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

94002 Initial hospital inpatient or observation ventilation assistance and management CPT · E&M - Miscellaneous

Classification E&M › E&M - Miscellaneous (CMS RBCS)

First observed 2013 — start of our 12-year window; the code predates it

National scale 455 services ▼ 5.8% YoY · 433 beneficiaries (CY2024, Medicare FFS)

Medicare paid $30K · $65.77 avg / service, national

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

Billing groups

Named groups billing this code

Named-group FFS services

379

Attributable volume · fee-for-service

FFS of Medicare

49%

Payer-mix frame

Services · year over year

Services YoY

-5.8%

FFS enrollment -2.2%

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

Estimated all-Medicare volume estimate

FFS + estimated MA

~778 services

379 observed fee-for-service (49%) · ~399 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 — 94002 (CY2024)

IN 149 NC 103 IL 86 FL 83 MA 21

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

$129K

Named-group allowed amount

$31K

Named-group Medicare payments

$25K

Avg charge / svc

$341

Avg allowed / svc

$83

Avg payment / svc

$66

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

$180–229

$229–277

$277–326

$326–375

$375–423

$423–472

$472–521

$521+

$180 7 groups · avg submitted charge / service $640

Market analyticsPlatform Methods →

Search a single state to see that market's full analytics — the free tier previews every panel, gated.

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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Data year: CY2024 CY2023 CY2022 CY2021 CY2020

Physician groups ranked by 94002 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	94002 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	DEACONESS HOSPITAL, INC.	EVANSVILLE	IN	HOSPITALIST	420	123	$41,451	$337	premium	82.6%	(812) 450-7338
2	NORTH CAROLINA MG LLC	RALEIGH	NC	PHYSICIAN ASSISTANT	674	78	$25,350	$325	premium	75.7%	(919) 881-0160
3	AMERICAN LUNG AND SLEEP DISORDERS CONSULTANTS PA	PINELLAS PARK	FL	NURSE PRACTITIONER	2	55	$9,900	$180	premium	66.3%	(727) 528-4900
4	LOYOLA UNIVERSITY MEDICAL CENTER	MAYWOOD	IL	NURSE PRACTITIONER	933	35	$14,140	$404	premium	40.7%	(708) 216-8372
5	ANESTHESIOLOGY GROUP ASSOCIATES PC	EVANSVILLE	IN	CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA)	48	26	$16,640	$640	premium	17.4%	(812) 473-0181
6	LIFEBRIDGE COMMUNITY PHYSICIANS INC	BALTIMORE	MA	NURSE PRACTITIONER	185	21	$4,200	$200	premium	100.0%	(410) 601-9000
7	NORTH CAROLINA MG LLC	RALEIGH	FL	PHYSICIAN ASSISTANT	674	17	$5,525	$325	premium	20.5%	(919) 881-0160
8	ANESTHESIOLOGY GROUP ASSOCIATES PC	EVANSVILLE	UT	CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA)	48	13	$8,320	$640	premium	100.0%	(812) 473-0181
9	UNIVERSITY OF FLORIDA JACKSONVILLE PHYSICIANS, INC.	JACKSONVILLE	FL	NURSE PRACTITIONER	884	11	$3,740	$340	premium	13.3%	(904) 244-1680

*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 →