NEVVI Medicare utilization intelligence
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Market snapshot

Nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS
86318 Test for detection of infectious agent antibody, qualitative or semiquantitative 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 6,813 services ▲ 13.7% YoY · 3,938 beneficiaries (CY2024, Medicare FFS)
Medicare paid $120K · $17.66 avg / service, national
CMS descriptor · RBCS classification · Medicare Part B physician/supplier claims, 12-year window
Billing groups
28
Named-group FFS services
735
FFS of Medicare
49%
Services YoY
+13.7%
FFS enrollment -2.2%
Estimated all-Medicare volume FFS + estimated MA estimate
~1,476 services

735 observed fee-for-service (50%) · ~741 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; 1 state without payer-mix data excluded. How we scale

Top states — 86318 (CY2024)
CA 4,978 AR 288 TX 201 MS 186 AL 171

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

Named-group submitted charges
$27K
Named-group allowed amount
$13K
Named-group Medicare payments
$13K
Avg charge / svc
$36
Avg allowed / svc
$18
Avg payment / svc
$18
Average charge per group
$20 28 groups · avg submitted charge / service $65
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Data year: CY2024 CY2023 CY2022  CY2021  CY2020 
# Physician group City St Specialty Providers 86318 svcs Submitted charges Avg charge Medicare $ Share* Phone
1 NEW HORIZONS PHYSICAL THERAPY LIMITED PARTNERSHIP NEW ALBANY KY ORTHOPEDIC SURGERY 86 90 $2,340 $26 100.0% —
2 FREEDMAN CLINIC OF INTERNAL MEDICINE LLP ALEXANDRIA LA INTERNAL MEDICINE 15 56 $3,197 $57 35.7% (318) 445-9331
3 MAINLINE HEALTH SYSTEMS INC MONTICELLO AR NURSE PRACTITIONER 59 50 $1,125 $22 17.4% (870) 367-6246
4 MEDICAL ASSOCIATES OF NORTHWEST ARKANSAS, PA FAYETTEVILLE AR FAMILY PRACTICE 106 41 $1,435 $35 14.2% (479) 521-0200
5 ST BERNARDS PHYSICIAN CLINICS INC JONESBORO AR NURSE PRACTITIONER 206 37 $1,295 $35 12.8% (870) 972-8181
6 LOUISIANA DEPARTMENT OF HEALTH - OFFICE OF PUBLIC HEALTH CROWLEY LA NURSE PRACTITIONER 33 33 $657 $20 21.0% (337) 788-7507
7 FAMILY MEDICINE OF WHITE HALL, P.A. WHITE HALL AR NURSE PRACTITIONER 6 33 $924 $28 11.5% (870) 850-8055
8 KELLY S SEGARS MD PC IUKA MS FAMILY PRACTICE 5 33 $1,617 $49 17.7% (662) 423-1000
9 DUTCH MEDICAL CLINICS, INC COLUMBUS MS NURSE PRACTITIONER 26 31 $1,550 $50 16.7% (662) 570-4770
10 SHOALS PRIMARY CARE, LLC SHEFFIELD AL NURSE PRACTITIONER 43 31 $837 $27 18.1% (256) 383-4473
11 CALHOUN FAMILY CARE CLINIC LLC WEST MONROE LA NURSE PRACTITIONER 2 31 $775 $25 19.7% (318) 644-2573
12 PARIS FAMILY PHYSICIANS,PA PARIS TX NURSE PRACTITIONER 6 26 $1,430 $55 12.9% (903) 669-0800
13 URGENT CARE NORTHWEST PC JASPER AL NURSE PRACTITIONER 14 20 $620 $31 11.7% (205) 387-2253
14 COLLOM AND CARNEY CLINIC ASSOCIATION TEXARKANA TX PHYSICIAN ASSISTANT 53 19 $1,178 $62 9.5% (903) 614-3200
15 UPPER VALLEY URGENT CARE CENTER EL PASO ZZ PHYSICIAN ASSISTANT 5 18 $1,170 $65 100.0% (915) 584-8882
16 HEALTHSTAR PHYSICIANS OF HOT SPRINGS PLLC HOT SPRINGS AR NURSE PRACTITIONER 57 18 $540 $30 6.2% (501) 651-4500
17 RANDY D WALKER, MD, PLLC DE QUEEN AR NURSE PRACTITIONER 10 18 $540 $30 6.2% (870) 584-3000
18 LAWRENCE COUNTY FAMILY CLINIC, PA WALNUT RIDGE AR FAMILY PRACTICE 6 17 $595 $35 5.9% (870) 886-3543
19 JIMMY R COUGHRAN A MEDICAL CORPORATION COLUMBIA LA NURSE PRACTITIONER 8 16 $400 $25 10.2% (318) 649-3766
20 NOVA MEDICA PLLC LIVONIA MI INTERNAL MEDICINE 5 15 $450 $30 24.2% (248) 478-1100
21 BATESVILLE CLINIC, P.A. BATESVILLE MS NURSE PRACTITIONER 5 15 $555 $37 8.1% (662) 563-7681
22 COMMUNITY HEALTH PARTNERS FRESNO CA INTERNAL MEDICINE 509 14 $713 $51 0.3% (559) 459-6000
23 NEXT LEVEL MEDICAL MANAGEMENT, LLC GRIFFIN GA FAMILY PRACTICE 2 14 $504 $36 28.0% (770) 228-2641
24 IMC-NORTH BALDWIN PRIMARY PLUS, LLC BAY MINETTE AL FAMILY PRACTICE 3 13 $286 $22 7.6% (251) 937-7100
25 TUSCALOOSA MEDCENTER NORTH, LLC NORTHPORT AL NURSE PRACTITIONER 26 12 $456 $38 7.0% (205) 333-1993
26 PECONIC BAY PRIMARY MEDICAL CARE RIVERHEAD NY PHYSICIAN ASSISTANT 71 12 $540 $45 7.6% (631) 727-1600
27 FAMILY MEDICAL AND URGENT CARE CLINIC OF MCDONOUGH, LLC MCDONOUGH GA NURSE PRACTITIONER 21 11 $630 $57 22.0% (770) 288-2822
28 BUTTE SILVER BOW PRIMARY HEALTH CARE CLINIC INC BUTTE MT NURSE PRACTITIONER 28 11 $330 $30 100.0% (406) 723-4075

*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 →