NEVVI Medicare utilization intelligence
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Market snapshot

31257 nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS

31257 — Exam of nose and sinus with removal of nasal sinus using an endoscope

Billing groups
16
Named-group FFS services
255
FFS of Medicare
49%
Services YoY
+5.9%
FFS enrollment -2.2%
Estimated all-Medicare volume FFS + estimated MA estimate
~499 services

255 observed fee-for-service (51%) · ~244 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 — 31257 (CY2024)

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

Named-group submitted charges
$685K
Named-group allowed amount
$154K
Named-group Medicare payments
$123K
Avg charge / svc
$2,686
Avg allowed / svc
$606
Avg payment / svc
$482
Average charge per group
$855 16 groups · avg submitted charge / service $9,927
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Data year: CY2024 CY2023 CY2022 🔒 CY2021 🔒 CY2020 🔒
Physician groups ranked by 31257 services, CY2024
#Physician group City St Specialty Providers 31257 svcs Submitted charges Avg charge Medicare $ locked column Share* Phone
1 REGENTS OF THE UNIVERSITY OF CALIFORNIA SAN DIEGO CA DIAGNOSTIC RADIOLOGY 2057 29 $105,896 $3,652 premium 34.1% (800) 926-8273
2 OTOLARYNGOLOGY SPECIALTY CARE LLC BATESVILLE IN OTOLARYNGOLOGY 3 24 $58,609 $2,442 premium 100.0% (812) 669-1490
3 NORTH FLORIDA SURGEONS PA JACKSONVILLE FL PHYSICIAN ASSISTANT 331 21 $54,054 $2,574 premium 11.6% (904) 396-1725
4 UNIVERSITY MEDICAL SERVICE ASSOCIATION INC TAMPA FL NURSE PRACTITIONER 814 20 $32,770 $1,639 premium 11.0%
5 LEHIGH VALLEY PHYSICIAN GROUP ALLENTOWN PA PHYSICIAN ASSISTANT 2389 18 $23,380 $1,299 premium 41.9%
6 MOUNTAIN VIEW HOSPITAL LLC IDAHO FALLS ID PHYSICIAN ASSISTANT 267 16 $34,825 $2,177 premium 100.0% (208) 535-4343
7 MASSACHUSETTS EYE AND EAR ASSOCIATES, INC BOSTON MA OPHTHALMOLOGY 406 16 $43,343 $2,709 premium 100.0% (617) 523-7900
8 ROCKY MOUNTAIN EAR NOSE AND THROAT CENTER PC MISSOULA MT QUALIFIED AUDIOLOGIST 20 16 $32,265 $2,017 premium 41.0% (406) 541-3937
9 ST PETERS HEALTH HELENA NE PHYSICIAN ASSISTANT 204 13 $22,963 $1,766 premium 33.3% (406) 447-2828
10 BRIGHAM AND WOMENS PHYSICIANS ORGANIZATION INC BOSTON PA PHYSICIAN ASSISTANT 2942 13 $45,276 $3,483 premium 30.2% (617) 732-5500
11 REGENTS OF THE UNIV OF CA SACRAMENTO CA DIAGNOSTIC RADIOLOGY 1608 13 $40,875 $3,144 premium 15.3% (877) 827-7463
12 SOUTH HILLS ENT ASSOCIATION BETHEL PARK PA QUALIFIED AUDIOLOGIST 8 12 $10,260 $855 premium 27.9% 4128317570325
13 SHEA CLINIC MEMPHIS TN OTOLARYNGOLOGY 8 11 $23,210 $2,110 premium 26.2% (901) 761-9720
14 ALPHARETTA ENT SPECIALISTS LLC ROSWELL GA OTOLARYNGOLOGY 4 11 $22,264 $2,024 premium 100.0% (770) 410-0202
15 ENT AND ALLERGY ASSOCIATES LLP YONKERS NY OTOLARYNGOLOGY 429 11 $109,200 $9,927 premium 100.0% (914) 963-8588
16 SOUTHWEST WYOMING ENT INC EVANSTON WY NURSE PRACTITIONER 2 11 $25,850 $2,350 premium 100.0% (307) 789-8721

*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 →