NEVVI Medicare utilization intelligence
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Market snapshot

Nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS
87541 Detection test by nucleic acid for legionella pneumophila (water borne bacteria), amplified probe technique CPT · Molecular Testing
Classification Test › Molecular Testing › Infectious Agent Detection by DNA/RNA (CMS RBCS)
First observed 2013 — start of our 12-year window; the code predates it
National scale 168,755 services ▲ 27.4% YoY · 131,492 beneficiaries (CY2024, Medicare FFS)
Medicare paid $5.8M · $34.38 avg / service, national
CMS descriptor · RBCS classification · Medicare Part B physician/supplier claims, 12-year window
Billing groups

12

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

2,387

Scaled from 1,207 observed FFS services.
FFS of Medicare

49%

Payer-mix frame
Services · year over year
Services YoY

+31.0%

All-Medicare est. · observed FFS +27.4%
Volume, not care. A shrinking fee-for-service denominator is not a shrinking market.
Estimated all-Medicare volume estimate
FFS + estimated MA

~2,387 services

1,207 observed fee-for-service (51%) · ~1,180 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 — 87541 (CY2024)
TX 66,705 CA 52,444 PA 12,012 FL 10,076 AZ 6,109

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

Billed → allowed → paid
Named-group submitted charges
$70K
Named-group allowed amount
$41K
Named-group Medicare payments
$41K
Avg charge / svc
$58
Avg allowed / svc
$34
Avg payment / svc
$34
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
$39 12 groups · avg submitted charge / service $75
Market analyticsPlatform Methods →

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Data year: CY2024 CY2023 CY2022  CY2021  CY2020 
# Physician group City St Specialty Providers 87541 svcs Submitted charges Avg charge Medicare $ Share of state* Phone
1 PHYSICIAN SERVICES OF THE GULF COAST LLC BILOXI MS NURSE PRACTITIONER 25 360 $15,790 $44 20.0% (228) 396-3945
2 ICM MEDICAL GROUP INC INGLEWOOD CA INTERNAL MEDICINE 3 314 $23,550 $75 0.6% (310) 855-0556
3 TEXAS FAITH LLC ARLINGTON TX FAMILY PRACTICE 10 158 $9,663 $61 0.2% (972) 734-5400
4 HEALTH FIRST URGENT CARE, PLLC RICHLAND WA PHYSICIAN ASSISTANT 13 94 $4,700 $50 51.6% (509) 300-1500
5 NEXUS HEALTH PRIMARY CARE LLC SANTA FE NM INTERNAL MEDICINE 7 74 $3,700 $50 29.5% (505) 395-3000
That's the top 5 of 12 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. 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 →