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Market snapshot

90684 nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS

90684 — Pcv21 vaccine im

Billing groups
16
Named-group FFS services
518
FFS of Medicare
49%
Services YoY
Estimated all-Medicare volume FFS + estimated MA estimate
~1,012 services

518 observed fee-for-service (51%) · ~494 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 — 90684 (CY2024)

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

Named-group submitted charges
$263K
Named-group allowed amount
$164K
Named-group Medicare payments
$164K
Avg charge / svc
$508
Avg allowed / svc
$316
Avg payment / svc
$316
Average charge per group
$264 16 groups · avg submitted charge / service $984
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Data year: CY2024 CY2023 CY2022 🔒 CY2021 🔒 CY2020 🔒
Physician groups ranked by 90684 services, CY2024
#Physician group City St Specialty Providers 90684 svcs Submitted charges Avg charge Medicare $ locked column Share* Phone
1 SUMMIT MEDICAL GROUP, PLLC KNOXVILLE TN FAMILY PRACTICE 622 151 $72,027 $477 premium 23.2% (865) 938-3627
2 FAMILY MEDICAL CLINIC OF NORTH MS INC SOUTHAVEN MS NURSE PRACTITIONER 13 59 $20,650 $350 premium 14.0% (662) 890-5555
3 ESSENTIAL FAMILY MEDICINE OF OMAHA LLC OMAHA NE FAMILY PRACTICE 4 46 $22,875 $497 premium 15.9% (402) 991-5353
4 TMH PHYSICIAN ASSOCIATES PLLC HOUSTON TX NURSE PRACTITIONER 1930 43 $40,905 $951 premium 4.1% (713) 266-9955
5 UPMC ALTOONA REGIONAL HEALTH SERVICES, INC. ALTOONA PA PHYSICIAN ASSISTANT 190 33 $12,516 $379 premium 9.9% (814) 941-8811
6 BOONE PHYSICIAN SERVICES LLC COLUMBIA MO PHYSICIAN ASSISTANT 236 25 $13,906 $556 premium 10.7% (573) 815-8000
7 UPMC WESTERN MARYLAND HEALTH SERVICES LLC CUMBERLAND MD PHYSICIAN ASSISTANT 171 24 $7,584 $316 premium 14.1%
8 UPMC COMMUNITY MEDICINE INC PITTSBURGH PA FAMILY PRACTICE 749 24 $7,584 $316 premium 7.2% (412) 281-0322
9 PINNACLE HEALTH REGIONAL PHYSICIANS LANCASTER PA OBSTETRICS/GYNECOLOGY 162 19 $6,004 $316 premium 5.7% (717) 393-1338
10 BAPTIST MEMORIAL MEDICAL GROUP, INC. MEMPHIS TN NURSE PRACTITIONER 549 18 $11,808 $656 premium 2.8% (901) 226-3882
11 BASS MEDICAL GROUP WALNUT CREEK CA OTOLARYNGOLOGY 318 17 $16,728 $984 premium 6.2%
12 NEW YORK UNIVERSITY NEW YORK NY DIAGNOSTIC RADIOLOGY 5704 14 $12,166 $869 premium 4.4% (212) 263-9700
13 STATE OF FRANKLIN HEALTHCARE ASSOCIATES, PLLC JOHNSON CITY TN NURSE PRACTITIONER 279 12 $4,140 $345 premium 1.8% (423) 926-8181
14 IOWA PHYSICIANS CLINIC MEDICAL FOUNDATION BETTENDORF IA NURSE PRACTITIONER 1202 11 $4,818 $438 premium 2.3%
15 PINNACLE HEALTH MEDICAL SERVICES HARRISBURG PA PHYSICIAN ASSISTANT 1060 11 $2,908 $264 premium 3.3% (717) 782-2100
16 MEDICAL FACULTY ASSOCIATES, INC WASHINGTON DC PHYSICIAN ASSISTANT 685 11 $6,630 $603 premium 32.4% (202) 715-4000

*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 →