Medicare procedure market data by CPT code & state

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Market snapshot

J9271 nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS

J9271 — Injection, pembrolizumab, 1 mg

Billing groups

262

Named-group FFS services

24,302,922

FFS of Medicare

49%

Services YoY

+4.2%

FFS enrollment -2.2%

Estimated all-Medicare volume FFS + estimated MA estimate

~48,613,002 services

24,302,922 observed fee-for-service (50%) · ~24,310,080 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; 1 state without payer-mix data excluded. How we scale

Top states — J9271 (CY2024)

FL 3,896,166 TX 2,835,551 CA 2,503,592 IL 1,469,521 VA 1,452,007

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

Named-group submitted charges

$3.3B

Named-group allowed amount

$1.3B

Named-group Medicare payments

$1.1B

Avg charge / svc

$138

Avg allowed / svc

$55

Avg payment / svc

$44

Average charge per group

$0–25

$25–50

$50–75

$75–100

$100–125

$125–150

$150–174

$174+

$0 262 groups · avg submitted charge / service $293

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 exact payer split, and this market total scaled to all of Medicare, labeled as an estimate.

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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Specialty market — Hematology: 27,200 services — specialty benchmark suppressed (fewer than 11 groups) — showing state benchmark. See Hematology across all states →

Data year: CY2024 CY2023 CY2022 🔒 CY2021 🔒 CY2020 🔒

Physician groups ranked by J9271 services, CY2024
#	Physician group	City	St	Specialty	Providers	J9271 svcs	Submitted charges	Avg charge	Medicare $ locked column	Share of specialty*	Share of state*	Phone
1	STOCKTON HEMATOLOGY ONCOLOGY MEDICAL GROUP INC	STOCKTON	CA	HEMATOLOGY	9	27,200	$3,768,356	$139	premium	—	1.1%	—

*"Share of specialty" is the group's share of disclosed Medicare-FFS services for the primary code among groups with the SAME modal specialty in the state; "share of state" is the same figure against the whole state. Specialty is each group's modal member specialty from CMS's clinician register — a multi-specialty group carries one label. Where fewer than 11 groups share the specialty in the state, the specialty share renders "—" — the specialty benchmark is suppressed (fewer than 11 groups) and the state share alongside is the benchmark. Group figures sum clinicians affiliated with exactly one group. 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 →