NEVVI Medicare utilization intelligence
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Market snapshot

Nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS
81450 Genomic sequence analysis panel of dna or combined dna and rna of 5-50 genes associated with blood and lymphatic system disorders CPT · Molecular Testing
Classification Test › Molecular Testing › Genetic Analysis (CMS RBCS)
First observed 2015
National scale 33,220 services · est. ▲ 7.7% YoY · 16,080 FFS beneficiaries (CY2024, all-Medicare estimate) — 16,747 observed fee-for-service services
Medicare paid $24.6M · est. · $740.49 avg / service, national — $12.4M observed FFS
CMS descriptor · RBCS classification · Medicare Part B physician/supplier claims, 12-year window
Billing groups

2

Named groups billing this code
Named-group all-Medicare svcs · est.

642

Scaled from 320 observed FFS services.
FFS of Medicare

49%

Payer-mix frame
Services · year over year
Services YoY

+7.7%

All-Medicare est. · observed FFS +4.4%
Volume, not care. A shrinking fee-for-service denominator is not a shrinking market.
Estimated all-Medicare volume estimate
FFS + estimated MA

~642 services

320 observed fee-for-service (50%) · ~322 estimated Medicare Advantage.

Billing for this code concentrates in one state — scaled by the national payer mix (FFS share as of 2024) — scaled estimate — assumes MA utilization mirrors FFS; not an observation. How we scale
Top states — 81450 (CY2024)
NJ 9,563 CA 5,220 FL 4,631 TN 2,442 NC 2,299

Est. all-Medicare services by billing state (scaled estimate — assumes MA utilization mirrors FFS); open a bar for that state's ranked market.

Billed → allowed → paid
Named-group submitted charges
$434K
Named-group allowed amount
$237K
Named-group Medicare payments
$475K · est.
— $237K observed FFS
Avg charge / svc
$1,355
Avg allowed / svc
$740
Avg payment / svc
$740
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
$1,296 2 groups · avg submitted charge / service $3,014
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Data year: CY2024 CY2023 CY2022  CY2021  CY2020 
# Physician group City St Specialty Providers 81450 svcs Submitted charges Avg charge Medicare $ Share of state* Phone
1 TENNESSEE ONCOLOGY PLLC NASHVILLE TN HEMATOLOGY/ONCOLOGY 360 309 $400,385 $1,296 26.6% (615) 385-3751
2 UCLA PATHOLOGY AND LABORATORY MEDICINE GROUP LOS ANGELES CA PATHOLOGY 65 11 $33,154 $3,014 0.4% (310) 267-2625

*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 — and the observed foundation every market figure here builds on. Market totals anchor on a labeled all-Medicare estimate scaled from that foundation, with the observed count disclosed beside it — Medicare only, never all-payer. Modeled all-payer databases project every payer statistically and typically run higher. Same market, different denominator. How the numbers reconcile →