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

94617 Test for exercise-induced spasm of lung airways CPT · Pulmonary test

Classification Test › Pulmonary (CMS RBCS)

First observed 2018

National scale 5,647 services ▼ 3.2% YoY · 3,680 beneficiaries (CY2024, Medicare FFS)

Medicare paid $320K · $56.70 avg / service, national

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

Billing groups

Named-group FFS services

1,276

FFS of Medicare

49%

Services YoY

-3.2%

FFS enrollment -2.2%

Estimated all-Medicare volume FFS + estimated MA estimate

~2,756 services

1,276 observed fee-for-service (46%) · ~1,480 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 — 94617 (CY2024)

FL 2,798 NY 989 CA 542 NC 330 IL 237

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

Named-group submitted charges

$245K

Named-group allowed amount

$101K

Named-group Medicare payments

$78K

Avg charge / svc

$192

Avg allowed / svc

$79

Avg payment / svc

$61

Average charge per group

$32–59

$59–87

$87–114

$114–141

$141–168

$168–196

$196–223

$223+

$32 11 groups · avg submitted charge / service $300

Market analyticsPlatform

a taste of the twelve-year trend layer

Market position — where this market sits on volume and growth among all state markets, and its rank.
Worth a look — every state market for this search, ranked by a published score: size, growth, fragmentation, below-expected volume.
Lookalike opportunities — groups billing below what peers of the same specialty, size, and state predict, with the expected figure shown.
National benchmarks — where each group's volume sits nationally and within its specialty.
Market structure — how concentrated this market is, and who owns the volume.
Medicare-wide scaling — the payer split, and this market total scaled to all of Medicare, labeled as an estimate.

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Data year: CY2024 CY2023 CY2022 CY2021 CY2020

Physician groups ranked by 94617 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	94617 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	PRIME PULMONARY AND SLEEP MEDICINE CENTER INC	BAKERSFIELD	CA	NURSE PRACTITIONER	6	486	$145,800	$300	premium	89.7%	(661) 599-2934
2	SERGIO L BALINGIT JR MD PA	THE VILLAGES	FL	NURSE PRACTITIONER	2	335	$50,250	$150	premium	12.0%	(352) 751-0448
3	ALABAMA INSTITUTE FOR SLEEP HEALTH LLC	CULLMAN	AL	NURSE PRACTITIONER	7	104	$13,000	$125	premium	61.5%	(256) 739-7050
4	HMV DIAGNOSTICS INC	HOLIDAY	VA	NURSE PRACTITIONER	21	70	$6,090	$87	premium	56.9%	(877) 202-1191
5	ARJUN D. ANEJA, M.D., LLC	ORMOND BEACH	FL	PULMONARY DISEASE	3	66	$2,125	$32	premium	2.4%	(386) 672-6356
6	CULLMAN INTERNAL MEDICINE, PC	CULLMAN	AL	NURSE PRACTITIONER	30	65	$9,360	$144	premium	38.5%	(256) 737-2100
7	TRIHEALTH H LLC	CINCINNATI	OH	OBSTETRICS/GYNECOLOGY	853	39	$7,800	$200	premium	100.0%	(513) 246-7000
8	HMV DIAGNOSTICS INC	HOLIDAY	TX	NURSE PRACTITIONER	21	36	$3,132	$87	premium	41.9%	(877) 202-1191
9	PULMONARY PHYSICIANS OF NORWICH PC	PLAINFIELD	CT	PULMONARY DISEASE	9	28	$2,800	$100	premium	32.9%	(860) 886-1862
10	SAADAH ALRAJAB MD MPH INC	FULLERTON	CA	CRITICAL CARE (INTENSIVISTS)	3	17	$2,650	$156	premium	3.1%	(714) 481-0172
11	NUVOAIR MEDICAL PC	TUCSON	AZ	NURSE PRACTITIONER	18	15	$934	$62	premium	100.0%	(833) 688-6247
12	MAINLAND PULMONARY ASSOCIATES PLLC	TEXAS CITY	TX	PULMONARY DISEASE	3	15	$1,380	$92	premium	17.4%	(409) 935-2995

*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 →