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

94680 Test to measure exhaled air for evaluation of lung function during rest and exercise CPT · Pulmonary test

Classification Test › Pulmonary (CMS RBCS)

First observed 2013 — start of our 12-year window; the code predates it

National scale 1,553 services ▼ 18.2% YoY · 1,535 beneficiaries (CY2024, Medicare FFS)

Medicare paid $54K · $34.92 avg / service, national

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

Billing groups

Named-group FFS services

692

FFS of Medicare

49%

Services YoY

-18.2%

FFS enrollment -2.2%

Estimated all-Medicare volume FFS + estimated MA estimate

~1,505 services

692 observed fee-for-service (46%) · ~813 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 — 94680 (CY2024)

FL 1,045 TN 128 CA 88 CO 88 AL 70

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

Named-group submitted charges

$78K

Named-group allowed amount

$28K

Named-group Medicare payments

$22K

Avg charge / svc

$113

Avg allowed / svc

$41

Avg payment / svc

$31

Average charge per group

$18–40

$40–62

$62–84

$84–106

$106–128

$128–150

$150–172

$172+

$18 12 groups · avg submitted charge / service $205

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 94680 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	94680 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	CISCA PULMONARY CRITICAL CARE INC	JACKSONVILLE	FL	PHYSICIAN ASSISTANT	3	226	$25,470	$113	premium	21.6%	(904) 396-0300
2	STATE OF FRANKLIN HEALTHCARE ASSOCIATES, PLLC	JOHNSON CITY	TN	NURSE PRACTITIONER	279	128	$15,546	$121	premium	100.0%	(423) 926-8181
3	UNIVERSITY PHYSICIANS INCORPORATED	AURORA	CO	PHYSICIAN ASSISTANT	3122	88	$18,040	$205	premium	100.0%	(720) 777-1234
4	ARTHUR F GELB MEDICAL CORP	LAKEWOOD	CA	PULMONARY DISEASE	3	73	$5,840	$80	premium	83.0%	(562) 633-2204
5	NORTHEAST FLORIDA LUNG CLINIC	JACKSONVILLE	FL	INTERNAL MEDICINE	3	43	$3,702	$86	premium	4.1%	(904) 853-6154
6	UNIVERSITY OF PENN - MEDICAL GROUP	PHILADELPHIA	PA	PHYSICIAN ASSISTANT	3505	42	$2,940	$70	premium	100.0%	(215) 662-2777
7	REGIONAL HEALTH MANAGEMENT CORPORATION	ANNISTON	AL	FAMILY PRACTICE	28	24	$432	$18	premium	34.3%	(256) 235-5015
8	UNIVERSITY OF UTAH ADULT SERVICES	SALT LAKE CITY	MI	PHYSICIAN ASSISTANT	1783	16	$480	$30	premium	100.0%	(801) 581-2121
9	CEDARS-SINAI MEDICAL CENTER	WEST HOLLYWOOD	CA	NURSE PRACTITIONER	802	15	$648	$43	premium	17.0%	(310) 423-3277
10	TAMPA LUNG SPECIALISTS, P.A.	TAMPA	FL	CRITICAL CARE (INTENSIVISTS)	16	14	$1,232	$88	premium	1.3%	(813) 879-3699
11	IOWA PHYSICIANS CLINIC MEDICAL FOUNDATION	BETTENDORF	IA	NURSE PRACTITIONER	1202	12	$1,611	$134	premium	100.0%	—
12	RIVERSIDE HEALTH SYSTEM	KANKAKEE	IL	NURSE PRACTITIONER	211	11	$2,024	$184	premium	100.0%	(815) 936-3240

*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 →