Monday, September 21, 2026

CMS Posts Cy2025 Part B National Utilization Data

 CMS has posted CY 2025 National Part B utilization data as simple Excel files.  Find them here:

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

For example, allowed dollars for code 81479 are up to $512M (for 205,000 services).

The same data will be posted in vastly more detailed sometime around June 2027, sortable for every physician and lab using each CPT code (here).

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Here's our analysis of the CY2024 data as written up in 9/2025.

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For 2025, PLA codes totaled about $1.5B, with almost half going to the top 3 codes.  The top 20 PLA codes had 90% of PLA dollars.


For mainstream codes 81162 to 81599, there were $1.9B in payments, with 27% of $512M going to 81479, unlisted code, used almost entirely at MolDx.

The top 20 mainstream codes had 80% of the dollars in this category.