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Market snapshot

Nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS
G0475 Hiv antigen/antibody, combination assay, screening HCPCS · General Laboratory test
Classification Test General Laboratory Immunoassay (CMS RBCS)
First observed 2015
National scale 21,777 services ▼ 1.7% YoY · 21,765 beneficiaries (CY2024, Medicare FFS)
Medicare paid $513K · $23.57 avg / service, national
CMS descriptor · RBCS classification · Medicare Part B physician/supplier claims, 12-year window
Billing groups
4
Named-group FFS services
164
FFS of Medicare
49%
Services YoY
-1.7%
FFS enrollment -2.2%
Estimated all-Medicare volume FFS + estimated MA estimate
~308 services

164 observed fee-for-service (53%) · ~144 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 — G0475 (CY2024)

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

Named-group submitted charges
$8K
Named-group allowed amount
$4K
Named-group Medicare payments
$4K
Avg charge / svc
$46
Avg allowed / svc
$24
Avg payment / svc
$24
Average charge per group
$25 4 groups · avg submitted charge / service $51
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Data year: CY2024 CY2023 CY2022 locked column CY2021 locked column CY2020 locked column
Physician groups ranked by G0475 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 G0475 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 MCFARLAND CLINIC PC AMES IA PHYSICIAN ASSISTANT 352 64 $3,250 $51 premium 100.0% (515) 239-4400
2 RONALD N SKUFCA DO PA DALLAS TX FAMILY PRACTICE 3 42 $2,058 $49 premium 1.9% (214) 826-2151
3 ST MARYS PHYSICIAN SERVICES LLC RUSSELLVILLE AR NURSE PRACTITIONER 48 33 $1,589 $48 premium 100.0% (479) 968-2345
4 BETHANY MEDICAL CENTER HIGH POINT NC PHYSICIAN ASSISTANT 63 25 $625 $25 premium 1.0% (336) 883-0029

*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 →