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Market snapshot

J9271 in VA CY2024

Medicare Part B FFS · CY2024 · as published by CMS

J9271 — Injection, pembrolizumab, 1 mg

Billing groups
7
Named-group FFS services
1,276,457
FFS of Medicare
61%
Services YoY
-8.0%
FFS enrollment -1.7%
Estimated all-Medicare volume FFS + estimated MA estimate
~2,062,537 services

1,276,457 observed fee-for-service (62%) · ~786,080 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. How we scale

Named-group submitted charges
$183.7M
Named-group allowed amount
$70.8M
Named-group Medicare payments
$56.4M
Avg charge / svc
$144
Avg allowed / svc
$55
Avg payment / svc
$44
Average charge per group
$112 7 groups · avg submitted charge / service $157
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Data year: CY2024 CY2023 CY2022 🔒 CY2021 🔒 CY2020 🔒
Physician groups ranked by J9271 services, CY2024
#Physician group City Specialty Providers J9271 svcs Submitted charges Avg charge Medicare $ locked column Share* Phone
1 VIRGINIA ONCOLOGY ASSOCIATES NORFOLK PHYSICIAN ASSISTANT 123 560,300 $85,326,600 $152 premium 38.6%
2 VIRGINIA CANCER INSTITUTE INCORPORATED NORTH CHESTERFIELD HEMATOLOGY/ONCOLOGY 50 234,006 $26,228,706 $112 premium 16.1% (804) 330-7990
3 ONCOLOGY AND HEMATOLOGY ASSOCIATES OF SOUTHWEST VIRGINIA INC ROANOKE NURSE PRACTITIONER 52 203,100 $30,939,600 $152 premium 14.0% (540) 982-0237
4 VIRGINIA CANCER SPECIALISTS, P.C. FAIRFAX HEMATOLOGY/ONCOLOGY 76 143,700 $21,883,800 $152 premium 9.9% (703) 280-5390
5 SHENANDOAH ONCOLOGY PC WINCHESTER NURSE PRACTITIONER 22 101,551 $14,318,550 $141 premium 7.0% (540) 662-1108
6 AMERICAN ONCOLOGY PARTNERS PA FORT WAYNE HEMATOLOGY/ONCOLOGY 333 24,000 $3,768,000 $157 premium 1.7% (260) 484-8830
7 MARYLAND ONCOLOGY HEMATOLOGY PA LAUREL HEMATOLOGY/ONCOLOGY 99 9,800 $1,234,800 $126 premium 0.7% (301) 982-9800

*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 →