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Market snapshot

31231 in MA CY2024

Medicare Part B FFS · CY2024 · as published by CMS

31231 — Diagnostic exam of nasal passages using an endoscope

Billing groups
39
Named-group FFS services
19,905
FFS of Medicare
64%
Services YoY
+7.0%
FFS enrollment -1.4%
Estimated all-Medicare volume FFS + estimated MA estimate
~30,833 services

19,905 observed fee-for-service (65%) · ~10,928 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

Named-group submitted charges
$14.2M
Named-group allowed amount
$3.5M
Named-group Medicare payments
$2.6M
Avg charge / svc
$714
Avg allowed / svc
$175
Avg payment / svc
$130
Average charge per group
$217 39 groups · avg submitted charge / service $1,796
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Specialty market — Qualified Audiologist: 1,226 services — specialty benchmark suppressed (fewer than 11 groups) — showing state benchmark. See Qualified Audiologist across all states →

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Data year: CY2024 CY2023 CY2022 🔒 CY2021 🔒 CY2020 🔒
Physician groups ranked by 31231 services, CY2024
#Physician group City Specialty Providers 31231 svcs Submitted charges Avg charge Medicare $ locked column Share of specialty*Share of state* Phone
1 VERNICK AND GOPAL,LLC CHESTNUT HILL QUALIFIED AUDIOLOGIST 5 921 $828,900 $900 premium 3.9% (617) 383-6800
2 COLDEN EAR NOSE THROAT AND ALLERGY LLC NEWBURYPORT QUALIFIED AUDIOLOGIST 5 305 $192,150 $630 premium 1.3% (978) 997-1550

*"Share of specialty" is the group's share of disclosed Medicare-FFS services for the primary code among groups with the SAME modal specialty in the state; "share of state" is the same figure against the whole state. Specialty is each group's modal member specialty from CMS's clinician register — a multi-specialty group carries one label. Where fewer than 11 groups share the specialty in the state, the specialty share renders "—" — the specialty benchmark is suppressed (fewer than 11 groups) and the state share alongside is the benchmark. Group figures sum clinicians affiliated with exactly one group. See Methods.

Comparing against an all-payer estimate?

These are exact counts from Medicare fee-for-service claims — roughly a third to half of most procedure markets, depending on payer mix. Modeled all-payer databases project the remainder statistically; we publish the audited floor and label it as such. Same market, different denominator. How the numbers reconcile →