CMS Releases Part B Utilization by CPT Code for CY2024

HEADER: If you love Medicare Part B utilization data, the agency has released its summary 2024 data files in Excel.

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CMS releases Part B  data annual in two different forms.   Sometime in the fall, it releases Part B data for the prior year (for us, CY2024) in Excel spreadsheets.  Find these here:

 https://www.cms.gov/data-research/statistics-trends-and-reports/part-b-national-summary-data-file

(I believe they've belatedly released the 2023 data along with 2024.)

This is simple data - CPT code, volume of national utilization, volume of dollars paid per code.

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At a longer delay, CMS releases an awesome cloud database of CPT code utilization by provider.  (E.g. Dr. Alvin Smith had 1,100 92114 office visits and 800 92115 office visits.)  Find that here, for CY2023:

https://data.cms.gov/provider-summary-by-type-of-service/medicare-physician-other-practitioners/medicare-physician-other-practitioners-by-provider-and-service

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Quick Look - PLA Codes

In Cy2024 data, there are PLA codes up to 0503U.  Together with"M" codes, these PLA codes were paid $682M dollars.   But the distribution among the 500 codes was highly skewed, with the top 15 codes paid 86% of the money, and the  top 4 codes paid 52% of the money. Click to enlarge.

The top two PLA codes, 0242U, 0326Ul, are Guardant's, garnering about $200M for about 40,000 services.

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Thanks to Jack Meehan at Nephron for flagging the data release.

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The CPT utilization files provide code numbers, but not descriptors.  Skilled Excel jockeys should be able to merge the code + descriptor tables found in the CLFS itself, with the CPT codes of the annual data, and get a spreadsheet with code + descriptor + dollars paid.  

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If you're still reading, you might enjoy an article about using Excel "PivotCharts" rather than "PivotTables" - at MakeUseOf here.  And you might enjoy a detailed automatic AI anaysis (via Chat GPT 5) of CMS new test pricing data - here.