NEVVI Medicare utilization intelligence
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Market snapshot

Nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS
94452 Test to measure lung function at high altitude 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 326 services · est. · 157 FFS beneficiaries (CY2024, all-Medicare estimate) — 158 observed fee-for-service services
Medicare paid $10K · est. · $31.40 avg / service, national — $5K observed FFS
CMS descriptor · RBCS classification · Medicare Part B physician/supplier claims, 12-year window
Billing groups

7

Named groups billing this code
Named-group all-Medicare svcs · est.

326

Scaled from 158 observed FFS services.
FFS of Medicare

49%

Payer-mix frame
Services · year over year
Services YoY

+51.6%

All-Medicare est. · observed FFS +42.3%
Volume, not care. A shrinking fee-for-service denominator is not a shrinking market.
Estimated all-Medicare volume estimate
FFS + estimated MA

~326 services

158 observed fee-for-service (48%) · ~168 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 — 94452 (CY2024)
AZ 133 CA 130 OH 34 FL 30

Est. all-Medicare services by billing state (scaled estimate — assumes MA utilization mirrors FFS); open a bar for that state's ranked market.

Billed → allowed → paid
Named-group submitted charges
$28K
Named-group allowed amount
$6K
Named-group Medicare payments
$10K · est.
— $5K observed FFS
Avg charge / svc
$175
Avg allowed / svc
$40
Avg payment / svc
$31
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
$40 7 groups · avg submitted charge / service $342
Market analyticsPlatform Methods →

Search a single state to see that market's full analytics — each panel renders gated on the free tier.

See it in full: nuclear heart imaging (78452) in Arizona is open as a live example — every paid panel, on real data.

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Data year: CY2024 CY2023 CY2022  CY2021  CY2020 
# Physician group City St Specialty Providers 94452 svcs Submitted charges Avg charge Medicare $ Share of state* Phone
1 MAYO CLINIC ARIZONA PHOENIX AZ PHYSICIAN ASSISTANT 1635 43 $10,750 $250 65.2% (800) 603-0558
2 SCRIPPS HEALTH LA JOLLA CA PHYSICIAN ASSISTANT 1431 39 $6,668 $171 60.9% (858) 455-9100
3 SJHMC PHYSICIAN SERVICES PHOENIX AZ NURSE PRACTITIONER 690 23 $920 $40 34.8% (602) 406-6017
4 CLEVELAND CLINIC CLEVELAND OH PHYSICIAN ASSISTANT 6828 15 $1,980 $132 100.0% —
5 SANSUM CLINIC SANTA BARBARA CA INTERNAL MEDICINE 322 14 $2,044 $146 21.9% (805) 681-7500
That's the top 5 of 7 groups. The platform ranks the whole market — code baskets, benchmarks, and the full ranked list. the full ranking is part of the market analytics platform — built, not launched yet. Notify me at launch →

*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 — and the observed foundation every market figure here builds on. Market totals anchor on a labeled all-Medicare estimate scaled from that foundation, with the observed count disclosed beside it — Medicare only, never all-payer. Modeled all-payer databases project every payer statistically and typically run higher. Same market, different denominator. How the numbers reconcile →