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

95070 Test for allergy using drugs CPT · Test - Miscellaneous

Classification Test › Test - Miscellaneous (CMS RBCS)

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

National scale 1,029 services ▲ 5.5% YoY · 1,020 beneficiaries (CY2024, Medicare FFS)

Medicare paid $27K · $26.71 avg / service, national

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

Billing groups

Named-group FFS services

368

FFS of Medicare

49%

Services YoY

+5.5%

FFS enrollment -2.2%

Estimated all-Medicare volume FFS + estimated MA estimate

~767 services

368 observed fee-for-service (48%) · ~399 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 — 95070 (CY2024)

MN 492 TN 99 AZ 84 NC 74 VA 62

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

Named-group submitted charges

$83K

Named-group allowed amount

$12K

Named-group Medicare payments

$9K

Avg charge / svc

$225

Avg allowed / svc

$32

Avg payment / svc

$25

Average charge per group

$72–112

$112–153

$153–194

$194–234

$234–275

$275–315

$315–356

$356+

$72 13 groups · avg submitted charge / service $424

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 95070 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	95070 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	MAYO CLINIC ARIZONA	PHOENIX	AZ	PHYSICIAN ASSISTANT	1635	84	$30,996	$369	premium	100.0%	(800) 603-0558
2	THE PULMONARY AND SLEEP CONSULTANTS LLC	JEFFERSON CITY	TN	NURSE PRACTITIONER	3	64	$8,832	$138	premium	64.6%	(865) 471-2573
3	MAYO CLINIC JACKSONVILLE	JACKSONVILLE	FL	NURSE PRACTITIONER	1587	45	$17,010	$378	premium	78.9%	(904) 953-2000
4	HH PHYSICIANS NETWORK	HUNTSVILLE	AL	PULMONARY DISEASE	105	36	$2,664	$74	premium	100.0%	(256) 265-8553
5	NORMAN REGIONAL PROVIDERS SPECIALTY CARE	NORMAN	OK	NURSE PRACTITIONER	162	22	$4,126	$188	premium	100.0%	(405) 307-5700
6	STATCARE OUTPATIENT LLC	KNOXVILLE	TN	PULMONARY DISEASE	41	19	$1,501	$79	premium	19.2%	—
7	SOUTHEAST LUNG AND CRITICAL CARE SPECIALISTS PC	SAVANNAH	GA	PULMONARY DISEASE	23	17	$1,286	$76	premium	100.0%	(912) 629-2290
8	GRANGER MEDICAL CLINIC PC	WEST VALLEY CITY	UT	PHYSICIAN ASSISTANT	193	15	$2,475	$165	premium	100.0%	(801) 965-3600
9	NORTH SHORE-LIJ MEDICAL PC	MANHASSET	NY	PHYSICIAN ASSISTANT	6294	15	$6,360	$424	premium	100.0%	—
10	PULMONARY AND CRITICAL CARE ASSOCIATES, P.C.	LEESBURG	VA	PULMONARY DISEASE	5	15	$3,000	$200	premium	24.2%	(703) 858-9693
11	EL PASO PULMONARY ASSOCIATION	EL PASO	TX	PULMONARY DISEASE	15	13	$935	$72	premium	39.4%	(915) 532-2477
12	CENTRAL DUPAGE PHYSICIAN GROUP	WHEATON	IL	PHYSICIAN ASSISTANT	1097	12	$2,318	$193	premium	100.0%	(630) 933-4800
13	SCRIPPS HEALTH	LA JOLLA	CA	PHYSICIAN ASSISTANT	1431	11	$1,379	$125	premium	100.0%	(858) 455-9100

*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 →