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Market snapshot

Nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS
86481 Tuberculosis test, enumeration of t-cells 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 31,775 services ▼ 6.4% YoY · 30,467 beneficiaries (CY2024, Medicare FFS)
Medicare paid $3.1M · $96.78 avg / service, national
CMS descriptor · RBCS classification · Medicare Part B physician/supplier claims, 12-year window
Billing groups
24
Named-group FFS services
4,898
FFS of Medicare
49%
Services YoY
-6.4%
FFS enrollment -2.2%
Estimated all-Medicare volume FFS + estimated MA estimate
~10,147 services

4,898 observed fee-for-service (48%) · ~5,249 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 — 86481 (CY2024)

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

Named-group submitted charges
$1.2M
Named-group allowed amount
$475K
Named-group Medicare payments
$475K
Avg charge / svc
$241
Avg allowed / svc
$97
Avg payment / svc
$97
Average charge per group
$125 24 groups · avg submitted charge / service $823
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Data year: CY2024 CY2023 CY2022 locked column CY2021 locked column CY2020 locked column
Physician groups ranked by 86481 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 86481 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 ASHEVILLE ARTHRITIS AND OSTEOPOROSIS CENTER PA ASHEVILLE NC RHEUMATOLOGY 11 613 $107,275 $175 premium 34.2% (828) 258-9533
2 CENTER FOR RHEUMATOLOGY MEDICAL CORPORATION LOS ANGELES CA RHEUMATOLOGY 9 593 $121,565 $205 premium 5.3% (310) 659-7878
3 ARTHRITIS AND RHEUMATOLOGY CLINICS OF KANSAS LLC WICHITA KS RHEUMATOLOGY 11 494 $103,740 $210 premium 37.2% 31661248151280
4 BORIS D RATINER, MD, INC TARZANA CA RHEUMATOLOGY 6 385 $57,750 $150 premium 3.5% (818) 996-4077
5 ARTHRITIS SPECIALTY CENTER,INC POCATELLO ID PHYSICIAN ASSISTANT 6 363 $108,900 $300 premium 100.0% (208) 234-1300
6 CAROLINA ARTHRITIS ASSOCIATES PA WILMINGTON NC RHEUMATOLOGY 5 304 $38,000 $125 premium 17.0% (910) 762-1182
7 LAKE CUMBERLAND RHEUMATOLOGY PLLC BOWLING GREEN KY RHEUMATOLOGY 20 293 $36,625 $125 premium 34.6% (606) 802-2300
8 WV MEDICAL SERVICES PC NORTHPORT AL RHEUMATOLOGY 7 284 $42,600 $150 premium 62.0% (205) 750-0030
9 WEST SUBURBAN CTR FOR ARTHRITIS WAUKESHA WI RHEUMATOLOGY 5 269 $123,740 $460 premium 93.7% (262) 785-0777
10 ARTHRITIS AND RHEUMATOLOGY CENTER PC ROSWELL GA RHEUMATOLOGY 22 211 $173,653 $823 premium 30.1% (770) 284-3150
11 ARTHRITIS AND OSTEOPOROSIS CLINIC OF BRAZOS VALLEY COLLEGE STATION TX PHYSICIAN ASSISTANT 3 172 $53,040 $308 premium 5.8% (979) 696-8000
12 SUTTER BAY MEDICAL FOUNDATION PALO ALTO CA INTERNAL MEDICINE 3716 158 $79,316 $502 premium 1.4% (415) 600-1020
13 MISSISSIPPI ARTHRITIS CLINIC PLLC JACKSON MS NURSE PRACTITIONER 8 119 $23,800 $200 premium 22.5% (601) 362-6900
14 JAYASHREE SINHA MD PC CLOVIS NM INTERNAL MEDICINE 2 96 $19,200 $200 premium 40.9% (575) 935-5051
15 FAITH HEALTHCARE INC MONTICELLO KY NURSE PRACTITIONER 17 86 $10,750 $125 premium 10.1% (606) 425-5768
16 RHEUMATOLOGY ASSOCIATES OF NORTH ALABAMA, PC HUNTSVILLE AL RHEUMATOLOGY 10 84 $12,600 $150 premium 18.3% (256) 551-6510
17 CAROLINA ARTHRITIS ASSOCIATES PA WILMINGTON SC RHEUMATOLOGY 5 79 $9,875 $125 premium 100.0% (910) 762-1182
18 ARTHRITIS HEALTH ASSOCIATES PLLC SYRACUSE NY RHEUMATOLOGY 5 65 $8,125 $125 premium 6.9% (315) 475-7669
19 ARTHRITIS AND OSTEOPOROSIS CONSULTANTS OF THE CAROLINAS PA CHARLOTTE NC RHEUMATOLOGY 13 44 $14,432 $328 premium 2.5% (704) 342-0252
20 FAIRVIEW EXPRESS CARE MINNEAPOLIS MN PHYSICIAN ASSISTANT 2007 36 $9,596 $267 premium 9.6% (612) 672-7422
21 LAKE CUMBERLAND RHEUMATOLOGY PLLC BOWLING GREEN IN RHEUMATOLOGY 20 36 $4,500 $125 premium 20.8% (606) 802-2300
22 H2 REHABILITATION SERVICES OF KENTUCKY, LLC BEREA KY ORTHOPEDIC SURGERY 194 35 $4,375 $125 premium 4.1% (859) 956-1055
23 RHEUMATOLOGY ASSOCIATES S.C. CHICAGO IL RHEUMATOLOGY 3 23 $4,025 $175 premium 12.2% (312) 226-8228
24 ARTHRITIS CENTER OF NEBRASKA LINCOLN NE PHYSICIAN ASSISTANT 8 22 $5,280 $240 premium 10.1% (402) 420-1212
25 OPTUM CARE WASHINGTON PLLC EVERETT WA PHYSICIAN ASSISTANT 695 20 $4,200 $210 premium 57.1% (425) 339-5442
26 HEALTHEAST MEDICAL RESEARCH INSTITUTE SAINT PAUL MN PHYSICIAN ASSISTANT 691 14 $3,718 $266 premium 3.7%

*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 →