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Market snapshot

Nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS
86386 Protein test for diagnosis and monitoring of bladder cancer CPT · General Laboratory test
Classification Test General Laboratory Immunoassay (CMS RBCS)
First observed 2013 — start of our 12-year window; the code predates it
National scale 3,743 services · est. ▼ 5.7% YoY · 1,414 FFS beneficiaries (CY2024, all-Medicare estimate) — 1,867 observed fee-for-service services
CMS descriptor · RBCS classification · Medicare Part B physician/supplier claims, 12-year window
Data year CY2024 CY2023 CY2022 locked column CY2021 locked column CY2020 locked column
Market overview
Market Brief 86386
The whole of 86386, written up and sourced.

The Brief is a national document for 86386. Its findings page carries one finding per chapter, each opening the chapter that prints its figure and the table behind it — like these, from the United States, CY2024, the market on this page.

  1. 1Size and growth. The national market for 86386 ran ~3,743 all-Medicare services (estimated), 1,867 observed fee-for-service in CY2024. The market is down 5.7% year over year. 6 billing groups and 14 clinicians bill it.
  2. 2Payment. Half the field lists between $53 and $78 per service; the median group lists $63. Submitted charges are provider-set list amounts, not payments.
  3. 3Geography. FL, MS, WI and OK lead the state markets — together 91% of state-market volume.
Estimated all-Medicare volume estimate
FFS + estimated MA

~3,743 services

1,867 observed fee-for-service (50%) · ~1,876 estimated Medicare Advantage.

Billing for this code concentrates in one state — scaled by the national payer mix (FFS share as of 2024) — scaled estimate — assumes MA utilization mirrors FFS; not an observation. How we scale
Average charge
per service, submitted list amounts — not payments · named-group basis, observed FFS
Average payment
per service, Medicare paid amounts — not charges · all disclosed claims, observed FFS basis
Charge-to-payment ratio
average list price vs average Medicare payment per service · named-group basis
What they charge

Half the field lists between $53 and $78

Submitted charges are provider-set list amounts, not payments · median $63 (named groups)
Every group, one dot6 billing groups · median $63

Each dot is one billing group — 6 of them list this code

$0$100$200average submitted charge per service, per billing groupmedian $63
One dot per billing group, 86386 nationwide CY2024 — average submitted charge per service, provider-set list amounts, not payments. The axis caps near the 95th percentile so the cluster is legible; groups beyond it draw at the cap in accent and are counted on the chart.
Where the market isobserved FFS services by state · CY2024
MEVTNHWAIDMTNDMNWI: 110WIILMINYMARIORNVWYSDIAINOHPANJCTCAUTCONE: 47NEMOKY: 34KYWVVA: 27VAMDDEAZNMKSARTNNCSCDCOK: 57OKLA: 55LAMS: 212MSALGAHIAKTXFL: 1325FL
Shaded low→high on observed fee-for-service services billed from each state · the /stats tile grid, at national scope. Shading ranks the states rather than spacing them along the range, so neighboring shades mean adjacent RANKS, not equal gaps — the key names the lowest and highest; each tile carries its own figure.
Which states movedservices per 1,000 FFS beneficiaries · CY2021 → CY2024
CY2021CY2024KY: 0 → 0LA: 0 → 0NE: 2 → 0VA: 0 → 0FL: 1 → 1MS: 0 → 1OK: 0 → 0WI: 0 → 0FL 1MS 0WI 0OK 01 FL1 MS0 WI0 OK
One line per state market, 8 drawn; the 4 leading states by volume are in accent, the rest are context lines. Both columns share one scale, so a slope is real change. A RATE against each state’s own fee-for-service population — assumption-free, and no all-Medicare estimate is used or implied. CY2021 is the left period because CY2020 is the pandemic year and a slope off it would read as growth almost everywhere. 10 states with a rate in only one of the two years are not drawn.

Open a state market: FL · MS · WI · OK · LA · NE · KY · VA — the group ranking lives in the Provider groups tab. Territories bill too; the tile grid draws the 50 states and DC.

Every group in this market, placed by list charge against volume

This market’s groups, on one chart6 groups · bubble = services
100One billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing group$20$50$100$150$200+Average submitted charge per service — list amounts, not paymentsServices per group — 86386, CY2024
One mark per physician group, 86386 nationwide CY2024 — marks are unnamed here: a mark’s position is its average list charge, and that figure is part of the platform. Submitted charges are provider-set list amounts, not payments.

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