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Market snapshot

Nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS
86021 Antibody identification test for white blood cell antibodies CPT · General Laboratory test
Classification Test General Laboratory Immunoassay (CMS RBCS)
First observed 2013 — start of our 12-year window; the code predates it
National scale 43,115 services ▲ 1.8% YoY · 37,831 beneficiaries (CY2024, Medicare FFS)
Medicare paid $636K · $14.74 avg / service, national
CMS descriptor · RBCS classification · Medicare Part B physician/supplier claims, 12-year window
Billing groups
7
Named-group FFS services
1,240
FFS of Medicare
49%
Services YoY
+1.8%
FFS enrollment -2.2%
Estimated all-Medicare volume FFS + estimated MA estimate
~2,673 services

1,240 observed fee-for-service (46%) · ~1,433 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 — 86021 (CY2024)

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

Named-group submitted charges
$57K
Named-group allowed amount
$18K
Named-group Medicare payments
$18K
Avg charge / svc
$46
Avg allowed / svc
$15
Avg payment / svc
$15
Average charge per group
$20 7 groups · avg submitted charge / service $250
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Data year: CY2024 CY2023 CY2022 locked column CY2021 locked column CY2020 locked column
Physician groups ranked by 86021 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 86021 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 CENTER FOR RHEUMATOLOGY MEDICAL CORPORATION LOS ANGELES CA RHEUMATOLOGY 9 332 $16,900 $51 premium 4.6% (310) 659-7878
2 EMERALD COAST RHEUMATOLOGY LLC LYNN HAVEN FL NURSE PRACTITIONER 10 307 $13,861 $45 premium 3.9% (850) 215-6400
3 RHEUMATOLOGY CONSULTANTS, LLP HEWLETT NY RHEUMATOLOGY 10 226 $11,300 $50 premium 8.9% (516) 295-4481
4 WEITZNER YONKER AND KAINE MD PA SARASOTA FL RHEUMATOLOGY 17 203 $4,060 $20 premium 2.6% 94136507701028
5 ARTHRITIS ASSOCIATES, P.A. SAN ANTONIO TX RHEUMATOLOGY 6 123 $5,043 $41 premium 3.6% 2104772626242
6 BONHOEFFER RHEUMATOLOGY INSTITUTE LLC GILBERT AZ NURSE PRACTITIONER 10 29 $851 $29 premium 1.0% (480) 494-2770
7 NORTH SHORE HEMATOLOGY ONCOLOGY ASSOCIATES PC SMITHTOWN NY NURSE PRACTITIONER 462 20 $5,000 $250 premium 0.8% (631) 751-3000

*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 →