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Market snapshot

Nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS
31255 Removal of nasal sinus using an endoscope CPT · Other Organ Systems procedure
Classification Procedure Other Organ Systems Nasal/Sinus Endoscopy (CMS RBCS)
First observed 2013 — start of our 12-year window; the code predates it
National scale 714 services ▼ 14.9% YoY · 642 beneficiaries (CY2024, Medicare FFS)
Medicare paid $303K · $424.22 avg / service, national
CMS descriptor · RBCS classification · Medicare Part B physician/supplier claims, 12-year window
Billing groups
25
Named-group FFS services
377
FFS of Medicare
49%
Services YoY
-14.9%
FFS enrollment -2.2%
Estimated all-Medicare volume FFS + estimated MA estimate
~748 services

377 observed fee-for-service (50%) · ~371 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 — 31255 (CY2024)

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

Named-group submitted charges
$878K
Named-group allowed amount
$100K
Named-group Medicare payments
$79K
Avg charge / svc
$2,328
Avg allowed / svc
$265
Avg payment / svc
$210
Average charge per group
$688 25 groups · avg submitted charge / service $7,900
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Data year: CY2024 CY2023 CY2022 locked column CY2021 locked column CY2020 locked column
Physician groups ranked by 31255 services, highest first, CY2024
# Physician group activate to sort City activate to sort St activate to sort Specialty activate to sort Providers activate to sort 31255 svcs sorted descending — activate to reverse Submitted charges activate to sort Avg charge activate to sort Medicare $ locked column Share* activate to sort Phone
1 MEDICAL CENTER EAR, NOSE AND THROAT ASSOCIATES OF HOUSTON, PLLC HOUSTON TX OTOLARYNGOLOGY 6 28 $68,320 $2,440 premium 13.7% (713) 795-0111
2 VINCENT P NALBONE M D LTD LAS VEGAS NV NURSE PRACTITIONER 2 24 $28,207 $1,175 premium 100.0% (702) 312-3333
3 ACCENT HEAD AND NECK GROUP P A LINWOOD NJ NURSE PRACTITIONER 2 24 $113,644 $4,735 premium 68.6% (609) 926-5556
4 TEXAS SINUS CENTER, P.A. SAN ANTONIO TX OTOLARYNGOLOGY 2 23 $18,423 $801 premium 11.2% (210) 607-4687
5 EASLEY HEAD AND NECK SURGERY PA EASLEY SC OTOLARYNGOLOGY 3 21 $51,450 $2,450 premium 100.0% (864) 855-2411
6 EAR,NOSE,AND THROAT OF NORTHWEST GEORGIA ROME GA NURSE PRACTITIONER 3 17 $134,300 $7,900 premium 100.0%
7 CORNERSTONE EAR NOSE AND THROAT PA INDIAN LAND NC OTOLARYNGOLOGY 9 16 $45,919 $2,870 premium 55.2% (704) 752-7575
8 ESTRELLA EAR NOSE AND THROAT PC GOODYEAR AZ PHYSICIAN ASSISTANT 4 16 $19,328 $1,208 premium 29.6% (623) 535-8770
9 BSA PHYSICIANS GROUP INC AMARILLO TX HOSPITALIST 118 15 $34,600 $2,307 premium 7.3% (806) 359-4673
10 SOUTHERN INDIANA ENT LLC COLUMBUS IN PHYSICIAN ASSISTANT 12 14 $39,600 $2,829 premium 51.9% (812) 376-3182
11 LEHIGH VALLEY PHYSICIAN GROUP ALLENTOWN PA PHYSICIAN ASSISTANT 2389 14 $40,900 $2,921 premium 100.0%
12 UNIVERSITY OTOLARYNGOLOGISTS INC COLUMBUS OH OTOLARYNGOLOGY 58 13 $15,950 $1,227 premium 34.2% (614) 538-2424
13 HERITAGE MEDICAL ASSOCIATES PC NASHVILLE TN INTERNAL MEDICINE 166 13 $18,620 $1,432 premium 100.0% (629) 255-2115
14 BOISE ENT LLC BOISE ID OTOLARYNGOLOGY 2 13 $14,438 $1,111 premium 100.0% (208) 229-2368
15 WILMINGTON EAR NOSE AND THROAT ASSOC PA WILMINGTON NC OTOLARYNGOLOGY 10 13 $32,699 $2,515 premium 44.8% 9107628754124
16 MASSACHUSETTS EYE AND EAR ASSOCIATES, INC BOSTON MA OPHTHALMOLOGY 406 12 $38,267 $3,189 premium 100.0% (617) 523-7900
17 COLORADO OTOLARYNGOLOGY ASSOCIATES, LLC COLORADO SPRINGS CO OTOLARYNGOLOGY 20 12 $14,735 $1,228 premium 100.0% (719) 867-7800
18 ENT AND ALLERGY ASSOCIATES OF FLORIDA, LLC BOCA RATON FL OTOLARYNGOLOGY 231 12 $28,800 $2,400 premium 25.5% (561) 391-3333
19 ASCENTIST PHYSICIANS GROUP LLC LEES SUMMIT KS OTOLARYNGOLOGY 104 11 $9,183 $835 premium 32.4% (816) 478-4200
20 MID-ATLANTIC ENT ANNAPOLIS MD OTOLARYNGOLOGY 6 11 $7,904 $719 premium 25.6% (410) 573-9191
21 HEAD AND NECK SURGERY OF KANSAS CITY P A OVERLAND PARK KS OTOLARYNGOLOGY 11 11 $17,640 $1,604 premium 32.4% (913) 599-4800
22 EAR,NOSE AND THROAT SPECIALISTS, L.L.C. WEST MONROE LA NURSE PRACTITIONER 3 11 $16,511 $1,501 premium 100.0% (318) 322-9882
23 EVMS ACADEMIC PHYSICIANS AND SURGEONS HEALTH SERVICES FOUNDATION NORFOLK VA OBSTETRICS/GYNECOLOGY 224 11 $12,825 $1,166 premium 100.0% (757) 446-7900
24 MEDICAL MANAGEMENT OF OCALA INC OCALA FL OTOLARYNGOLOGY 8 11 $7,563 $688 premium 23.4% (352) 732-5042
25 EAR NOSE THROAT OF NEW JERSEY, P.A. TOMS RIVER NJ OTOLARYNGOLOGY 2 11 $47,850 $4,350 premium 31.4%

*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 →