Medicare procedure market data by CPT code & state

Market snapshot

Nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS

P9603 Travel allowance one way in connection with medically necessary laboratory specimen collection drawn from home bound or nursing home bound patient; prorated miles actually travelled HCPCS · General Laboratory test

Classification Test › General Laboratory (CMS RBCS)

First observed 2013 — start of our 12-year window; the code predates it

National scale 49.47M services ▲ 6.9% YoY · 646,028 beneficiaries (CY2024, Medicare FFS)

Medicare paid $53.3M · $1.08 avg / service, national

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

Billing groups

Named-group FFS services

46,300

FFS of Medicare

49%

Services YoY

+6.9%

FFS enrollment -2.2%

Estimated all-Medicare volume FFS + estimated MA estimate

~98,493 services

46,300 observed fee-for-service (47%) · ~52,193 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 — P9603 (CY2024)

FL 12,769,237 IL 7,420,754 OH 3,614,304 CA 3,025,867 NJ 2,888,573

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

Named-group submitted charges

$68K

Named-group allowed amount

$51K

Named-group Medicare payments

$51K

Avg charge / svc

Avg allowed / svc

Avg payment / svc

Average charge per group

$1–2

$2–3

$3–4

$4–6

$6–7

$7–8

$8–9

$9+

$1 14 groups · avg submitted charge / service $20

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 P9603 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	P9603 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	M3C	KNOXVILLE	TN	NURSE PRACTITIONER	6	21,516	$32,563	$2	premium	7.2%	(865) 298-1500
2	ASSOCIATED CLINICIANS OF EAST TEXAS	LONGVIEW	TX	PHYSICIAN ASSISTANT	107	18,594	$21,011	$1	premium	0.8%	—
3	MARQUIS CLINICAL SERVICES LLC	MILWAUKIE	OR	NURSE PRACTITIONER	23	1,488	$1,742	$1	premium	6.4%	(971) 206-5164
4	MAYO CLINIC	ROCHESTER	MN	NURSE PRACTITIONER	4896	1,478	$6,534	$4	premium	100.0%	(507) 284-2511
5	PINE PARK HEALTH, INC	BERKELEY	CA	NURSE PRACTITIONER	23	982	$1,110	$1	premium	0.0%	(510) 929-1400
6	URGENT CARE NEVADA LLC	LAS VEGAS	NV	PHYSICIAN ASSISTANT	101	387	$437	$1	premium	0.0%	(702) 901-8320
7	THE VANCOUVER CLINIC INC PS	VANCOUVER	WA	PHYSICIAN ASSISTANT	574	372	$558	$2	premium	1.4%	(360) 882-2778
8	WK MOLLER CASSIERE CLINIC	SHREVEPORT	LA	INTERNAL MEDICINE	10	329	$372	$1	premium	0.0%	(318) 212-3456
9	PRIVIA MEDICAL GROUP WASHINGTON PLLC	WALLA WALLA	WA	NURSE PRACTITIONER	73	311	$466	$2	premium	1.2%	50952537201405
10	FRANCISCAN MEDICAL GROUP	TACOMA	WA	PHYSICIAN ASSISTANT	1407	309	$464	$2	premium	1.2%	(253) 428-2200
11	PROLIANCE SURGEONS INC P S	ISSAQUAH	WA	PHYSICIAN ASSISTANT	395	243	$364	$2	premium	0.9%	(425) 313-5422
12	NOVARI PRIMARY CARE LLC	MUKILTEO	WA	NURSE PRACTITIONER	20	104	$156	$2	premium	0.4%	(425) 405-8089
13	UNITED ELITE HOSPITALISTS LLC	PALOS HEIGHTS	IL	INTERNAL MEDICINE	25	96	$1,939	$20	premium	0.0%	(708) 587-0000
14	CURA HEALTHCARE	ALBUQUERQUE	WA	NURSE PRACTITIONER	80	91	$136	$2	premium	0.4%	(505) 413-3719

*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 →