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Market snapshot

Nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS
94003 Follow-up 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 11,035 services ▼ 21.7% YoY · 1,382 beneficiaries (CY2024, Medicare FFS)
Medicare paid $559K · $50.69 avg / service, national
CMS descriptor · RBCS classification · Medicare Part B physician/supplier claims, 12-year window
Billing groups
20
Named-group FFS services
6,503
FFS of Medicare
49%
Services YoY
-21.7%
FFS enrollment -2.2%
Estimated all-Medicare volume FFS + estimated MA estimate
~12,430 services

6,503 observed fee-for-service (52%) · ~5,927 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 — 94003 (CY2024)

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

Named-group submitted charges
$1.2M
Named-group allowed amount
$418K
Named-group Medicare payments
$333K
Avg charge / svc
$182
Avg allowed / svc
$64
Avg payment / svc
$51
Average charge per group
$100 20 groups · avg submitted charge / service $278
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Data year: CY2024 CY2023 CY2022 locked column CY2021 locked column CY2020 locked column
Physician groups ranked by 94003 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 94003 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 PULMONARY MEDICAL CONSULTANTS INC DARBY PA PULMONARY DISEASE 2 1,457 $160,270 $110 premium 65.0% (610) 534-6140
2 LOYOLA UNIVERSITY MEDICAL CENTER MAYWOOD IL NURSE PRACTITIONER 933 1,438 $399,764 $278 premium 36.4% (708) 216-8372
3 TRUDOC LLC CLIFTON NJ INTERNAL MEDICINE 5 805 $86,135 $107 premium 100.0% (973) 928-2300
4 RESPIRATORY, CRITICAL CARE AND SLEEP SPECIALISTS, LLC DES PLAINES IL PULMONARY DISEASE 9 532 $78,820 $148 premium 13.5% (847) 376-8969
5 MEMORIAL HEALTH PARTNERS FOUNDATION, INC CHATTANOOGA TN NURSE PRACTITIONER 459 445 $87,812 $197 premium 100.0% (423) 495-2620
6 BRIGHAM AND WOMENS PHYSICIANS ORGANIZATION INC BOSTON MA PHYSICIAN ASSISTANT 2942 423 $113,655 $269 premium 79.8% (617) 732-5500
7 INTERFAITH PROFESSIONAL PHYSICIAN SERVICES PC BROOKLYN NY INTERNAL MEDICINE 384 268 $48,057 $179 premium 100.0%
8 HEALTHEAST MEDICAL RESEARCH INSTITUTE SAINT PAUL MN PHYSICIAN ASSISTANT 691 222 $53,169 $240 premium 100.0%
9 RML HEALTH PROVIDERS LIMITED PARTNERSHIP HINSDALE IL INTERNAL MEDICINE 11 197 $38,863 $197 premium 5.0% (630) 286-4000
10 AMERICAN LUNG AND SLEEP DISORDERS CONSULTANTS PA PINELLAS PARK FL NURSE PRACTITIONER 2 194 $24,250 $125 premium 64.9% (727) 528-4900
11 LIFEBRIDGE COMMUNITY PHYSICIANS INC BALTIMORE MA NURSE PRACTITIONER 185 107 $16,585 $155 premium 20.2% (410) 601-9000
12 UNIVERSITY OF CINCINNATI PHYSICIANS COMPANY LLC CINCINNATI OH NURSE PRACTITIONER 1504 90 $17,010 $189 premium 100.0% (513) 584-1000
13 EPHRAIM MCDOWELL HEALTH RESOURCE INC DANVILLE KY NURSE PRACTITIONER 157 75 $10,050 $134 premium 49.0% (859) 236-2222
14 TEXAS TECH UNIVERSITY HEALTH SCIENCES CENTER EL PASO EL PASO TX NURSE PRACTITIONER 306 60 $9,960 $166 premium 100.0% (915) 215-5200
15 PULMONARY PHYSICIANS OF SOUTH FLORIDA LLC MIAMI FL PULMONARY DISEASE 39 57 $12,882 $226 premium 19.1% (305) 267-5544
16 UNIVERSITY OF FLORIDA JACKSONVILLE PHYSICIANS, INC. JACKSONVILLE FL NURSE PRACTITIONER 884 36 $8,940 $248 premium 12.0% (904) 244-1680
17 PRISMA HEALTH MEDICAL GROUP-MIDLANDS COLUMBIA SC PHYSICIAN ASSISTANT 1017 29 $4,437 $153 premium 9.3% (803) 749-5101
18 MOUNT SINAI COMMUNITY FOUNDATION CHICAGO IL INTERNAL MEDICINE 253 28 $6,052 $216 premium 0.7% (773) 257-6672
19 GEISINGER CLINIC DANVILLE PA PHYSICIAN ASSISTANT 3426 28 $2,800 $100 premium 1.2% (570) 271-6144
20 INTENSIVE CARE EXPERTS HEALTH NETWORK, LLC PORT CHARLOTTE FL NURSE PRACTITIONER 89 12 $1,344 $112 premium 4.0% (941) 625-3200

*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 →