Medicare procedure market data by CPT code & state

Market snapshot

Nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS

87210 Smear 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 37,547 services · est. ▲ 6.9% YoY · 14,549 FFS beneficiaries (CY2024, all-Medicare estimate) — 18,635 observed fee-for-service services

Medicare paid $213K · est. · $5.67 avg / service, national — $106K observed FFS

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

Billing groups

144

Named groups billing this code

Named-group all-Medicare svcs · est.

13,668

Scaled from 6,787 observed FFS services.

FFS of Medicare

49%

Payer-mix frame

Services · year over year

Services YoY

+6.9%

All-Medicare est. · observed FFS +3.0%

Volume, not care. A shrinking fee-for-service denominator is not a shrinking market.

Estimated all-Medicare volume estimate

FFS + estimated MA

~13,668 services

6,787 observed fee-for-service (50%) · ~6,881 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 — 87210 (CY2024)

CA 4,695 NY 4,582 PA 2,988 WI 2,189 TX 1,878

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

$147K

Named-group allowed amount

$38K

Named-group Medicare payments

$77K · est.

— $38K observed FFS

Avg charge / svc

$22

Avg allowed / svc

Avg payment / svc

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

$6–11

$11–16

$16–21

$21–26

$26–31

$31–36

$36–41

$41+

$6 144 groups · avg submitted charge / service $120

Market analyticsPlatform Methods →

Search a single state to see that market's full analytics — each panel renders gated on the free tier.

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

Physician groups ranked by 87210 services, highest first, CY2024
#	Physician group locked column	City locked column	St locked column	Specialty locked column	Providers locked column	87210 svcs	Submitted charges locked column	Avg charge locked column	Medicare $ locked column	Share of state* locked column	Phone
1	JEFFERSON UNIVERSITY PHYSICIANS	PHILADELPHIA	PA	DIAGNOSTIC RADIOLOGY	1570	1,097	$21,940	$20	premium	78.0%	—
2	PRIVIA MEDICAL GROUP, LLC	ARLINGTON	VA	NURSE PRACTITIONER	1477	248	$3,720	$15	premium	25.2%	—
3	JACKSON CLINIC PA	JACKSON	TN	NURSE PRACTITIONER	183	174	$1,914	$11	premium	30.1%	(731) 422-0213
4	NORTH SHORE-LIJ MEDICAL PC	MANHASSET	NY	PHYSICIAN ASSISTANT	6294	163	$4,401	$27	premium	7.4%	—
5	MID-ATLANTIC WOMENS CARE PLC	NORFOLK	VA	OBSTETRICS/GYNECOLOGY	153	152	$4,560	$30	premium	15.4%	(757) 466-6350

That's the top 5 of 144 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 →

*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 →