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

87800 Detection test by nucleic acid for multiple organisms, direct probe(s) 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 4,314 services ▼ 20.7% YoY · 3,630 beneficiaries (CY2024, Medicare FFS)

Medicare paid $184K · $42.68 avg / service, national

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

Billing groups

Named-group FFS services

442

FFS of Medicare

49%

Services YoY

-20.7%

FFS enrollment -2.2%

Estimated all-Medicare volume FFS + estimated MA estimate

~1,032 services

442 observed fee-for-service (43%) · ~590 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 — 87800 (CY2024)

NY 1,663 PA 1,064 TX 617 CT 208 KS 142

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

Named-group submitted charges

$56K

Named-group allowed amount

$19K

Named-group Medicare payments

$19K

Avg charge / svc

$127

Avg allowed / svc

$43

Avg payment / svc

$43

Average charge per group

$65–83

$83–101

$101–119

$119–137

$137–155

$155–173

$173–190

$190+

$65 9 groups · avg submitted charge / service $214

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.

View the live example →

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.

Notify me at launch →

Data year: CY2024 CY2023 CY2022 CY2021 CY2020

Physician groups ranked by 87800 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	87800 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	PHYSICIANS FOR WOMEN'S HEALTH, LLC	DANBURY	CT	OBSTETRICS/GYNECOLOGY	320	208	$26,000	$125	premium	100.0%	(203) 730-8789
2	SOUTHERN OB GYN ASSOCIATES P C	VALDOSTA	GA	DIAGNOSTIC RADIOLOGY	17	71	$8,946	$126	premium	51.4%	(229) 241-2800
3	PROVIDENCE HEALTH AND SERVICES WASHINGTON	SPOKANE	WA	PHYSICIAN ASSISTANT	771	48	$6,192	$129	premium	100.0%	—
4	EDMUND RHETT, JR., M.D., P.A.	MT PLEASANT	SC	OBSTETRICS/GYNECOLOGY	2	30	$6,000	$200	premium	100.0%	(843) 375-2210
5	LOFTUS, RYU AND BARTOL MD'S PC	SYRACUSE	NY	OBSTETRICS/GYNECOLOGY	6	21	$1,365	$65	premium	1.3%	(315) 671-0070
6	OBSTETRICAL AND GYNECOLOGICAL ASSOCIATES OF CORPUS CHRISTI	CORPUS CHRISTI	TX	OBSTETRICS/GYNECOLOGY	7	18	$1,800	$100	premium	2.9%	(361) 994-5454
7	VICTORIA WOMEN'S CLINIC ASSOCIATES	VICTORIA	TX	OBSTETRICS/GYNECOLOGY	9	17	$1,530	$90	premium	2.8%	(361) 578-5233
8	ELBOWOODS MEMORIAL HEALTH CENTER	NEW TOWN	PR	NURSE PRACTITIONER	24	15	$3,210	$214	premium	100.0%	(701) 627-4750
9	COASTAL BEND WOMENS CENTER PLLC	CORPUS CHRISTI	TX	OBSTETRICS/GYNECOLOGY	10	14	$1,050	$75	premium	2.3%	(361) 993-6000

*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 →