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Market snapshot

Nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS
J9280 Injection, mitomycin, 5 mg HCPCS · Chemotherapy treatment
Classification Treatment Chemotherapy Chemotherapeutic Agent (CMS RBCS)
First observed 2013 — start of our 12-year window; the code predates it
National scale 7,417 services ▲ 26.7% YoY · 860 beneficiaries (CY2024, Medicare FFS)
Medicare paid $327K · $44.13 avg / service, national
CMS descriptor · RBCS classification · Medicare Part B physician/supplier claims, 12-year window
Billing groups
9
Named-group FFS services
3,124
FFS of Medicare
49%
Services YoY
+26.7%
FFS enrollment -2.2%
Estimated all-Medicare volume FFS + estimated MA estimate
~5,758 services

3,124 observed fee-for-service (54%) · ~2,634 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 — J9280 (CY2024)

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

Named-group submitted charges
$676K
Named-group allowed amount
$170K
Named-group Medicare payments
$135K
Avg charge / svc
$216
Avg allowed / svc
$54
Avg payment / svc
$43
Average charge per group
$115 9 groups · avg submitted charge / service $318
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Data year: CY2024 CY2023 CY2022 locked column CY2021 locked column CY2020 locked column
Physician groups ranked by J9280 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 J9280 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 PIERRE MENDOZA MD LLC TOMS RIVER NJ PATHOLOGY 3 857 $171,400 $200 premium 96.4% (732) 230-2611
2 UROLOGY OF VIRGINIA, PLLC VIRGINIA BEACH VA PHYSICIAN ASSISTANT 75 680 $78,200 $115 premium 100.0% (757) 452-3599
3 AHS OKLAHOMA PHYSICIAN GROUP LLC TULSA OK FAMILY PRACTICE 308 536 $118,456 $221 premium 82.7%
4 VITALMD GROUP HOLDING LLC MIAMI FL OBSTETRICS/GYNECOLOGY 531 352 $111,936 $318 premium 12.6% (305) 273-4641
5 SMH PHYSICIAN SERVICES INC SARASOTA FL PHYSICIAN ASSISTANT 766 304 $91,200 $300 premium 10.9%
6 PRECISION HEALTHCARE SPECIALISTS, LLC FORT MYERS FL PHYSICIAN ASSISTANT 100 256 $66,755 $261 premium 9.2% (239) 291-6970
7 NORMAN UROLOGY ASSOCIATES PC NORMAN OK PHYSICIAN ASSISTANT 10 112 $31,536 $282 premium 17.3% (405) 360-9966
8 DAVID B KAYE MD INC FRESNO CA OPHTHALMOLOGY 6 16 $4,000 $250 premium 100.0% (559) 432-1000
9 PINNACLE EYE CENTER INC MELBOURNE FL OPHTHALMOLOGY 3 11 $2,101 $191 premium 0.4% (321) 255-4949

*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 →