NEVVI Medicare utilization intelligence
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Market snapshot

Nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS
85220 Clotting factor v (acg or proaccelerin) measurement CPT · General Laboratory test
Classification Test General Laboratory Clinical Chemistry (CMS RBCS)
First observed 2013 — start of our 12-year window; the code predates it
National scale 3,061 services · est. ▼ 4.9% YoY · 1,200 FFS beneficiaries (CY2024, all-Medicare estimate) — 1,464 observed fee-for-service services
CMS descriptor · RBCS classification · Medicare Part B physician/supplier claims, 12-year window
Data year: CY2024 CY2023 CY2022 locked column CY2021 locked column CY2020 locked column
Market overview

Nationally, 3 billing groups and 3 clinicians bill 85220 — ~3,061 all-Medicare services · est. (1,464 observed FFS), and volume is down 4.9% year over year.

TX, NC, NJ and AZ lead the state markets — together 72% of state-market volume.

Market Brief 85220
The whole of 85220, written up and sourced.

The Brief is a national document for 85220. Its findings page carries one finding per chapter, each opening the chapter that prints its figure and the table behind it — like these, from the United States, CY2024, the market on this page.

  1. 1Size and growth. The national market for 85220 ran ~3,061 all-Medicare services (estimated), 1,464 observed fee-for-service in CY2024. The market is down 4.9% year over year. 3 billing groups and 3 clinicians bill it.
  2. 2Payment. Half the field lists between $35 and $207 per service; the median group lists $35. Submitted charges are provider-set list amounts, not payments.
  3. 3Geography. TX, NC, NJ and AZ lead the state markets — together 72% of state-market volume.
Estimated all-Medicare volume estimate
FFS + estimated MA

~3,061 services

1,464 observed fee-for-service (48%) · ~1,597 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
Average charge

$69

per service, submitted list amounts — not payments · observed FFS basis
Charge-to-payment ratio

4.1×

average list $69 vs average Medicare payment $17 per service · basis-independent
Billing groups

3

3 at the ≥11-service disclosure floor
What they charge

Half the field lists between $35 and $207

Submitted charges are provider-set list amounts, not payments · median $35 (named groups)
Every group, one dot3 billing groups · median $35

Each dot is one billing group — 3 of them list this code

$0$200$400average submitted charge per service, per billing groupmedian $35
One dot per billing group, 85220 nationwide CY2024 — average submitted charge per service, provider-set list amounts, not payments. The axis caps near the 95th percentile so the cluster is legible; groups beyond it draw at the cap in accent and are counted on the chart.
Where the market isobserved FFS services by state · CY2024
MEVTNHWAIDMTNDMN: 59MNWI: 13WIIL: 19ILMINY: 36NYMARIORNVWYSDIAINOH: 22OHPANJ: 198NJCTCA: 84CAUTCO: 11CONEMOKYWVVAMDDEAZ: 154AZNMKS: 13KSARTN: 33TNNC: 235NCSCDCOKLAMSAL: 12ALGA: 21GAHIAKTX: 463TXFL: 91FL
Shaded low→high on observed fee-for-service services billed from each state · the /stats tile grid, at national scope. Shading ranks the states rather than spacing them along the range, so neighbouring shades mean adjacent RANKS, not equal gaps — the key names the lowest and highest; each tile carries its own figure.
Which states movedservices per 1,000 FFS beneficiaries · CY2021 → CY2024
CY2021CY2024AL: 0 → 0CA: 0 → 0CO: 0 → 0FL: 0 → 0GA: 0 → 0IL: 0 → 0KS: 0 → 0MN: 0 → 0NY: 0 → 0OH: 0 → 0WI: 0 → 0AZ: 0 → 0NC: 0 → 0NJ: 0 → 0TX: 0 → 0NC 0NJ 0TX 0AZ 00 NC0 TX0 AZ0 NJ
One line per state market, 15 drawn; the 4 leading states by volume are in accent, the rest are context lines. Both columns share one scale, so a slope is real change. A RATE against each state’s own fee-for-service population — assumption-free, and no all-Medicare estimate is used or implied. CY2021 is the left period because CY2020 is the pandemic year and a slope off it would read as growth almost everywhere. 2 states with a rate in only one of the two years are not drawn.

Open a state market: TX · NC · NJ · AZ · FL · CA · MN · NY · TN · OH · GA · IL — the group ranking lives in the Provider groups tab. Territories bill too; the tile grid draws the 50 states and DC.

Every group in this market, placed by list charge against volume

The whole field, one canvas3 groups · bubble = services
One billing groupOne billing groupOne billing group$50$125$250$375$500+Average submitted charge per service — list amounts, not paymentsServices per group — 85220, CY2024
One mark per physician group, 85220 nationwide CY2024 — marks are unnamed here: a mark’s position is its average list charge, and that figure is part of the platform. Submitted charges are provider-set list amounts, not payments.