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Market snapshot

Nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS
J0491 Injection, anifrolumab-fnia, 1 mg HCPCS · Treatment
Classification Treatment Injections and Infusions (nononcologic) (CMS RBCS)
First observed 2022
National scale 571,533 services · est. ▲ 84.9% YoY · 192 FFS beneficiaries (CY2024, all-Medicare estimate) — 280,825 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 J0491
The whole of J0491, written up and sourced.

The Brief is a national document for J0491. 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 J0491 ran ~571,533 all-Medicare services (estimated), 280,825 observed fee-for-service in CY2024. The market is up 84.9% year over year. 6 billing groups and 13 clinicians bill it.
  2. 2Payment. Half the field lists between $35 and $47 per service; the median group lists $37. Submitted charges are provider-set list amounts, not payments.
  3. 3Geography. AZ, TX, OK and OR lead the state markets — together 64% of state-market volume.
Estimated all-Medicare volume estimate
FFS + estimated MA

~571,533 services

280,825 observed fee-for-service (49%) · ~290,708 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
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 $35 and $47

Submitted charges are provider-set list amounts, not payments · median $37 (named groups)
Every group, one dot6 billing groups · median $37

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

$0$30$60average submitted charge per service, per billing groupmedian $37
One dot per billing group, J0491 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: 24900WIILMINY: 8100NYMARIOR: 30600ORNVWYSDIAINOHPANJCTCA: 29400CAUTCONEMOKYWVVAMDDEAZ: 56700AZNMKSARTNNCSC: 27300SCDCOK: 39600OKLAMSALGAHIAKTX: 54025TXFL: 10200FL
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.

Open a state market: AZ · TX · OK · OR · CA · SC · WI · FL · NY — 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
10,000One billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing group$10$25$50$75$100+Average submitted charge per service — list amounts, not paymentsServices per group — J0491, CY2024
One mark per physician group, J0491 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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