NEVVI Medicare utilization intelligence
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Market snapshot

Nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS
80306 Testing for presence of drug, read by instrument assisted observation CPT · General Laboratory test
Classification Test › General Laboratory › Drug Tests (CMS RBCS)
First observed 2017
National scale 5,671 services ▼ 9.7% YoY · 3,827 beneficiaries (CY2024, Medicare FFS)
Medicare paid $94K · $16.59 avg / service, national
CMS descriptor · RBCS classification · Medicare Part B physician/supplier claims, 12-year window
Billing groups

20

Named groups billing this code
Named-group FFS services

3,363

Attributable volume · fee-for-service
FFS of Medicare

49%

Payer-mix frame
Services · year over year
Services YoY

-9.7%

FFS enrollment -2.2%
Volume, not care. A shrinking fee-for-service denominator is not a shrinking market.
Estimated all-Medicare volume estimate
FFS + estimated MA

~7,126 services

3,363 observed fee-for-service (47%) · ~3,763 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 — 80306 (CY2024)
TX 995 CO 824 NY 778 CA 737 MN 525

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
$423K
Named-group allowed amount
$56K
Named-group Medicare payments
$56K
Avg charge / svc
$126
Avg allowed / svc
$17
Avg payment / svc
$17
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
$30 20 groups · avg submitted charge / service $250
Market analyticsPlatform Methods →

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Data year: CY2024 CY2023 CY2022  CY2021  CY2020 
# Physician group City St Specialty Providers 80306 svcs Submitted charges Avg charge Medicare $ Share* Phone
1 MOUNTAIN VIEW PAIN SPECIALISTS AURORA CO PHYSICIAN ASSISTANT 54 824 $206,000 $250 100.0% (303) 645-4363
2 AMARILLO MEDICAL SPECIALISTS,LLP AMARILLO TX NURSE PRACTITIONER 37 777 $93,240 $120 78.1% (806) 358-8331
3 SPINE AND PAIN CONSULTANT PLLC STATEN ISLAND NY ANESTHESIOLOGY 6 762 $38,100 $50 97.9% (718) 667-3577
4 PAIN CARE SPECIALISTS OF OREGON LLC SALEM OR PHYSICIAN ASSISTANT 6 150 $10,828 $72 72.5% (503) 371-1010
5 DEAN HEALTH SYSTEMS INC MADISON WI PHYSICIAN ASSISTANT 1200 146 $25,112 $172 36.0% (608) 260-2900
6 EAST COAST SPINE JOINT AND SPORTS MEDICINE HOBOKEN NJ PHYSICAL THERAPIST IN PRIVATE PRACTICE 10 92 $4,600 $50 100.0% (201) 533-9200
7 ORTHOPEDIC AND SPORTS MEDICINE SPECIALISTS OF GREEN BAY SC GREEN BAY WI ORTHOPEDIC SURGERY 50 73 $6,491 $89 18.0% —
8 UNIVERSITY OF MINNESOTA PHYSICIANS MINNEAPOLIS MN FAMILY PRACTICE 148 72 $5,472 $76 13.7% —
9 OLIVE BRANCH FAMILY MEDICAL CENTER OLIVE BRANCH MS NURSE PRACTITIONER 7 56 $2,800 $50 100.0% (662) 895-4949
10 GROUP HEALTH COOPERATIVE OF SOUTH CENTRAL WISCONSIN MADISON WI DIAGNOSTIC RADIOLOGY 229 54 $7,452 $138 13.3% (608) 831-1766
11 NORTHEASTERN UTAH MEDICAL GROUP ROOSEVELT UT PHYSICIAN ASSISTANT 52 46 $3,204 $70 46.0% (435) 722-4691
12 CORA HEALTH SERVICES INC THE VILLAGES FL ORTHOPEDIC SURGERY 1187 46 $1,380 $30 61.3% (352) 693-3378
13 CENTRACARE CLINIC SAINT CLOUD MN PHYSICIAN ASSISTANT 747 45 $1,600 $36 8.6% (320) 252-5131
14 MEDICAL ASSOCIATES OF NORTHWEST ARKANSAS, PA FAYETTEVILLE AR FAMILY PRACTICE 106 43 $2,881 $67 18.7% (479) 521-0200
15 CENTRAL OKLAHOMA FAMILY MEDICAL CENTER INC ADA OK NURSE PRACTITIONER 58 35 $1,750 $50 100.0% (580) 436-5111
16 PRAXIS HEALTH PC BEND OR PHYSICIAN ASSISTANT 173 33 $2,366 $72 15.9% (541) 388-2333
17 HOSPITALIST MEDICINE PHYSICIANS OF WASHINGTON - TCS PORTLAND OR CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) 214 24 $1,721 $72 11.6% (503) 215-1111
18 UNIVERSITY OF MINNESOTA PHYSICIANS MINNEAPOLIS WA FAMILY PRACTICE 148 20 $1,520 $76 4.9% —
19 THE ASSOCIATION OF UNIVERSITY PHYSICIANS SEATTLE WA PHYSICIAN ASSISTANT 3612 19 $1,362 $72 4.6% (206) 364-0500
20 GROUP HEALTH PLAN INC SAINT PAUL MN PHYSICIAN ASSISTANT 1627 17 $1,292 $76 3.2% (651) 221-3456
21 DEAN HEALTH SYSTEMS INC MADISON NY PHYSICIAN ASSISTANT 1200 16 $2,752 $172 2.1% (608) 260-2900
22 COLUMBIA PAIN MANAGEMENT, INC. HOOD RIVER CA PHYSICIAN ASSISTANT 16 13 $932 $72 1.8% (541) 386-9500

*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 →