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

94625 Professional services for outpatient pulmonary rehabilitation, per session CPT · Treatment - Miscellaneous

Classification Treatment › Treatment - Miscellaneous (CMS RBCS)

First observed 2022

National scale 26,901 services ▼ 39.5% YoY · 1,580 beneficiaries (CY2024, Medicare FFS)

Medicare paid $1.6M · $60.31 avg / service, national

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

Billing groups

Named-group FFS services

5,175

FFS of Medicare

49%

Services YoY

-39.5%

FFS enrollment -2.2%

Estimated all-Medicare volume FFS + estimated MA estimate

~10,607 services

5,175 observed fee-for-service (49%) · ~5,432 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 — 94625 (CY2024)

MD 15,334 TX 2,979 IL 2,145 NY 1,439 CA 1,125

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

Named-group submitted charges

$1.5M

Named-group allowed amount

$362K

Named-group Medicare payments

$281K

Avg charge / svc

$284

Avg allowed / svc

$70

Avg payment / svc

$54

Average charge per group

$66–126

$126–186

$186–246

$246–306

$306–366

$366–426

$426–486

$486+

$66 13 groups · avg submitted charge / service $764

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.

Or just look at it: nuclear heart imaging (78452) in Arizona is open as a live example — the full paid view, real data.

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Nevvi's market analytics platform — code baskets, market structure and share, the twelve-year trend layer — is built and not launched yet. We're gathering interest in it.

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Data year: CY2024 CY2023 CY2022 CY2021 CY2020

Physician groups ranked by 94625 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	94625 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	EISENHOWER MEDICAL CENTER	RANCHO MIRAGE	CA	NURSE PRACTITIONER	457	936	$714,972	$764	premium	83.2%	(760) 340-3911
2	NEW HEART, INC	ALBUQUERQUE	NM	CARDIAC ELECTROPHYSIOLOGY	2	726	$47,588	$66	premium	100.0%	(505) 881-8195
3	ORLANDO HEALTH MEDICAL GROUP INC	ORLANDO	FL	PHYSICIAN ASSISTANT	2145	717	$121,890	$170	premium	80.0%	(407) 896-1100
4	CONSENSUS MEDICAL GROUP LLC	JERSEY CITY	NJ	PHYSICIAN ASSISTANT	144	563	$92,895	$165	premium	92.4%	(201) 464-8888
5	NORTH SHORE-LIJ MEDICAL PC	MANHASSET	NY	PHYSICIAN ASSISTANT	6294	445	$162,870	$366	premium	30.9%	—
6	SCOTT AND WHITE CLINIC	TEMPLE	TX	PHYSICIAN ASSISTANT	2435	374	$27,302	$73	premium	12.6%	(254) 724-2663
7	MAYO CLINIC ARIZONA	PHOENIX	AZ	PHYSICIAN ASSISTANT	1635	256	$60,160	$235	premium	100.0%	(800) 603-0558
8	NUVOAIR MEDICAL PC	TUCSON	CO	NURSE PRACTITIONER	18	256	$22,331	$87	premium	100.0%	(833) 688-6247
9	TEMPLE FACULTY PRACTICE PLAN INC	PHILADELPHIA	PA	PHYSICIAN ASSISTANT	1330	232	$51,040	$220	premium	58.7%	—
10	INDIGO PARTNERS LLC	MUNSTER	IN	FAMILY PRACTICE	4	229	$20,610	$90	premium	100.0%	(219) 267-1799
11	NEW YORK UNIVERSITY	NEW YORK	NY	DIAGNOSTIC RADIOLOGY	5704	226	$90,400	$400	premium	15.7%	(212) 263-9700
12	CLEVELAND CLINIC FLORIDA	WESTON	FL	NURSE PRACTITIONER	720	179	$53,342	$298	premium	20.0%	(954) 659-5000
13	SOUTHEAST LUNG AND CRITICAL CARE SPECIALISTS PC	SAVANNAH	GA	PULMONARY DISEASE	23	36	$3,312	$92	premium	23.7%	(912) 629-2290

*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 →