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Market snapshot

Nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS
86161 Measurement of complement function (immune system proteins) 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 17,171 services · est. ▲ 9.0% YoY · 6,348 FFS beneficiaries (CY2024, all-Medicare estimate) — 8,359 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, 6 billing groups and 24 clinicians bill 86161 — ~17,171 all-Medicare services · est. (8,359 observed FFS), and volume is up 9.0% year over year.

CA, FL, NC and NJ lead the state markets — together 69% of state-market volume.

Market Brief 86161
The whole of 86161, written up and sourced.

The Brief is a national document for 86161. 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 86161 ran ~17,171 all-Medicare services (estimated), 8,359 observed fee-for-service in CY2024. The market is up 9.0% year over year. 6 billing groups and 24 clinicians bill it.
  2. 2Payment. Half the field lists between $33 and $57 per service; the median group lists $48. Submitted charges are provider-set list amounts, not payments.
  3. 3Geography. CA, FL, NC and NJ lead the state markets — together 69% of state-market volume.
Estimated all-Medicare volume estimate
FFS + estimated MA

~17,171 services

8,359 observed fee-for-service (49%) · ~8,812 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

$43

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

3.7×

average list $43 vs average Medicare payment $12 per service · basis-independent
Billing groups

6

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

Half the field lists between $33 and $57

Submitted charges are provider-set list amounts, not payments · median $48 (named groups)
Every group, one dot6 billing groups · median $48

Each dot is one billing group — 6 of them list this code

$0$30$60average submitted charge per service, per billing groupmedian $48
One dot per billing group, 86161 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
MEVTNHWA: 64WAIDMTNDMN: 109MNWI: 38WIIL: 96ILMINY: 96NYMA: 339MARIOR: 13ORNV: 12NVWYSDIA: 12IAINOH: 55OHPA: 45PANJ: 718NJCTCA: 2908CAUT: 39UTCO: 220CONEMOKYWVVA: 23VAMD: 16MDDEAZ: 186AZNMKS: 117KSARTN: 63TNNC: 837NCSC: 160SCDCOK: 11OKLAMSAL: 62ALGA: 101GAHIAKTX: 666TXFL: 1330FL
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 → 0AZ: 0 → 0CO: 0 → 1GA: 0 → 0IA: 0 → 0IL: 0 → 0KS: 0 → 0MA: 0 → 0MD: 0 → 0MN: 0 → 0NV: 0 → 0NY: 0 → 0OH: 0 → 0OK: 0 → 0PA: 0 → 0TN: 0 → 0TX: 0 → 0UT: 0 → 0WA: 0 → 0WI: 0 → 0CA: 1 → 1FL: 1 → 1NC: 1 → 1NJ: 1 → 1CA 1NC 1FL 1NJ 11 CA1 NC1 NJ1 FL
One line per state market, 24 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. 5 states with a rate in only one of the two years are not drawn.

Open a state market: CA · FL · NC · NJ · TX · MA · CO · AZ · SC · KS · MN · GA — 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 canvas6 groups · bubble = services
1001,000One billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing group$10$25$50$75$100+Average submitted charge per service — list amounts, not paymentsServices per group — 86161, CY2024
One mark per physician group, 86161 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.