Medicare procedure market data by CPT code & state

Market snapshot

Nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS

81456 Genomic sequence analysis panel of rna of 51 or more genes associated with blood and lymphatic system disorders CPT · Molecular Testing

Classification Test › Molecular Testing › Genetic Analysis (CMS RBCS)

First observed 2023

National scale 40,181 services · est. ▲ 37.8% YoY · 19,416 FFS beneficiaries (CY2024, all-Medicare estimate) — 20,041 observed fee-for-service services

Medicare paid $114.9M · est. · $2858.54 avg / service, national — $57.3M observed FFS

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

Billing groups

Named groups billing this code

Named-group all-Medicare svcs · est.

1,163

Scaled from 580 observed FFS services.

FFS of Medicare

49%

Payer-mix frame

Services · year over year

Services YoY

+37.8%

All-Medicare est. · observed FFS +33.0%

Volume, not care. A shrinking fee-for-service denominator is not a shrinking market.

Estimated all-Medicare volume estimate

FFS + estimated MA

~1,163 services

580 observed fee-for-service (50%) · ~583 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 — 81456 (CY2024)

IL 28,898 FL 5,028 NJ 1,064 MA 807 PA 287

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

$5.2M

Named-group allowed amount

$1.7M

Named-group Medicare payments

$3.3M · est.

— $1.7M observed FFS

Avg charge / svc

$9,051

Avg allowed / svc

$2,861

Avg payment / svc

$2,861

Totals are named-group (attributable) sums. Allowed is Medicare’s fee-schedule recognized price — what CMS recognizes, before the 80% Medicare pays.

Market analyticsPlatform Methods →

Search a single state to see that market's full analytics — each panel renders gated on the free tier.

See it in full: nuclear heart imaging (78452) in Arizona is open as a live example — every paid panel, on real data.

View the live example →

Data year: CY2024 CY2023 CY2022 CY2021 CY2020

Physician groups ranked by 81456 services, highest first, CY2024
#	Physician group locked column	City locked column	St locked column	Specialty locked column	Providers locked column	81456 svcs	Submitted charges locked column	Avg charge locked column	Medicare $ locked column	Share of state* locked column	Phone
1	REGIONAL CANCER CARE ASSOCIATES LLC	HACKENSACK	NJ	HEMATOLOGY/ONCOLOGY	153	580	$5,249,580	$9,051	premium	91.3%	(201) 996-2210

*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 →