NEVVI Medicare utilization intelligence
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Market snapshot

Nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS
86618 Analysis for antibody borrelia burgdorferi (lyme disease bacteria) 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 158,397 services ▼ 0.7% YoY · 134,964 beneficiaries (CY2024, Medicare FFS)
Medicare paid $2.6M · $16.68 avg / service, national
CMS descriptor · RBCS classification · Medicare Part B physician/supplier claims, 12-year window
Billing groups
30
Named-group FFS services
4,929
FFS of Medicare
49%
Services YoY
-0.7%
FFS enrollment -2.2%
Estimated all-Medicare volume FFS + estimated MA estimate
~9,863 services

4,929 observed fee-for-service (50%) · ~4,934 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 — 86618 (CY2024)

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

Named-group submitted charges
$323K
Named-group allowed amount
$82K
Named-group Medicare payments
$82K
Avg charge / svc
$66
Avg allowed / svc
$17
Avg payment / svc
$17
Average charge per group
$17 30 groups · avg submitted charge / service $250
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Data year: CY2024 CY2023 CY2022 locked column CY2021 locked column CY2020 locked column
Physician groups ranked by 86618 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 86618 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 MIDDLETOWN MEDICAL PC MIDDLETOWN NY NURSE PRACTITIONER 172 1,360 $24,190 $18 premium 5.1% (845) 342-4774
2 OPTUM MEDICAL CARE PC MOUNT KISCO NY INTERNAL MEDICINE 1040 886 $20,848 $24 premium 3.3% (914) 241-1050
3 NORTH SHORE HEMATOLOGY ONCOLOGY ASSOCIATES PC SMITHTOWN NY NURSE PRACTITIONER 462 598 $149,500 $250 premium 2.2% (631) 751-3000
4 RHEUMATOLOGY CONSULTANTS, LLP HEWLETT NY RHEUMATOLOGY 10 435 $19,575 $45 premium 1.6% (516) 295-4481
5 CRYSTAL RUN HEALTHCARE PHYSICIANS LLP MIDDLETOWN NY NURSE PRACTITIONER 372 379 $18,950 $50 premium 1.4% (845) 703-6999
6 MARYLAND PRIMARY CARE PHYSICIANS, LLC ARNOLD MD NURSE PRACTITIONER 100 228 $11,400 $50 premium 4.9% (410) 757-7600
7 ATRIUS HEALTH INC BOSTON MA NURSE PRACTITIONER 1196 168 $11,592 $69 premium 1.3% (617) 421-1000
8 VALLEY MEDICAL GROUP PC GREENFIELD MA PHYSICIAN ASSISTANT 108 149 $12,665 $85 premium 1.1% (413) 774-6301
9 COMMUNITY CARE PHYSICIANS PLLC LATHAM NY DIAGNOSTIC RADIOLOGY 370 147 $5,880 $40 premium 0.6% (518) 782-3700
10 SUMMIT MEDICAL GROUP PA BERKELEY HEIGHTS NJ PHYSICIAN ASSISTANT 1183 75 $5,250 $70 premium 0.1% (908) 273-4300
11 MIDDLETOWN MEDICAL PC MIDDLETOWN NJ NURSE PRACTITIONER 172 54 $920 $17 premium 0.1% (845) 342-4774
12 MANCHESTER MEDICAL CENTER PLLC MANCHESTER CENTER VT EMERGENCY MEDICINE 2 40 $5,852 $146 premium 100.0% (802) 768-1718
13 CLEVELAND CLINIC CLEVELAND OH PHYSICIAN ASSISTANT 6828 40 $3,480 $87 premium 1.2%
14 NORTH SHORE HEMATOLOGY ONCOLOGY ASSOCIATES PC SMITHTOWN PA NURSE PRACTITIONER 462 39 $9,750 $250 premium 0.6% (631) 751-3000
15 CORE PHYSICIANS LLC EXETER NH PHYSICIAN ASSISTANT 292 32 $1,728 $54 premium 58.2% (603) 929-1195
16 PROHEALTH PHYSICIANS PC WALLINGFORD CT PHYSICIAN ASSISTANT 215 29 $812 $28 premium 11.2% (203) 265-9600
17 PLATTSBURGH MEDICAL CARE PLLC PLATTSBURGH NY NURSE PRACTITIONER 10 22 $1,760 $80 premium 0.1% (518) 566-0672
18 GENESIS MEDICAL ASSOCIATES, INC. PITTSBURGH PA PHYSICIAN ASSISTANT 96 22 $1,276 $58 premium 0.3% (412) 369-9943
19 HOLZER CLINIC LLC GALLIPOLIS OH NURSE PRACTITIONER 267 21 $5,145 $245 premium 0.7% (740) 446-5050
20 SAINT PETERS UNIVERSITY HOSPITAL NEW BRUNSWICK NJ INTERNAL MEDICINE 143 19 $1,330 $70 premium 0.0% (732) 745-8600
21 OPTUM MEDICAL CARE PC MOUNT KISCO ME INTERNAL MEDICINE 1040 17 $290 $17 premium 3.6% (914) 241-1050
22 URGENT CARE SPECIALISTS PC WILBRAHAM MA PHYSICIAN ASSISTANT 11 17 $476 $28 premium 0.1% (413) 599-3800
23 MISSION MEDICAL CARE PC ROCKVILLE CENTRE NY NURSE PRACTITIONER 51 16 $4,000 $250 premium 0.1% (212) 803-3339
24 INTERMED PA SOUTH PORTLAND ME NURSE PRACTITIONER 181 14 $681 $49 premium 3.0% (207) 874-1489
25 ARTHRITIS AND RHEUMATOLOGY CONSULTANTS PA EDINA MN RHEUMATOLOGY 12 14 $798 $57 premium 1.2% (952) 893-1959
26 NORTHERN MEDICAL GROUP, PLLC BREWSTER NY INTERNAL MEDICINE 35 13 $910 $70 premium 0.0% (845) 279-5187
27 VALLEY MEDICAL GROUP PC GREENFIELD NY PHYSICIAN ASSISTANT 108 13 $1,105 $85 premium 0.0% (413) 774-6301
28 IMPACT HEALTH PC ORANGE NY NURSE PRACTITIONER 70 13 $221 $17 premium 0.0% (203) 497-3861
29 HEALTHCARE PARTNERS OF SARATOGA LTD MALTA NY PHYSICIAN ASSISTANT 68 12 $756 $63 premium 0.0% (518) 289-2020
30 SARATOGA HOSPITAL SARATOGA SPRINGS NY PHYSICIAN ASSISTANT 353 12 $480 $40 premium 0.0% (518) 583-8421
31 MARTIN'S POINT HEALTH CARE, INC. BRUNSWICK NH FAMILY PRACTICE 94 12 $466 $39 premium 21.8% (207) 798-4050
32 SUFFOLK PRIMARY HEALTH LLC RIVERHEAD NY NURSE PRACTITIONER 29 11 $187 $17 premium 0.0% (631) 208-4460
33 ALLINA HEALTH SYSTEM MINNEAPOLIS MN PHYSICIAN ASSISTANT 3855 11 $878 $80 premium 1.0% (612) 863-4000
34 INSPIRA HEALTH NETWORK URGENT CARE PC GLASSBORO NJ FAMILY PRACTICE 43 11 $242 $22 premium 0.0% (856) 582-1500

*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 →