Medicare procedure market data by CPT code & state

Market snapshot

Nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS

86900 Blood group typing (abo) 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 116,157 services · est. ▲ 4.9% YoY · 46,111 FFS beneficiaries (CY2024, all-Medicare estimate) — 56,439 observed fee-for-service services

Medicare paid $340K · est. · $2.92 avg / service, national — $165K observed FFS

CMS descriptor · RBCS classification · Medicare Part B physician/supplier claims, 12-year window

Estimated all-Medicare volume estimate

FFS + estimated MA

~116,157 services

56,439 observed fee-for-service (49%) · ~59,718 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

Payments · FFS observed

$165K

all-Medicare ≈$340K — estimate; price parity assumed as well

Rate per 1,000 FFS

2.0

claims denominator · a rate — never scaled

Named groups

6 at the ≥11-service disclosure floor

Top states — 86900 (CY2024)

FL 18,150 CA 14,356 MN 12,337 NJ 12,090 NC 6,656

Est. all-Medicare services by billing state (scaled estimate — assumes MA utilization mirrors FFS); open a bar for that state's ranked market.

The 12-year rate

Growing on the honest basis across 12 years

Per 1,000 FFS beneficiaries, claims denominator · the dated per-year table is a Platform view

What they charge

Half the field lists between $10 and $26

$9–13

$13–17

$17–21

$21–25

$25–29

$29–34

$34–38

$38+

Submitted charges are provider-set list amounts, not payments · median $20 (named groups)

National benchmarks

Computed for this market — a Platform view

Market position

Computed for this market — a Platform view

The whole field, one canvas

Computed for this market — a Platform view

See it in full: nuclear heart imaging (78452) in Arizona is open as a live example — every paid panel, on real data.

View the live example →

Data year: CY2024 CY2023 CY2022 CY2021 CY2020

sorts locked on the free tier · services rank pinned · refine and export are Platform features

GALEN MEDICAL GROUP, PC

CHATTANOOGA · TN · NURSE PRACTITIONER · 123 providers · hospital-affiliated · (423) 643-2500

67services 15.6%Share of state* $25avg list Medicare $

HEALTHEAST MEDICAL RESEARCH INSTITUTE

SAINT PAUL · CA · PHYSICIAN ASSISTANT · 691 providers · hospital-affiliated · —

54services 0.8%Share of state* $9avg list Medicare $

HEALTHEAST MEDICAL RESEARCH INSTITUTE

SAINT PAUL · MN · PHYSICIAN ASSISTANT · 691 providers · hospital-affiliated · —

52services 1.0%Share of state* $9avg list Medicare $

ADVOCATE HEALTH AND HOSPITALS CORPORATION

BUFFALO GROVE · IL · NURSE PRACTITIONER · 3045 providers · hospital-affiliated · (847) 459-1160

39services 4.9%Share of state* $26avg list Medicare $

FAIRVIEW EXPRESS CARE

MINNEAPOLIS · MN · PHYSICIAN ASSISTANT · 2007 providers · hospital-affiliated · (612) 672-7422

30services 0.6%Share of state* $9avg list Medicare $

You are at the seam — 5 of 6 groups named.

That's the top 5 of 6 groups. The platform ranks the whole market — code baskets, benchmarks, and the full ranked list. the full ranking is part of the market analytics platform — built, not launched yet. Notify me at launch →

Medicare $ counts 86900 payments in the market each row names, CY2024; avg list is that row's submitted charges per service on the same basis — list amounts, not payments.

*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 — and the observed foundation every market figure here builds on. Market totals anchor on a labeled all-Medicare estimate scaled from that foundation, with the observed count disclosed beside it — Medicare only, never all-payer. Modeled all-payer databases project every payer statistically and typically run higher. Same market, different denominator. How the numbers reconcile →