If you sell a lung cancer early-detection or nodule test, every claims tool has shown you a single lab NPI and called that your market. It isn't. The lab bills the code; the physicians who order it are the market, and Medicare files them somewhere else. This page shows you exactly where, with the real numbers.
Tests like CyPath Lung (0406U), Nodify XL2 (0080U), and the Nodify CDT autoantibody assay (0360U) are Proprietary Laboratory Analyses codes, billed under one reference-lab NPI each. In 2024, 0406U shows a single Medicare biller on 118 tests; 0080U a single biller on 5,206. Claims record the lab, not the ordering physician, so a claims search for your buyers comes up empty. The market is visible anyway: the physicians who screen for lung cancer and work up nodules bill procedures with their own names on them, and the hospitals treating lung cancer rank as your accounts. Prospect 811 packages that whole play into one page called a Target Pack.
I carried a bag for six years, so I know the search you ran before you got here. You found some claims data, typed in your PLA code, 0406U or 0080U or whatever your lab runs, and you got exactly one provider back. A reference laboratory, often in another state. Not your territory, not a physician you can call, not a market.
So you concluded the reasonable thing: the data has nothing for you. And you went back to lunch drops and warm referrals while reps in claims-visible markets walk into every account with a ranked target list.
That one lab NPI was never the size of your market. It is an artifact of who submits the bill. Here is what is actually happening, and then the two lists that fix it.
A PLA code is billed by the laboratory that runs the test, not by the physician who ordered it. When a pulmonologist sends a patient's blood or sputum out, the lab submits the claim under its own NPI. That is why 0406U, 0080U, and 0360U each show a single Medicare biller: one lab per test, billing for the whole country. The ordering physician, the person you actually sell to, never appears on the claim at all.
It is a different kind of hiding than most niche markets, where Medicare suppresses any provider billing a code ten or fewer times a year. Here the volume is not suppressed, it is consolidated onto one lab. Either way, the roster you want is not in the utilization file, and no physician-claims search will ever produce it.
And to be clear, Medicare pays for these tests, and pays well: $760 for CyPath Lung, $3,520 for Nodify XL2 on the 2026 clinical lab fee schedule. The dollars are real. The buyer list is just filed somewhere claims tools do not look. So instead of searching claims for a customer who is not there, you triangulate: two strong legs plus a roster, all public data, all named.
The Sunshine Act names every clinician a manufacturer pays: consulting, speaking, meals, research, with no claim-count minimum. In device markets that roster is the warmest cold list a rep can hold. In molecular diagnostics it is thinner, because labs run small payment programs, and that is worth saying out loud.
The makers of the anchor tests here, bioAffinity and Precision Pathology behind CyPath Lung, and Biodesix behind the Nodify line, report almost nothing to Open Payments. Veracyte, whose Percepta genomic classifier plays in the same nodule-workup space, is the one rostered maker, with 270 paid clinicians on the books. A payment recipient is a clinician engaged with a manufacturer, not a confirmed orderer, so treat this leg as a supplement.
Which is exactly why this pack does not lean on the money map. It leans on the two legs Medicare cannot hide: the procedures your buyers bill, and the hospitals that treat the disease.
Medicare's physician files do record who screens for lung cancer and who works up the nodules those screens find. Three groups, each with its own honest label:
G0296 is the shared-decision counseling visit a clinician bills before ordering a low-dose CT, the exact moment a risk-stratification test fits: 2,873 clinicians ever, 1,192 in 2024. The screening scan itself, 71271, has 12,317 billers, which maps the screening-active programs in your territory.
Diagnostic and navigational bronchoscopy, transbronchial biopsy, and EBUS staging (31622, 31628, 31629, 31627, 31652, 31653) are the interventional-pulmonology universe. 31628 alone has 2,440 billers, 1,079 in 2024. These are the physicians a blood or sputum test helps decide who goes to biopsy.
Image-guided core needle biopsy of the thorax (32408): 2,814 billers ever, 1,311 in 2024. A risk-stratification test earns its keep by keeping low-risk nodules off this table. That is the clinical pitch and the cost pitch in one procedure.
Hospitals bill respiratory-neoplasm admissions under MS-DRGs 180 and 181, and that data is public too: 19,700 discharges nationally in 2024. The app ranks every facility by that volume, in your state or across the country, with year-over-year trend and average Medicare payment per stay. Add the major-chest-procedure DRGs (163 to 165) and you also have the thoracic-surgery programs where nodules get resected.
That is your account list: the buildings where lung cancer shows up, whether or not any claim ever names your test. In Texas alone the pack ranks 47 hospitals, led by Methodist Hospital San Antonio, Houston Methodist, and Baylor University Medical Center in Dallas. Cross the facility list with the screening and bronchoscopy physicians and you know which programs to walk into first.
Inside Prospect 811 this ships as a Target Pack: Lung Cancer Early Detection & Nodule Risk. Open it, set your state or territory zips, and the legs load as ranked, filterable lists: the screening and workup physicians from live claims, the facility accounts by DRG, and the competitor roster where it exists. Every row clicks through to a full profile with contact info, and everything feeds the built-in CRM, day routes, and Doug, the built-in AI assistant.
The caveats live on the page where you decide, not buried in a footnote: this is traditional Medicare fee-for-service data, so Medicare Advantage volume is undercounted, though lung cancer screening and nodule workup skew older and are covered better here than most niches. Payment rosters mean engagement, not usage. And a PLA code billed by one lab will never name your ordering physician, which is the entire reason this pack exists.
Already a user? Jump straight to the pack.
Prospect 811 is $79 a month on your personal card, self-serve, cancel anytime, with a 14-day full refund. Open the pack, set your territory, and walk into your next call already knowing who screens, who biopsies, and where the volume is.
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