NEVVI Medicare utilization intelligence
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Market snapshot

Nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS
94016 Test to measure expiratory airflow and volume initiated by patient and evaluated by provider CPT · Pulmonary test
Classification Test Pulmonary Pulmonary Function Testing (CMS RBCS)
First observed 2013 — start of our 12-year window; the code predates it
National scale 6,372 services ▼ 3.0% YoY · 5,404 beneficiaries (CY2024, Medicare FFS)
Medicare paid $119K · $18.60 avg / service, national
CMS descriptor · RBCS classification · Medicare Part B physician/supplier claims, 12-year window
Billing groups
28
Named-group FFS services
3,073
FFS of Medicare
49%
Services YoY
-3.0%
FFS enrollment -2.2%
Estimated all-Medicare volume FFS + estimated MA estimate
~6,319 services

3,073 observed fee-for-service (49%) · ~3,246 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 — 94016 (CY2024)

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

Named-group submitted charges
$166K
Named-group allowed amount
$75K
Named-group Medicare payments
$58K
Avg charge / svc
$54
Avg allowed / svc
$25
Avg payment / svc
$19
Average charge per group
$26 28 groups · avg submitted charge / service $150
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Data year: CY2024 CY2023 CY2022 locked column CY2021 locked column CY2020 locked column
Physician groups ranked by 94016 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 94016 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 CALIFORNIA PULMONARY ASSOCIATES INC UPLAND CA PULMONARY DISEASE 7 469 $17,830 $38 premium 15.4% (626) 914-5219
2 ARCADIA MEDICAL ASSOCIATES PA ARCADIA FL INTERNAL MEDICINE 20 326 $15,648 $48 premium 89.8% (863) 993-2966
3 NAQVI AND NAQVI MD INC NEWPORT BEACH CA ENDOCRINOLOGY 3 299 $16,440 $55 premium 9.8% (949) 548-3177
4 FRESNO COMMUNITY HOSPITAL AND MEDICAL CENTER FRESNO CA CARDIOVASCULAR DISEASE (CARDIOLOGY) 56 272 $10,880 $40 premium 8.9% (559) 433-8000
5 PERVAIZ IQBAL PHYSICIAN PC BROOKLYN NY INTERNAL MEDICINE 2 264 $14,784 $56 premium 35.7% (718) 756-1309
6 CHS PHYSICIAN PARTNERS PC ROSLYN NY PHYSICIAN ASSISTANT 734 250 $20,000 $80 premium 33.8%
7 AV CRITICAL CARE INC LANCASTER CA INTERNAL MEDICINE 12 202 $14,140 $70 premium 6.6% (661) 948-8000
8 HUNTINGTON BEACH INTERNAL MEDICINE GROUP INC NEWPORT BEACH CA INTERNAL MEDICINE 3 126 $3,778 $30 premium 4.1% (949) 274-8030
9 RIVERSIDE FACULTY MEDICAL GROUP INC MORENO VALLEY CA INTERNAL MEDICINE 79 117 $7,350 $63 premium 3.8% (951) 656-1500
10 ALEGENT CREIGHTON CLINIC OMAHA IA PHYSICIAN ASSISTANT 942 112 $7,840 $70 premium 100.0%
11 ALLERGY AND ASTHMA CARE OF WACO, PA. WACO TX ALLERGY/IMMUNOLOGY 2 102 $5,575 $55 premium 17.9% 2547533646205
12 COUNTY OF SANTA CLARA SAN JOSE CA INTERNAL MEDICINE 1001 83 $3,975 $48 premium 2.7% (408) 885-5000
13 KITTITAS COUNTY PUBLIC HOSPITAL DIST 1 ELLENSBURG WA PHYSICIAN ASSISTANT 84 80 $4,960 $62 premium 72.7% (509) 933-8777
14 MESA PULMONARY GROUP INC COSTA MESA CA PULMONARY DISEASE 6 60 $3,000 $50 premium 2.0% (949) 873-5537
15 CEDARS-SINAI MEDICAL CENTER WEST HOLLYWOOD CA NURSE PRACTITIONER 802 40 $3,600 $90 premium 1.3% (310) 423-3277
16 HOSPITAL PHYSICIAN SERVICES OF FLORIDA PA TALLAHASSEE FL INTERNAL MEDICINE 224 37 $959 $26 premium 10.2% (850) 325-5000
17 COMMUNITY HEALTH OF CENTRAL WASHINGTON YAKIMA WA FAMILY PRACTICE 78 30 $1,860 $62 premium 27.3% (509) 452-4520
18 PROS MEDICAL CLINIC INC MONTCLAIR CA FAMILY PRACTICE 2 30 $1,800 $60 premium 1.0% (909) 621-2562
19 TJH MEDICAL SERVICES PC JAMAICA NY INTERNAL MEDICINE 211 26 $3,900 $150 premium 3.5% (718) 206-6797
20 DESERT OASIS MEDICAL CENTER PLLC BULLHEAD CITY AZ INTERNAL MEDICINE 2 26 $664 $26 premium 8.2% (928) 758-0121
21 INPATIENT SPECIALISTS OF CALIFORNIA PC SAN BERNARDINO CA INTERNAL MEDICINE 370 25 $1,250 $50 premium 0.8% (909) 883-8711
22 HEALTHCARE PARTNERS AFFILIATES MEDICAL GROUP CARSON CA INTERNAL MEDICINE 771 22 $1,672 $76 premium 0.7% (310) 830-9706
23 LOZITO MEDICAL ASSOCIATES HAWTHORNE NJ INTERNAL MEDICINE 2 15 $1,200 $80 premium 14.4% (973) 423-4770
24 HEALTHY LIFE CORPORATION PHOENIX AZ NURSE PRACTITIONER 11 14 $700 $50 premium 4.4% (623) 385-7900
25 WINFIELD INTERNAL MEDICINE, PC WINFIELD AL INTERNAL MEDICINE 3 12 $468 $39 premium 100.0% (205) 487-4224
26 USC CARE MEDICAL GROUP INC LOS ANGELES CA DIAGNOSTIC RADIOLOGY 1374 12 $960 $80 premium 0.4% (800) 872-2273
27 HOSPITAL CONSULTANTS PC TROY MI HOSPITALIST 43 11 $407 $37 premium 100.0% (248) 694-1000
28 CONTINUUM FAMILY CARE LLC MARYVILLE MO CLINICAL SOCIAL WORKER 3 11 $594 $54 premium 100.0% (660) 220-2123

*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 →