NEVVI Medicare utilization intelligence
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Market snapshot

81005 nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS

81005 — Analysis of urine, except immunoassays

Billing groups
15
Named-group FFS services
2,633
FFS of Medicare
49%
Services YoY
+40.4%
FFS enrollment -2.2%
Estimated all-Medicare volume FFS + estimated MA estimate
~5,434 services

2,633 observed fee-for-service (48%) · ~2,801 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 — 81005 (CY2024)

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

Named-group submitted charges
$53K
Named-group allowed amount
$6K
Named-group Medicare payments
$6K
Avg charge / svc
$20
Avg allowed / svc
$2
Avg payment / svc
$2
Average charge per group
$4 15 groups · avg submitted charge / service $50
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Data year: CY2024 CY2023 CY2022 🔒 CY2021 🔒 CY2020 🔒
Physician groups ranked by 81005 services, CY2024
#Physician group City St Specialty Providers 81005 svcs Submitted charges Avg charge Medicare $ locked column Share* Phone
1 NICHOLAS R HALPER MD PC ROCKVILLE CENTRE NY FAMILY PRACTICE 7 937 $17,803 $19 premium 39.7% (516) 536-2221
2 VANTAGE MEDICAL ASSOCIATES PC FAR ROCKAWAY NY NURSE PRACTITIONER 56 505 $9,595 $19 premium 21.4% (516) 792-1600
3 RONALD C FAGAN MD PC FARMINGDALE NY INTERNAL MEDICINE 4 350 $7,000 $20 premium 14.8% (516) 752-7000
4 SC PHYSICIAN GROUP GLENDALE CA FAMILY PRACTICE 2 321 $9,630 $30 premium 100.0%
5 COOKEVILLE REGIONAL MEDICAL GROUP INC COOKEVILLE TN NURSE PRACTITIONER 54 107 $535 $5 premium 100.0% (931) 783-2143
6 SUMMIT MEDICAL GROUP PA BERKELEY HEIGHTS NJ PHYSICIAN ASSISTANT 1183 104 $936 $9 premium 27.5% (908) 273-4300
7 RIOS HEALTHCARE ASSOCIATES PLLC HOUSTON TX INTERNAL MEDICINE 2 89 $534 $6 premium 31.3% (832) 323-9230
8 HOPKINS MINOR EMERGENCY CENTER LLC SULPHUR SPRINGS TX NURSE PRACTITIONER 8 51 $2,550 $50 premium 18.0% (903) 885-2911
9 OPTUM MEDICAL CARE PC MOUNT KISCO NY INTERNAL MEDICINE 1040 47 $893 $19 premium 2.0% (914) 241-1050
10 MANHATTAN INTERNAL MEDICINE ASSOCIATES PC NEW YORK NY INTERNAL MEDICINE 6 35 $665 $19 premium 1.5% (212) 725-5300
11 GRAYSON CREEK MEDICAL CLINIC LLC MOSELLE MS NURSE PRACTITIONER 3 23 $138 $6 premium 3.2% (601) 620-9991
12 HUNT REGIONAL URGENT CARE GREENVILLE TX PHYSICIAN ASSISTANT 27 21 $1,000 $48 premium 7.4% (903) 408-7979
13 ACCESS MEDICAL CLINIC ARKANSAS LTC LLC MALVERN AR NURSE PRACTITIONER 136 15 $54 $4 premium 6.6% (501) 337-9820
14 AMERICAN CURRENT CARE PA HOUSTON MS PHYSICIAN ASSISTANT 570 14 $575 $41 premium 1.9% (281) 679-5600
15 PRIMAMED PHYSICIANS, PLLC PLANO TX NURSE PRACTITIONER 64 14 $700 $50 premium 4.9% (972) 733-0095

*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 →