Medicare procedure market data by CPT code & state

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Market snapshot

86735 nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS

86735 — Analysis for antibody to mumps virus

Billing groups

Named-group FFS services

FFS of Medicare

49%

Services YoY

+27.6%

FFS enrollment -2.2%

Estimated all-Medicare volume FFS + estimated MA estimate

~139 services

74 observed fee-for-service (53%) · ~65 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 — 86735 (CY2024)

NJ 5,999 CA 3,712 NY 1,885 NC 1,144 TX 698

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

Named-group submitted charges

$4K

Named-group allowed amount

$946

Named-group Medicare payments

$946

Avg charge / svc

$50

Avg allowed / svc

$13

Avg payment / svc

$13

Average charge per group

$13–22

$22–31

$31–39

$39–48

$48–57

$57–65

$65–74

$74+

$13 4 groups · avg submitted charge / service $88

Market analyticsPlatform

a taste of the twelve-year trend layer

Market position — where this market sits on volume and growth among all state markets, and its rank.
Worth a look — every state market for this search, ranked by a published score: size, growth, fragmentation, below-expected volume.
Lookalike opportunities — groups billing below what peers of the same specialty, size, and state predict, with the expected figure shown.
National benchmarks — where each group's volume sits nationally and within its specialty.
Market structure — how concentrated this market is, and who owns the volume.
Medicare-wide scaling — the exact payer split, and this market total scaled to all of Medicare, labeled as an estimate.

Nevvi's market analytics platform — code baskets, market structure and share, the twelve-year trend layer — is built and not launched yet. We're gathering interest in it.

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Data year: CY2024 CY2023 CY2022 🔒 CY2021 🔒 CY2020 🔒

Physician groups ranked by 86735 services, CY2024
#	Physician group	City	St	Specialty	Providers	86735 svcs	Submitted charges	Avg charge	Medicare $ locked column	Share*	Phone
1	ATRIUS HEALTH INC	BOSTON	MA	NURSE PRACTITIONER	1196	27	$1,431	$53	premium	5.1%	(617) 421-1000
2	SUTTER BAY MEDICAL FOUNDATION	PALO ALTO	CA	INTERNAL MEDICINE	3716	17	$1,499	$88	premium	0.5%	(415) 600-1020
3	BORO PARK OBSTETRICS AND GYNECOLOGY P.C.	BROOKLYN	NY	OBSTETRICS/GYNECOLOGY	17	16	$624	$39	premium	0.8%	71897227001121
4	OPTUM MEDICAL CARE PC	MOUNT KISCO	NY	INTERNAL MEDICINE	1040	14	$183	$13	premium	0.7%	(914) 241-1050

*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 →