Medicare procedure market data by CPT code & state

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Market snapshot

Nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS

87205 Special gram or giemsa stain for microorganism 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 232,589 services ▼ 0.3% YoY · 185,419 beneficiaries (CY2024, Medicare FFS)

Medicare paid $971K · $4.17 avg / service, national

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

Billing groups

Named-group FFS services

1,629

FFS of Medicare

49%

Services YoY

-0.3%

FFS enrollment -2.2%

Estimated all-Medicare volume FFS + estimated MA estimate

~3,392 services

1,629 observed fee-for-service (48%) · ~1,763 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 — 87205 (CY2024)

FL 33,059 CA 32,104 NJ 22,636 GA 18,142 TX 13,190

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

Named-group submitted charges

$34K

Named-group allowed amount

$7K

Named-group Medicare payments

$7K

Avg charge / svc

$21

Avg allowed / svc

Avg payment / svc

Average charge per group

$6–11

$11–16

$16–21

$21–25

$25–30

$30–35

$35–40

$40+

$6 20 groups · avg submitted charge / service $61

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 payer split, and this market total scaled to all of Medicare, labeled as an estimate.

Or just look at it: nuclear heart imaging (78452) in Arizona is open as a live example — the full paid view, real data.

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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 87205 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	87205 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	CLEVELAND CLINIC	CLEVELAND	OH	PHYSICIAN ASSISTANT	6828	529	$12,336	$23	premium	10.2%	—
2	SUTTER BAY MEDICAL FOUNDATION	PALO ALTO	CA	INTERNAL MEDICINE	3716	275	$7,975	$29	premium	0.9%	(415) 600-1020
3	MCFARLAND CLINIC PC	AMES	IA	PHYSICIAN ASSISTANT	352	117	$1,872	$16	premium	8.3%	(515) 239-4400
4	OPTUM CARE WASHINGTON PLLC	EVERETT	WA	PHYSICIAN ASSISTANT	695	112	$1,092	$10	premium	2.0%	(425) 339-5442
5	SOUTHVIEW MEDICAL GROUP, PC	BIRMINGHAM	AL	INTERNAL MEDICINE	39	89	$534	$6	premium	2.4%	(205) 933-4640
6	ATRIUS HEALTH INC	BOSTON	MA	NURSE PRACTITIONER	1196	70	$1,190	$17	premium	1.1%	(617) 421-1000
7	AUSTIN REGIONAL CLINIC PA	AUSTIN	TX	FAMILY PRACTICE	389	51	$1,020	$20	premium	0.4%	(512) 346-6611
8	THE CLINICAL SKIN CENTER OF NORTHERN VIRGINIA PLLC	FAIRFAX	VA	DERMATOLOGY	6	47	$564	$12	premium	0.9%	(703) 620-8900
9	ALLINA HEALTH SYSTEM	MINNEAPOLIS	MN	PHYSICIAN ASSISTANT	3855	43	$860	$20	premium	2.1%	(612) 863-4000
10	WEST TENNESSEE BONE AND JOINT CLINIC PC	JACKSON	TN	ORTHOPEDIC SURGERY	60	42	$504	$12	premium	0.5%	(731) 661-9825
11	RIVERSIDE PHYSICIAN SERVICES INC	NEWPORT NEWS	VA	PHYSICIAN ASSISTANT	793	37	$407	$11	premium	0.7%	—
12	JACKSON CLINIC PA	JACKSON	TN	NURSE PRACTITIONER	183	37	$444	$12	premium	0.4%	(731) 422-0213
13	PHYSICIANS EAST PA	GREENVILLE	NC	NURSE PRACTITIONER	104	37	$1,628	$44	premium	0.4%	(252) 355-4357
14	ASSOCIATED CLINICIANS OF EAST TEXAS	LONGVIEW	TX	PHYSICIAN ASSISTANT	107	36	$648	$18	premium	0.3%	—
15	UNIVERSITY OF SOUTH ALABAMA	MOBILE	AL	GYNECOLOGICAL ONCOLOGY	4	31	$1,906	$61	premium	0.8%	(251) 665-8000
16	DERMATOLOGY DIVISION UNIVERSITY OF UTAH MEDICAL CENTER	SALT LAKE CITY	UT	DERMATOLOGY	73	14	$167	$12	premium	12.2%	(801) 587-6340
17	ATRIUS HEALTH INC	BOSTON	UT	NURSE PRACTITIONER	1196	14	$238	$17	premium	12.2%	(617) 421-1000
18	GENESIS HEALTHCARE PARTNERS PC	TORRANCE	CA	GASTROENTEROLOGY	211	14	$270	$19	premium	0.0%	(310) 534-8400
19	ARIZONA COMMUNITY PHYSICIANS PC	TUCSON	AZ	FAMILY PRACTICE	163	12	$240	$20	premium	0.1%	(520) 547-5725
20	SALEM CLINIC PC	SALEM	OR	DIAGNOSTIC RADIOLOGY	102	11	$220	$20	premium	0.4%	(503) 399-2424
21	PRIVIA MEDICAL GROUP, LLC	ARLINGTON	VA	NURSE PRACTITIONER	1477	11	$231	$21	premium	0.2%	—

*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 →