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Market snapshot

31254 nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS

31254 — Partial removal of nasal sinus using an endoscope

Billing groups
50
Named-group FFS services
1,737
FFS of Medicare
49%
Services YoY
+34.3%
FFS enrollment -2.2%
Estimated all-Medicare volume FFS + estimated MA estimate
~3,584 services

1,737 observed fee-for-service (48%) · ~1,847 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

Top states — 31254 (CY2024)
CA 542 TX 477 AZ 450 FL 238 AL 155

Disclosed Medicare fee-for-service services by billing state; open a bar for that state's ranked market.

Named-group submitted charges
$3.6M
Named-group allowed amount
$600K
Named-group Medicare payments
$479K
Avg charge / svc
$2,051
Avg allowed / svc
$345
Avg payment / svc
$276
Average charge per group
$772 50 groups · avg submitted charge / service $4,900
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Data year: CY2024 CY2023 CY2022 🔒 CY2021 🔒 CY2020 🔒
#Physician group City St Specialty Providers 31254 svcs Submitted charges Avg charge Medicare $ Share* Phone
1 BRIAN G LEE MD PLLC SCOTTSDALE AZ NURSE PRACTITIONER 18 322 $528,080 $1,640 71.6% (480) 994-0308
2 MEDICAL CENTER EAR, NOSE AND THROAT ASSOCIATES OF HOUSTON, PLLC HOUSTON TX OTOLARYNGOLOGY 6 145 $342,200 $2,360 30.4% (713) 795-0111
3 ROANOKE VALLEY ENT AND ALLERGY PC ROANOKE VA PHYSICIAN ASSISTANT 5 85 $196,515 $2,312 100.0% (540) 968-7368
4 MICHAEL BUBLIK MD PC GLENDALE CA OTOLARYNGOLOGY 2 80 $237,000 $2,962 14.8% (818) 649-1433
5 BREATHE FREE SINUS AND ALLERGY CENTERS OF FLORIDA LLC PENSACOLA FL OTOLARYNGOLOGY 3 70 $125,247 $1,789 29.4% (850) 990-9407
6 ENT CENTER OF NORTHWEST ALABAMA, LLC FLORENCE AL NURSE PRACTITIONER 5 68 $88,862 $1,307 43.9% (417) 986-6734
7 TRACY BYERLY II MD PA FREDERICKSBURG TX PHYSICIAN ASSISTANT 3 66 $80,124 $1,214 13.8% —
8 JOSEPH M CAPO MD PC LEVITTOWN NY OTOLARYNGOLOGY 13 61 $141,864 $2,326 47.3% (516) 731-6644
9 VALLEY EAR NOSE AND THROAT ASSOCIATES PC ATHENS AL OTOLARYNGOLOGY 6 48 $84,368 $1,758 31.0% (256) 233-1650
10 ASCENTIST PHYSICIANS GROUP LLC LEES SUMMIT KS OTOLARYNGOLOGY 104 45 $140,163 $3,115 53.6% (816) 478-4200
11 CV ENT SURGICAL GROUP WEST HILLS CA OTOLARYNGOLOGY 3 42 $205,800 $4,900 7.7% (818) 888-7878
12 FLORIDA ENT ASSOCIATES INC MIAMI FL OTOLARYNGOLOGY 161 42 $84,240 $2,006 17.6% (305) 595-6200
13 ARIZONA DESERT EAR NOSE AND THROAT SPECIALIST PLLC PHOENIX AZ QUALIFIED AUDIOLOGIST 7 35 $135,415 $3,869 7.8% (623) 512-4162
14 EAR, NOSE AND THROAT CONSULTANTS OF NEVADA HENDERSON NV OTOLARYNGOLOGY 15 29 $33,408 $1,152 58.0% (702) 792-6700
15 TEXAS HEALTH CARE PLLC FORT WORTH TX NURSE PRACTITIONER 364 28 $46,421 $1,658 5.9% (817) 920-0484
16 OHI WEST MEDICAL GROUP II LLC ZEPHYRHILLS FL NURSE PRACTITIONER 417 28 $46,216 $1,651 11.8% (813) 751-3375
17 ENT AND ALLERGY ASSOCIATES LLP YONKERS NY OTOLARYNGOLOGY 429 27 $117,504 $4,352 20.9% (914) 963-8588
18 TEXAS EAR, NOSE AND THROAT SPECIALISTS, PLLC HOUSTON TX OTOLARYNGOLOGY 122 26 $82,500 $3,173 5.5% (281) 492-7827
19 MODERN NOSE CLINIC LLC SALEM OR PHYSICIAN ASSISTANT 6 25 $31,000 $1,240 100.0% (503) 584-1174
20 OKLAHOMA OTOLARYNGOLOGY ASSOCIATES LLC NORMAN OK OTOLARYNGOLOGY 15 24 $18,524 $772 100.0% (405) 364-2666
21 SCRIPPS HEALTH INPATIENT PROVIDERS MEDICAL GROUP INC SAN DIEGO CA INTERNAL MEDICINE 205 23 $63,264 $2,751 4.2% (619) 294-8111
22 SINUS AND NASAL SPECIALISTS OF LOUISIANA BATON ROUGE LA OTOLARYNGOLOGY 2 22 $49,179 $2,235 100.0% (225) 819-1181
23 COASTAL CAROLINA ENT DO PA WHITEVILLE NC OTOLARYNGOLOGY 6 21 $42,000 $2,000 65.6% (910) 914-0540
24 MICHAEL V RIESBERG MD OTOLARYNGOLOGY AND PERFORMING ARTS MEDICINE PENSACOLA FL NURSE PRACTITIONER 3 19 $25,146 $1,323 8.0% (850) 476-0700
25 WARREN OTOLOGIC GROUP, INC WARREN OH NURSE PRACTITIONER 7 18 $30,590 $1,699 43.9% (330) 856-4000
26 EAR NOSE AND THROAT CONSULTANTS OF NORTH MISSISSIPPI PLLC OXFORD MS QUALIFIED AUDIOLOGIST 10 18 $47,685 $2,649 27.3% (662) 234-1337
27 ENT OF OKLAHOMA PLLC LAWTON TX OTOLARYNGOLOGY 5 18 $29,751 $1,653 3.8% (580) 531-0022
28 ROCKY MOUNTAIN EAR NOSE AND THROAT CENTER PC MISSOULA MT QUALIFIED AUDIOLOGIST 20 18 $19,570 $1,087 100.0% (406) 541-3937
29 CHARLESTON ENT ASSOCIATES, LLC CHARLESTON SC OTOLARYNGOLOGY 76 16 $17,283 $1,080 25.0% (843) 766-7103
30 CORPUS CHRISTI ENT SINUS AND ALLERGY,PLLC CORPUS CHRISTI TX NURSE PRACTITIONER 5 16 $22,336 $1,396 3.4% (361) 287-0100
31 NATIONAL SINUS INSTITUTE PLLC DEMING TX PHYSICIAN ASSISTANT 35 15 $16,240 $1,083 3.1% (575) 449-8949
32 SCRIPPS HEALTH LA JOLLA CA PHYSICIAN ASSISTANT 1431 15 $36,291 $2,419 2.8% (858) 455-9100
33 EXHALE SINUS PLLC SCHAUMBURG IL PHYSICIAN ASSISTANT 6 15 $17,120 $1,141 40.5% (773) 234-5880
34 UNIVERSITY MEDICAL ASSOCIATES OF THE MEDICAL UNIVERSITY OF SOUTH CAROL CHARLESTON SC PHYSICIAN ASSISTANT 1692 15 $47,502 $3,167 23.4% (843) 792-1414
35 WESTSIDE HEAD AND NECK CULVER CITY CA OTOLARYNGOLOGY 6 14 $15,990 $1,142 2.6% (310) 204-4111
36 NORTHSIDE SURGICAL PROFESSIONAL SERVICES LLC ATLANTA GA PHYSICIAN ASSISTANT 368 13 $19,931 $1,533 25.5% —
37 NORTHEAST ATLANTA EAR NOSE AND THROAT, P.C. LAWRENCEVILLE GA OTOLARYNGOLOGY 15 13 $45,000 $3,462 25.5% (770) 237-3000
38 MAYO CLINIC ARIZONA PHOENIX AZ PHYSICIAN ASSISTANT 1635 13 $19,278 $1,483 2.9% (800) 603-0558
39 SOUTH FLORIDA SURGICAL SPECIALISTS LLC CORAL SPRINGS FL GENERAL SURGERY 92 13 $17,342 $1,334 5.5% (954) 344-3000
40 EAR NOSE AND THROAT CONSULTANTS PC SOUTHFIELD MI QUALIFIED AUDIOLOGIST 31 13 $19,890 $1,530 100.0% (248) 569-5985
41 GILLUM FACIAL PLASTIC SURGERY PC MARION IN NURSE PRACTITIONER 2 12 $13,950 $1,162 17.1% (765) 651-4278
42 TRIHEALTH H LLC CINCINNATI OH OBSTETRICS/GYNECOLOGY 853 12 $17,879 $1,490 29.3% (513) 246-7000
43 COMMUNITY PHYSICIANS OF INDIANA INC INDIANAPOLIS IN PHYSICIAN ASSISTANT 1594 12 $11,567 $964 17.1% —
44 ANNAPOLIS ENT SURGICAL CENTER LLC ANNAPOLIS MD QUALIFIED AUDIOLOGIST 45 11 $8,750 $795 15.3% (410) 266-3900
45 DUKE HEALTH INTEGRATED PRACTICE INC DURHAM NC PHYSICIAN ASSISTANT 3051 11 $37,045 $3,368 34.4% (919) 684-8111
46 EAR NOSE AND THROAT SPECIALTIES PC LINCOLN NE OTOLARYNGOLOGY 17 11 $16,898 $1,536 100.0% (402) 484-4974
47 MIDWEST ENT ALLIANCE PLLC PARK RIDGE IL OTOLARYNGOLOGY 95 11 $14,225 $1,293 29.7% (847) 674-5585
48 UNIVERSITY HOSPITALS MEDICAL GROUP INC CLEVELAND OH NURSE PRACTITIONER 2232 11 $21,546 $1,959 26.8% —
49 CITY MEDICAL OF UPPER EAST SIDE PLLC NEW YORK NY PHYSICIAN ASSISTANT 657 11 $33,990 $3,090 8.5% (212) 271-4364
50 ENT AND ALLERGY ASSOCIATES OF FLORIDA, LLC BOCA RATON FL OTOLARYNGOLOGY 231 11 $20,213 $1,838 4.6% (561) 391-3333

*Share of the state's disclosed Medicare-FFS services for the primary code, counted once per clinician. "St" is the state the volume was billed from: a group appears in each state where its clinicians bill Medicare, with that state's volume and share ("City" is the group's registered location). Group figures sum clinicians affiliated with exactly one group; clinicians in several groups are listed in each group's drill-down but not volume-attributed to any single group, so shares reflect attributable volume. 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 →