Medicare procedure market data by CPT code & state

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Market snapshot

Nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS

85004 White blood cell count CPT · General Laboratory test

Classification Test › General Laboratory › Blood Count (CMS RBCS)

First observed 2013 — start of our 12-year window; the code predates it

National scale 20,846 services ▼ 5.8% YoY · 10,524 beneficiaries (CY2024, Medicare FFS)

Medicare paid $131K · $6.29 avg / service, national

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

Billing groups

Named-group FFS services

3,156

FFS of Medicare

49%

Services YoY

-5.8%

FFS enrollment -2.2%

Estimated all-Medicare volume FFS + estimated MA estimate

~6,103 services

3,156 observed fee-for-service (52%) · ~2,947 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 — 85004 (CY2024)

MS 3,445 MA 2,468 FL 2,076 AZ 1,461 NJ 1,215

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

Named-group submitted charges

$118K

Named-group allowed amount

$20K

Named-group Medicare payments

$20K

Avg charge / svc

$37

Avg allowed / svc

Avg payment / svc

Average charge per group

$20–24

$24–28

$28–32

$32–35

$35–39

$39–43

$43–47

$47+

$20 7 groups · avg submitted charge / service $51

Market analyticsPlatform

a taste of the twelve-year trend layer

Market position — where this market sits on volume and growth among all state markets, and its rank.
Worth a look — every state market for this search, ranked by a published score: size, growth, fragmentation, below-expected volume.
Lookalike opportunities — groups billing below what peers of the same specialty, size, and state predict, with the expected figure shown.
National benchmarks — where each group's volume sits nationally and within its specialty.
Market structure — how concentrated this market is, and who owns the volume.
Medicare-wide scaling — the payer split, and this market total scaled to all of Medicare, labeled as an estimate.

Or just look at it: nuclear heart imaging (78452) in Arizona is open as a live example — the full paid view, real data.

View the live example →

Nevvi's market analytics platform — code baskets, market structure and share, the twelve-year trend layer — is built and not launched yet. We're gathering interest in it.

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Data year: CY2024 CY2023 CY2022 CY2021 CY2020

Physician groups ranked by 85004 services, highest first, CY2024
#	Physician group activate to sort	City activate to sort	St activate to sort	Specialty activate to sort	Providers activate to sort	85004 svcs sorted descending — activate to reverse	Submitted charges activate to sort	Avg charge activate to sort	Medicare $ locked column	Share* activate to sort	Phone
1	HATTIESBURG CLINIC PA	HATTIESBURG	MS	FAMILY PRACTICE	530	1,293	$65,943	$51	premium	37.5%	(601) 264-6000
2	CARLOS PORTU MD PLLC	NAPLES	FL	NURSE PRACTITIONER	4	1,274	$38,220	$30	premium	61.4%	(239) 235-7908
3	AVERA QUEEN OF PEACE	MITCHELL	SD	DIAGNOSTIC RADIOLOGY	116	427	$8,540	$20	premium	37.8%	(605) 995-2000
4	PRAIRIE LAKES HEALTH CARE SYSTEM INC	WATERTOWN	SD	PHYSICIAN ASSISTANT	126	61	$1,525	$25	premium	5.4%	(605) 882-4743
5	ATRIUS HEALTH INC	BOSTON	MA	NURSE PRACTITIONER	1196	49	$1,274	$26	premium	2.0%	(617) 421-1000
6	PROFESSIONAL SERVICE FUND OF DEBORAH HEART AND LUNG CENTER	BROWNS MILLS	NJ	CARDIOVASCULAR DISEASE (CARDIOLOGY)	121	35	$1,750	$50	premium	2.9%	(609) 893-6611
7	GROUP HEALTH PLAN INC	SAINT PAUL	MN	PHYSICIAN ASSISTANT	1627	17	$440	$26	premium	3.2%	(651) 221-3456

*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 →