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Market snapshot

94004 nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS

94004 — Nursing facility ventilation assistance and management

Billing groups
13
Named-group FFS services
12,968
FFS of Medicare
49%
Services YoY
+3.3%
FFS enrollment -2.2%
Estimated all-Medicare volume FFS + estimated MA estimate
~22,800 services

12,968 observed fee-for-service (57%) · ~9,832 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 — 94004 (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
$613K
Named-group Medicare payments
$482K
Avg charge / svc
$89
Avg allowed / svc
$47
Avg payment / svc
$37
Average charge per group
$72 13 groups · avg submitted charge / service $169
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Data year: CY2024 CY2023 CY2022 🔒 CY2021 🔒 CY2020 🔒
Physician groups ranked by 94004 services, CY2024
#Physician group City St Specialty Providers 94004 svcs Submitted charges Avg charge Medicare $ locked column Share* Phone
1 TRUDOC LLC CLIFTON NJ INTERNAL MEDICINE 5 5,602 $442,558 $79 premium 98.9% (973) 928-2300
2 THOMAS B HAZLEHURST M D DALY CITY CA NURSE PRACTITIONER 3 1,376 $103,200 $75 premium 99.1% (650) 400-0277
3 LIFEBRIDGE COMMUNITY PULMONOLOGY LLC OWINGS MILLS MD NURSE PRACTITIONER 5 1,294 $122,930 $95 premium 38.3% (410) 484-5686
4 PULMONARY MEDICAL CONSULTANTS INC DARBY PA PULMONARY DISEASE 2 1,189 $130,790 $110 premium 76.3% (610) 534-6140
5 MEDSTAR MEDICAL GROUP II LLC WASHINGTON MD PHYSICIAN ASSISTANT 3707 878 $96,580 $110 premium 26.0% (202) 429-2401
6 YOUR GOOD HEALTH, LLC EAST RIDGE TN NURSE PRACTITIONER 13 877 $65,775 $75 premium 100.0% (423) 867-4969
7 BRISTOL HOSPITAL MULTI SPECIALTY GROUP, INC. BRISTOL CT PHYSICIAN ASSISTANT 156 529 $38,180 $72 premium 30.7% (860) 314-6046
8 MEDICAL CHEST ASSOCIATES PA HOUSTON TX PULMONARY DISEASE 4 380 $38,000 $100 premium 100.0% (713) 467-8888
9 RESPIRATORY, CRITICAL CARE AND SLEEP SPECIALISTS, LLC DES PLAINES IL PULMONARY DISEASE 9 373 $46,998 $126 premium 50.5% (847) 376-8969
10 UNIVERSITY OF MARYLAND ST JOSEPH MEDICAL GROUP LLC TOWSON MD NURSE PRACTITIONER 292 356 $51,976 $146 premium 10.5% (410) 337-4877
11 PULMONARY PHYSICIANS OF SOUTH FLORIDA LLC MIAMI FL PULMONARY DISEASE 39 64 $10,816 $169 premium 11.2% (305) 267-5544
12 INTENSIVE CARE EXPERTS HEALTH NETWORK, LLC PORT CHARLOTTE FL NURSE PRACTITIONER 89 38 $4,256 $112 premium 6.7% (941) 625-3200
13 LOS ANGELES LUNG CENTER A PROFESSIONAL MEDICAL CORP LOS ANGELES CA PULMONARY DISEASE 3 12 $1,800 $150 premium 0.9% (323) 913-9130

*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 →