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

J9999 Not otherwise classified, antineoplastic drugs 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 1,894 services ▲ 12.7% YoY · 824 beneficiaries (CY2024, Medicare FFS)

Medicare paid $81K · $42.95 avg / service, national

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

Billing groups

Named-group FFS services

1,534

FFS of Medicare

49%

Services YoY

+12.7%

FFS enrollment -2.2%

Estimated all-Medicare volume FFS + estimated MA estimate

~3,305 services

1,534 observed fee-for-service (46%) · ~1,771 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 — J9999 (CY2024)

FL 1,250 NM 377 CA 238 KS 29

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

Named-group submitted charges

$212K

Named-group allowed amount

$73K

Named-group Medicare payments

$58K

Avg charge / svc

$138

Avg allowed / svc

$48

Avg payment / svc

$38

Average charge per group

$0–47

$47–94

$94–141

$141–188

$188–234

$234–281

$281–328

$328–375

$0 12 groups · avg submitted charge / service $375

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.

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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 J9999 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	J9999 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	CANCER/BLOOD AND MEDICINE CLINIC LLC	EL PASO	NM	HEMATOLOGY/ONCOLOGY	3	377	$22,230	$59	premium	100.0%	(575) 650-3335
2	RETINA MACULA SPECIALISTS OF MIAMI LLC	PLANTATION	FL	OPHTHALMOLOGY	23	332	$62,670	$189	premium	26.6%	(954) 452-9922
3	SANT P CHAWLA M D INC	SANTA MONICA	CA	HEMATOLOGY	4	238	$2	$0	premium	100.0%	(310) 552-9999
4	ST LUKES CATARACT AND LASER INSTITUTE	TARPON SPRINGS	FL	CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA)	48	230	$86,250	$375	premium	18.4%	(727) 943-3111
5	JONATHAN M FRANTZ, MD PA	FORT MYERS	FL	PHYSICIAN ASSISTANT	25	114	$10,260	$90	premium	9.1%	—
6	ATLANTIC EYE INSTITUTE, P.A.	JACKSONVILLE	FL	OPHTHALMOLOGY	10	104	$10,400	$100	premium	8.3%	(904) 241-7865
7	SOUTH FLORIDA RETINA INSTITUTE PLLC	MIAMI	FL	OPHTHALMOLOGY	2	29	$5,800	$200	premium	2.3%	(786) 590-1777
8	SALINA REGIONAL HEALTH CENTER INC	SALINA	KS	NURSE PRACTITIONER	160	29	$35	$1	premium	100.0%	—
9	JULIA NEMIROFF, MD PLLC	PALM BEACH GARDENS	FL	OPHTHALMOLOGY	2	23	$3,150	$137	premium	1.8%	(561) 331-1797
10	ST MICHAELS EYE AND LASER INSTITUTE INC	LARGO	FL	OPHTHALMOLOGY	5	22	$1,980	$90	premium	1.8%	(727) 585-2200
11	RETINA VITREOUS CONSULTANTS	FT LAUDERDALE	FL	OPHTHALMOLOGY	44	19	$2,850	$150	premium	1.5%	(954) 776-6880
12	ST LUKES AT THE VILLAGES PA	THE VILLAGES	FL	CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA)	17	17	$6,375	$375	premium	1.4%	(352) 350-8484

*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 →