NEVVI Medicare utilization intelligence
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Market snapshot

Nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS
87015 Concentration of specimen for infectious agents CPT · General Laboratory test
Classification Test › General Laboratory (CMS RBCS)
First observed 2013 — start of our 12-year window; the code predates it
National scale 109,202 services · est. ▲ 10.6% YoY · 27,950 FFS beneficiaries (CY2024, all-Medicare estimate) — 52,425 observed fee-for-service services
Medicare paid $714K · est. · $6.54 avg / service, national — $343K observed FFS
CMS descriptor · RBCS classification · Medicare Part B physician/supplier claims, 12-year window
Billing groups

3

Named groups billing this code
Named-group all-Medicare svcs · est.

251

Scaled from 131 observed FFS services.
FFS of Medicare

49%

Payer-mix frame
Services · year over year
Services YoY

+10.6%

All-Medicare est. · observed FFS +7.3%
Volume, not care. A shrinking fee-for-service denominator is not a shrinking market.
Estimated all-Medicare volume estimate
FFS + estimated MA

~251 services

131 observed fee-for-service (52%) · ~120 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 — 87015 (CY2024)
TX 33,176 CA 18,451 FL 9,866 NC 8,896 NJ 7,010

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

Billed → allowed → paid
Named-group submitted charges
$4K
Named-group allowed amount
$858
Named-group Medicare payments
$2K · est.
— $858 observed FFS
Avg charge / svc
$33
Avg allowed / svc
$7
Avg payment / svc
$7
Totals are named-group (attributable) sums. Allowed is Medicare’s fee-schedule recognized price — what CMS recognizes, before the 80% Medicare pays.
Average charge per group
$17 3 groups · avg submitted charge / service $55
Market analyticsPlatform Methods →

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Data year: CY2024 CY2023 CY2022  CY2021  CY2020 
# Physician group City St Specialty Providers 87015 svcs Submitted charges Avg charge Medicare $ Share of state* Phone
1 SUTTER BAY MEDICAL FOUNDATION PALO ALTO CA INTERNAL MEDICINE 3716 57 $3,135 $55 0.6% (415) 600-1020
2 EMES PROFESSIONAL ASSOCIATES INC EDISON NJ PATHOLOGY 4 55 $918 $17 1.3% —
3 CLEVELAND CLINIC CLEVELAND OH PHYSICIAN ASSISTANT 6828 19 $330 $17 3.6% —

*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 →