 beneficiaries (CY2024, Medicare FFS)

Medicare paid $4.6M · $13.41 avg / service, national

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

Billing groups

Named-group FFS services

11,863

FFS of Medicare

49%

Services YoY

-1.1%

FFS enrollment -2.2%

Estimated all-Medicare volume FFS + estimated MA estimate

~24,756 services

11,863 observed fee-for-service (48%) · ~12,893 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 — 80197 (CY2024)

CA 53,463 NC 37,283 NJ 35,232 FL 33,065 TX 27,300

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

Named-group submitted charges

$1.9M

Named-group allowed amount

$159K

Named-group Medicare payments

$159K

Avg charge / svc

$159

Avg allowed / svc

$13

Avg payment / svc

$13

Average charge per group

$41–79

$79–116

$116–154

$154–191

$191–229

$229–266

$266–304

$304+

$41 12 groups · avg submitted charge / service $532

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 80197 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	80197 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	MAYO CLINIC ARIZONA	PHOENIX	AZ	PHYSICIAN ASSISTANT	1635	8,951	$1,655,935	$185	premium	39.0%	(800) 603-0558
2	FAIRVIEW CLINICS	EAGAN	MN	FAMILY PRACTICE	816	882	$36,351	$41	premium	8.3%	(651) 406-8860
3	TEXAS ONCOLOGY PA	DALLAS	TX	PHYSICIAN ASSISTANT	995	478	$48,278	$101	premium	1.8%	—
4	FAIRVIEW EXPRESS CARE	MINNEAPOLIS	MN	PHYSICIAN ASSISTANT	2007	314	$12,967	$41	premium	2.9%	(612) 672-7422
5	HEALTHEAST MEDICAL RESEARCH INSTITUTE	SAINT PAUL	MN	PHYSICIAN ASSISTANT	691	303	$12,528	$41	premium	2.8%	—
6	CLEVELAND CLINIC	CLEVELAND	OH	PHYSICIAN ASSISTANT	6828	266	$28,836	$108	premium	3.1%	—
7	ST CHARLES HEALTH SYSTEM INC	BEND	OR	PHYSICIAN ASSISTANT	373	171	$17,271	$101	premium	7.7%	(541) 706-7715
8	EASTERN NEPHROLOGY ASSOCIATES PLLC	GREENVILLE	NC	NEPHROLOGY	77	132	$5,437	$41	premium	0.4%	(252) 752-8880
9	SUTTER BAY MEDICAL FOUNDATION	PALO ALTO	CA	INTERNAL MEDICINE	3716	130	$13,260	$102	premium	0.2%	(415) 600-1020
10	METROLINA NEPHROLOGY ASSOCIATES PA	CHARLOTTE	NC	NEPHROLOGY	87	119	$9,520	$80	premium	0.3%	(704) 731-6451
11	WEST CENTRAL PATHOLOGY SPECIALISTS SC	QUINCY	IL	PATHOLOGY	4	88	$46,856	$532	premium	1.0%	21722384006209
12	WAKE FOREST UNIVERSITY HEALTH SCIENCES	WINSTON SALEM	NC	PHYSICIAN ASSISTANT	2609	29	$2,320	$80	premium	0.1%	(336) 713-9800

*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 →