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

95801 Sleep study including heart rate and breathing CPT · Neurologic test

Classification Test › Neurologic › Sleep Study (CMS RBCS)

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

National scale 240 services ▲ 20.6% YoY · 230 beneficiaries (CY2024, Medicare FFS)

Medicare paid $8K · $34.21 avg / service, national

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

Billing groups

Named-group FFS services

117

FFS of Medicare

49%

Services YoY

+20.6%

FFS enrollment -2.2%

Estimated all-Medicare volume FFS + estimated MA estimate

~225 services

117 observed fee-for-service (52%) · ~108 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 — 95801 (CY2024)

CA 89 GA 53 IA 28 TX 26 AZ 21

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

Named-group submitted charges

$24K

Named-group allowed amount

$5K

Named-group Medicare payments

$3K

Avg charge / svc

$208

Avg allowed / svc

$41

Avg payment / svc

$29

Average charge per group

$109–125

$125–140

$140–156

$156–171

$171–187

$187–202

$202–218

$218+

$109 2 groups · avg submitted charge / service $240

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.

View the live example →

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 95801 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	95801 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	THE REGENTS OF THE UNIVERSITY OF CALIFORNIA	LOS ANGELES	CA	INTERNAL MEDICINE	1424	89	$21,324	$240	premium	100.0%	(310) 825-7922
2	TRINITY MEDICAL CENTER	BETTENDORF	IA	NURSE PRACTITIONER	97	28	$3,052	$109	premium	100.0%	(563) 742-3180

*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 →