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Market snapshot

86364 nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS

86364 — Measurement of tissue transglutaminase

Billing groups
16
Named-group FFS services
2,340
FFS of Medicare
49%
Services YoY
+8.9%
FFS enrollment -2.2%
Estimated all-Medicare volume FFS + estimated MA estimate
~3,973 services

2,340 observed fee-for-service (59%) · ~1,633 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 — 86364 (CY2024)
NJ 36,402 NC 34,448 CA 17,052 TX 15,078 FL 13,393

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

Named-group submitted charges
$110K
Named-group allowed amount
$26K
Named-group Medicare payments
$26K
Avg charge / svc
$47
Avg allowed / svc
$11
Avg payment / svc
$11
Average charge per group
$15 16 groups · avg submitted charge / service $450
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Data year: CY2024 CY2023 CY2022 🔒 CY2021 🔒 CY2020 🔒
#Physician group City St Specialty Providers 86364 svcs Submitted charges Avg charge Medicare $ Share* Phone
1 CAPITAL DIGESTIVE CARE LLC WASHINGTON MD GASTROENTEROLOGY 238 880 $40,550 $46 33.9% (202) 296-3449
2 DUPAGE MEDICAL GROUP LTD GLEN ELLYN IL PHYSICIAN ASSISTANT 1323 377 $13,195 $35 10.3% (630) 469-9200
3 CLEVELAND CLINIC CLEVELAND OH PHYSICIAN ASSISTANT 6828 244 $18,180 $75 4.4% —
4 ATRIUS HEALTH INC BOSTON MA NURSE PRACTITIONER 1196 170 $5,290 $31 2.7% (617) 421-1000
5 FACULTY PHYSICIANS AND SURGEONS OF LLUSM LOMA LINDA CA DIAGNOSTIC RADIOLOGY 1317 166 $2,490 $15 1.0% —
6 SUMMIT MEDICAL GROUP PA BERKELEY HEIGHTS NJ PHYSICIAN ASSISTANT 1183 98 $3,430 $35 0.3% (908) 273-4300
7 CENTRAL DUPAGE PHYSICIAN GROUP WHEATON IL PHYSICIAN ASSISTANT 1097 96 $3,360 $35 2.6% (630) 933-4800
8 ALLINA HEALTH SYSTEM MINNEAPOLIS MN PHYSICIAN ASSISTANT 3855 73 $1,842 $25 2.6% (612) 863-4000
9 THE AUSTIN DIAGNOSTIC CLINIC PLLC AUSTIN TX NEPHROLOGY 86 58 $2,030 $35 0.4% (512) 447-2211
10 NORTH SHORE HEMATOLOGY ONCOLOGY ASSOCIATES PC SMITHTOWN NY NURSE PRACTITIONER 462 34 $15,300 $450 0.6% (631) 751-3000
11 VANGUARD MEDICAL GROUP PA VERONA NJ PHYSICIAN ASSISTANT 58 28 $980 $35 0.1% (973) 239-2600
12 TANNER MEMORIAL CLINIC LAYTON OH PHYSICIAN ASSISTANT 249 28 $1,120 $40 0.5% (801) 773-4840
13 FAIRVIEW CLINICS EAGAN MN FAMILY PRACTICE 816 26 $794 $31 0.9% (651) 406-8860
14 HEALTHEAST MEDICAL RESEARCH INSTITUTE SAINT PAUL MN PHYSICIAN ASSISTANT 691 24 $732 $30 0.9% —
15 CORE PHYSICIANS LLC EXETER NH PHYSICIAN ASSISTANT 292 24 $672 $28 100.0% (603) 929-1195
16 THE VANCOUVER CLINIC INC PS VANCOUVER WA PHYSICIAN ASSISTANT 574 14 $434 $31 0.3% (360) 882-2778

*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 →