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Market snapshot

Nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS
80504 Pathology clinical consultation for moderately complex clinical problem, 21-40 minutes CPT · Anatomic Pathology test
Classification Test › Anatomic Pathology › Surgical Pathology Examination (CMS RBCS)
First observed 2022
National scale 3,325 services ▼ 4.1% YoY · 2,968 beneficiaries (CY2024, Medicare FFS)
Medicare paid $118K · $35.34 avg / service, national
CMS descriptor · RBCS classification · Medicare Part B physician/supplier claims, 12-year window
Billing groups
25
Named-group FFS services
2,243
FFS of Medicare
49%
Services YoY
-4.1%
FFS enrollment -2.2%
Estimated all-Medicare volume FFS + estimated MA estimate
~4,822 services

2,243 observed fee-for-service (47%) · ~2,579 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 — 80504 (CY2024)
MI 507 AZ 475 PA 284 MA 279 TX 250

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

Named-group submitted charges
$513K
Named-group allowed amount
$102K
Named-group Medicare payments
$77K
Avg charge / svc
$229
Avg allowed / svc
$46
Avg payment / svc
$35
Average charge per group
$67 25 groups · avg submitted charge / service $481
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Data year: CY2024 CY2023 CY2022  CY2021  CY2020 
# Physician group City St Specialty Providers 80504 svcs Submitted charges Avg charge Medicare $ Share* Phone
1 BEAUMONT MEDICAL GROUP HOSPITAL BASED SERVICES TROY MI DIAGNOSTIC RADIOLOGY 583 280 $134,680 $481 55.2% (248) 964-1187
2 BANNER-UNIVERSITY MEDICAL GROUP TUCSON AZ INTERNAL MEDICINE 1068 266 $17,822 $67 56.0% (520) 694-0111
3 THE EMORY CLINIC INC ATLANTA GA NURSE PRACTITIONER 3484 246 $50,250 $204 100.0% (404) 778-7525
4 EASTERN MAINE MEDICAL CENTER BANGOR ME PHYSICIAN ASSISTANT 697 229 $58,412 $255 100.0% (207) 973-7000
5 MAYO CLINIC ARIZONA PHOENIX AZ PHYSICIAN ASSISTANT 1635 186 $35,340 $190 39.2% (800) 603-0558
6 AEGIS HEALTH SERVICES LLC SANDY SPRINGS TX PATHOLOGY 2 126 $16,173 $128 50.4% (410) 834-8110
7 CENTRE PATHOLOGY ASSOCIATES PC STATE COLLEGE PA PATHOLOGY 3 117 $20,475 $175 41.2% (814) 234-6117
8 COMANCHE COUNTY HOSPITAL AUTHORITY LAWTON OK PATHOLOGY 4 106 $12,190 $115 100.0% (580) 355-8620
9 HENNEPIN HEALTHCARE SYSTEM INC MINNEAPOLIS MN PHYSICIAN ASSISTANT 895 82 $33,210 $405 66.7% (612) 873-6963
10 HENRY FORD HEALTH SYSTEM DETROIT MI PHYSICIAN ASSISTANT 2536 80 $38,480 $481 15.8% (313) 916-2600
11 THE ASSOCIATION OF UNIVERSITY PHYSICIANS SEATTLE WA PHYSICIAN ASSISTANT 3612 72 $10,489 $146 33.6% (206) 364-0500
12 THE BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS CHICAGO IL NURSE PRACTITIONER 1170 59 $16,580 $281 83.1% —
13 UTMB FACULTY GROUP PRACTICE GALVESTON TX NURSE PRACTITIONER 1068 58 $7,888 $136 23.2% (409) 772-2222
14 MEDICAL FOUNDATION INC MERIDIAN MS DIAGNOSTIC RADIOLOGY 198 47 $7,238 $154 100.0% (601) 484-6700
15 UNIVERSITY PHYSICIAN GROUP DETROIT MI NURSE PRACTITIONER 405 46 $4,770 $104 9.1% (800) 527-6266
16 UNMC PHYSICIANS OMAHA NE PHYSICIAN ASSISTANT 1514 43 $5,562 $129 100.0% (402) 559-4000
17 UNIVERSITY OF VERMONT MEDICAL CENTER INC BURLINGTON VT PHYSICIAN ASSISTANT 1194 42 $10,077 $240 100.0% (802) 847-0000
18 GENERAL HOSPITAL PATHOLOGISTS LTD VIRGINIA BCH VA PATHOLOGY 3 40 $5,760 $144 100.0% (757) 463-5240
19 UNIVERSITY OF MIAMI MIAMI FL NURSE PRACTITIONER 2331 33 $12,435 $377 100.0% (305) 689-5437
20 PATHOLOGY ASSOCIATES OF NORTH TEXAS, P A WICHITA FALLS TX PATHOLOGY 6 18 $2,700 $150 7.2% (940) 322-7284
21 STATE UNIVERSITY OF IOWA IOWA CITY IA PHYSICIAN ASSISTANT 1902 18 $3,362 $187 19.6% (319) 678-8201
22 UNIVERSITY OF TEXAS HEALTH SCIENCE CENTER AT SAN ANTONIO SAN ANTONIO TX PHYSICIAN ASSISTANT 1326 14 $1,926 $138 5.6% (210) 450-7044
23 JORDAN PHYSICIAN ASSOCIATES INC PLYMOUTH MA NURSE PRACTITIONER 166 12 $2,112 $176 4.3% (508) 210-5920
24 ASSOCIATE PATHOLOGISTS OF JOLIET PLLC JOLIET IL PATHOLOGY 4 12 $1,932 $161 16.9% (815) 725-7222
25 MEMORIAL HEMATOLOGY LYMPHOMA GROUP NEW YORK NY NURSE PRACTITIONER 226 11 $2,970 $270 6.8% (212) 639-2000

*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 →