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

96004 Physician review of gait analysis test CPT · Neurologic test

Classification Test › Neurologic (CMS RBCS)

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

National scale 1,721 services ▲ 6.3% YoY · 1,522 beneficiaries (CY2024, Medicare FFS)

Medicare paid $145K · $84.12 avg / service, national

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

Billing groups

Named-group FFS services

1,369

FFS of Medicare

49%

Services YoY

+6.3%

FFS enrollment -2.2%

Estimated all-Medicare volume FFS + estimated MA estimate

~2,844 services

1,369 observed fee-for-service (48%) · ~1,475 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 — 96004 (CY2024)

NY 366 FL 279 CA 239 MN 195 AZ 182

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

Named-group submitted charges

$644K

Named-group allowed amount

$151K

Named-group Medicare payments

$116K

Avg charge / svc

$471

Avg allowed / svc

$110

Avg payment / svc

$85

Average charge per group

$130–213

$213–296

$296–379

$379–462

$462–545

$545–628

$628–711

$711+

$130 14 groups · avg submitted charge / service $962

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 96004 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	96004 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	NEW YORK UNIVERSITY	NEW YORK	NY	DIAGNOSTIC RADIOLOGY	5704	366	$257,664	$704	premium	100.0%	(212) 263-9700
2	MAYO CLINIC	ROCHESTER	MN	NURSE PRACTITIONER	4896	195	$108,323	$556	premium	100.0%	(507) 284-2511
3	RAINEY PAIN AND PERFORMANCE PC	SIERRA VISTA	AZ	PHYSICAL THERAPIST IN PRIVATE PRACTICE	8	138	$17,940	$130	premium	75.8%	(520) 459-1386
4	UNIVERSITY HEALTH SYSTEM, INC.	KNOXVILLE	FL	NURSE PRACTITIONER	561	112	$107,744	$962	premium	40.1%	(865) 305-6333
5	LAKE AREA PHYSICAL THERAPY INC.	MELROSE	FL	ORTHOPEDIC SURGERY	365	108	$17,258	$160	premium	38.7%	—
6	PREMIER PODIATRY, L.L.C.	CLIFTON	NJ	PODIATRY	2	72	$10,800	$150	premium	100.0%	(973) 315-5555
7	FOOT CARE CENTER LLC	BILLINGS	WY	PODIATRY	5	58	$12,760	$220	premium	100.0%	(406) 206-1600
8	FOOT CARE CENTER LLC	BILLINGS	MT	PODIATRY	5	53	$11,660	$220	premium	76.8%	(406) 206-1600
9	THE EMORY CLINIC INC	ATLANTA	WV	NURSE PRACTITIONER	3484	52	$24,337	$468	premium	100.0%	(404) 778-7525
10	FOOT CARE CENTER LLC	BILLINGS	CO	PODIATRY	5	46	$10,120	$220	premium	100.0%	(406) 206-1600
11	MAYO CLINIC ARIZONA	PHOENIX	AZ	PHYSICIAN ASSISTANT	1635	44	$21,560	$490	premium	24.2%	(800) 603-0558
12	THE EMORY CLINIC INC	ATLANTA	GA	NURSE PRACTITIONER	3484	29	$13,595	$469	premium	50.9%	(404) 778-7525
13	STANFORD HEALTH CARE	STANFORD	CA	DIAGNOSTIC RADIOLOGY	3039	22	$14,014	$637	premium	9.2%	(650) 723-4000
14	LA MEDICAL CLINIC INC	GLENDALE	CA	GENERAL PRACTICE	3	21	$3,150	$150	premium	8.8%	(818) 696-2156
15	EINSTEIN PRACTICE PLAN INC	PHILADELPHIA	PA	DIAGNOSTIC RADIOLOGY	740	20	$5,800	$290	premium	100.0%	(215) 456-8242
16	ILLINOIS BONE AND JOINT INSTITUTE, LLC	BANNOCKBURN	IL	ORTHOPEDIC SURGERY	595	18	$4,734	$263	premium	100.0%	—
17	DANIEL J HUFF PODIATRY DPM PC	PROVIDENCE	UT	PODIATRY	5	15	$2,970	$198	premium	100.0%	(435) 787-1023

*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 →