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Market snapshot

86316 nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS

86316 — Analysis for detection of tumor marker

Billing groups
10
Named-group FFS services
7,160
FFS of Medicare
49%
Services YoY
+4.8%
FFS enrollment -2.2%
Estimated all-Medicare volume FFS + estimated MA estimate
~13,878 services

7,160 observed fee-for-service (52%) · ~6,718 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 — 86316 (CY2024)

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

Named-group submitted charges
$442K
Named-group allowed amount
$145K
Named-group Medicare payments
$145K
Avg charge / svc
$62
Avg allowed / svc
$20
Avg payment / svc
$20
Average charge per group
$42 10 groups · avg submitted charge / service $115
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Data year: CY2024 CY2023 CY2022 🔒 CY2021 🔒 CY2020 🔒
Physician groups ranked by 86316 services, CY2024
#Physician group City St Specialty Providers 86316 svcs Submitted charges Avg charge Medicare $ locked column Share* Phone
1 TOWER UROLOGY INC LOS ANGELES CA UROLOGY 13 2,027 $182,430 $90 premium 36.6% 3108549898159
2 ADVANCED UROLOGY INSTITUTE LLC INVERNESS FL UROLOGY 147 1,060 $44,509 $42 premium 32.9% (352) 726-9707
3 GREATER BOSTON UROLOGY LLC FRAMINGHAM MA UROLOGY 42 974 $48,700 $50 premium 78.1%
4 CHESAPEAKE UROLOGY ASSOCIATES LLC BALTIMORE MD UROLOGY 160 930 $47,204 $51 premium 75.2% (410) 825-5454
5 UROLOGY GROUP PC GERMANTOWN TN UROLOGY 17 569 $28,450 $50 premium 42.8% (901) 767-8158
6 TRI STATE UROLOGIC SERVICES PSC INC CINCINNATI OH UROLOGY 74 569 $29,019 $51 premium 36.2% (513) 841-7750
7 BAYLOR COLLEGE OF MEDICINE HOUSTON TX CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) 1222 366 $15,738 $43 premium 11.8%
8 TOWER UROLOGY INC LOS ANGELES AZ UROLOGY 13 206 $18,540 $90 premium 13.1% 3108549898159
9 TRI STATE UROLOGIC SERVICES PSC INC CINCINNATI KY UROLOGY 74 194 $9,894 $51 premium 92.8% (513) 841-7750
10 AUC UROLOGISTS LLC MYRTLE BEACH SC PHYSICIAN ASSISTANT 28 180 $11,375 $63 premium 84.5% (843) 347-2450
11 TRI STATE UROLOGIC SERVICES PSC INC CINCINNATI MI UROLOGY 74 37 $1,887 $51 premium 57.8% (513) 841-7750
12 GEORGETOWN PHYSICIAN ASSOCIATES, LLC MURRELLS INLET SC FAMILY PRACTICE 230 33 $2,088 $63 premium 15.5% (843) 652-8450
13 SETON FAMILY OF DOCTORS AUSTIN TX PHYSICIAN ASSISTANT 804 15 $1,725 $115 premium 0.5% (512) 324-7300

*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 →