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Market snapshot

31259 nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS

31259 — Removal of tissue from sphenoid sinus using an endoscope

Billing groups
41
Named-group FFS services
750
FFS of Medicare
49%
Services YoY
+11.1%
FFS enrollment -2.2%
Estimated all-Medicare volume FFS + estimated MA estimate
~1,435 services

750 observed fee-for-service (52%) · ~685 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 — 31259 (CY2024)
KS 228 CA 227 PA 122 TX 121 TN 95

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

Named-group submitted charges
$3.0M
Named-group allowed amount
$457K
Named-group Medicare payments
$363K
Avg charge / svc
$3,945
Avg allowed / svc
$610
Avg payment / svc
$484
Average charge per group
$1,064 41 groups · avg submitted charge / service $22,500
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Data year: CY2024 CY2023 CY2022 🔒 CY2021 🔒 CY2020 🔒
#Physician group City St Specialty Providers 31259 svcs Submitted charges Avg charge Medicare $ Share* Phone
1 ASCENTIST PHYSICIANS GROUP LLC LEES SUMMIT KS OTOLARYNGOLOGY 104 66 $324,804 $4,921 28.9% (816) 478-4200
2 UNIVERSITY OF PENN - MEDICAL GROUP PHILADELPHIA PA PHYSICIAN ASSISTANT 3505 59 $169,560 $2,874 48.4% (215) 662-2777
3 ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI NEW YORK NY PHYSICIAN ASSISTANT 2818 28 $630,000 $22,500 68.3% (212) 241-4812
4 LEHIGH VALLEY PHYSICIAN GROUP ALLENTOWN PA PHYSICIAN ASSISTANT 2389 26 $35,625 $1,370 21.3% —
5 VIRGINIA MASON MEDICAL CENTER SEATTLE WA PHYSICIAN ASSISTANT 879 25 $40,591 $1,624 40.3% (206) 223-6600
6 SUMMIT MEDICAL GROUP PA BERKELEY HEIGHTS NJ PHYSICIAN ASSISTANT 1183 25 $85,584 $3,423 51.0% (908) 273-4300
7 MASSACHUSETTS EYE AND EAR ASSOCIATES, INC BOSTON MA OPHTHALMOLOGY 406 22 $73,784 $3,354 100.0% (617) 523-7900
8 UNIVERSITY OF MIAMI MIAMI FL NURSE PRACTITIONER 2331 21 $56,177 $2,675 23.6% (305) 689-5437
9 JOHNS HOPKINS UNIVERSITY BALTIMORE MD NURSE PRACTITIONER 2900 20 $56,765 $2,838 100.0% (410) 502-4340
10 OTOLARYNGOLOGY ASSOCIATES PC FAIRFAX DE OTOLARYNGOLOGY 30 20 $35,871 $1,794 23.0% (703) 383-8130
11 UNIVERSITY MEDICAL ASSOCIATES OF THE MEDICAL UNIVERSITY OF SOUTH CAROL CHARLESTON SC PHYSICIAN ASSISTANT 1692 20 $155,167 $7,758 38.5% (843) 792-1414
12 OU HEALTH PARTNERS INC OKLAHOMA CITY OK PHYSICIAN ASSISTANT 1160 20 $59,211 $2,961 100.0% (405) 271-4311
13 SINUS AND NASAL SPECIALISTS OF LOUISIANA BATON ROUGE LA OTOLARYNGOLOGY 2 19 $49,595 $2,610 57.6% (225) 819-1181
14 THE REGENTS OF THE UNIVERSITY OF CALIFORNIA LOS ANGELES CA OTOLARYNGOLOGY 34 18 $52,788 $2,933 7.9% (310) 794-1110
15 NORTH FLORIDA SURGEONS PA JACKSONVILLE FL PHYSICIAN ASSISTANT 331 17 $38,532 $2,267 19.1% (904) 396-1725
16 REGENTS OF THE UNIVERSITY OF CALIFORNIA SAN DIEGO CA DIAGNOSTIC RADIOLOGY 2057 16 $60,588 $3,787 7.0% (800) 926-8273
17 HEAD AND NECK ASSOCIATES OF ORANGE COUNTY AN INCORPRATE MISSION VIEJO CA OTOLARYNGOLOGY 16 16 $33,750 $2,109 7.0% (949) 364-4361
18 RUSH UNIVERSITY MEDICAL GROUP CHICAGO IL PHYSICIAN ASSISTANT 1496 15 $31,376 $2,092 100.0% (312) 563-2875
19 PROLIANCE SURGEONS INC P S ISSAQUAH WA PHYSICIAN ASSISTANT 395 14 $30,892 $2,207 22.6% (425) 313-5422
20 JEFFERSON UNIVERSITY PHYSICIANS PHILADELPHIA PA DIAGNOSTIC RADIOLOGY 1570 14 $35,235 $2,517 11.5% —
21 WICHITA SURGICAL SPECIALISTS PA WICHITA KS GENERAL SURGERY 60 14 $36,000 $2,571 6.1% (316) 263-0296
22 ROCKY MOUNTAIN EAR NOSE AND THROAT CENTER PC MISSOULA MT QUALIFIED AUDIOLOGIST 20 14 $31,099 $2,221 100.0% (406) 541-3937
23 TRUSTEES OF COLUMBIA UNIVERSITY IN THE CITY OF NEW YORK NEW YORK NY NURSE PRACTITIONER 2273 13 $44,710 $3,439 31.7% (212) 305-8559
24 STANFORD HEALTH CARE STANFORD CA DIAGNOSTIC RADIOLOGY 3039 13 $47,390 $3,645 5.7% (650) 723-4000
25 EAR, NOSE AND THROAT MEDICAL AND SURGICAL GROUP, LLC NORTH HAVEN CT OTOLARYNGOLOGY 11 13 $60,000 $4,615 100.0% (203) 234-1324
26 TRACY BYERLY II MD PA FREDERICKSBURG TX PHYSICIAN ASSISTANT 3 13 $18,486 $1,422 10.7% —
27 MID-SOUTH EAR NOSE AND THROAT PC GERMANTOWN TN NURSE PRACTITIONER 32 13 $21,000 $1,615 13.7% (901) 755-5300
28 COASTAL EAR NOSE AND THROAT LLC NEPTUNE NJ OTOLARYNGOLOGY 19 13 $17,415 $1,340 26.5% (732) 280-7855
29 USC CARE MEDICAL GROUP INC LOS ANGELES CA DIAGNOSTIC RADIOLOGY 1374 13 $22,100 $1,700 5.7% (800) 872-2273
30 CHARLOTTE EYE EAR NOSE AND THROAT ASSOCIATES PA CHARLOTTE NC QUALIFIED AUDIOLOGIST 158 13 $37,840 $2,911 28.9% (704) 295-3414
31 SJHMC PHYSICIAN SERVICES PHOENIX AZ NURSE PRACTITIONER 690 12 $20,615 $1,718 26.7% (602) 406-6017
32 OROHEALTH CORPORATION A NON PROFIT HEALTHCARE SYSTEM OROVILLE CA INTERNAL MEDICINE 124 12 $28,458 $2,372 5.3% (530) 532-8654
33 NORTH SHORE-LIJ MEDICAL PC MANHASSET PA PHYSICIAN ASSISTANT 6294 12 $56,565 $4,714 9.8% —
34 NORTH SHORE-LIJ MEDICAL PC MANHASSET NC PHYSICIAN ASSISTANT 6294 12 $79,191 $6,599 26.7% —
35 COASTAL EAR, NOSE AND THROAT, HEAD AND NECK SURGERY ASSOCIATES, PLLC GULFPORT MS OTOLARYNGOLOGY 9 12 $50,400 $4,200 31.6% (228) 539-3824
36 UNIVERSITY PHYSICIAN ASSOCIATES OF NEW JERSEY INC NEWARK NJ INTERNAL MEDICINE 381 11 $219,300 $19,936 22.4% (973) 972-5004
37 SCRIPPS HEALTH INPATIENT PROVIDERS MEDICAL GROUP INC SAN DIEGO CA INTERNAL MEDICINE 205 11 $27,000 $2,455 4.8% (619) 294-8111
38 GEORGETOWN EAR, NOSE AND THROAT CENTER, PA GEORGETOWN TX OTOLARYNGOLOGY 2 11 $18,743 $1,704 9.1% (512) 869-0604
39 AOP, INC. CAMP HILL PA PHYSICIAN ASSISTANT 12 11 $11,700 $1,064 9.0% (717) 763-7400
40 MURFREESBORO MEDICAL CLINIC, P.A. MURFREESBORO TN NURSE PRACTITIONER 172 11 $17,840 $1,622 11.6% (615) 867-7925
41 ENT AND ALLERGY OF DELAWARE LLC NEWARK DE OTOLARYNGOLOGY 42 11 $18,406 $1,673 12.6% (302) 998-0300
42 UNIVERSITY OF ALABAMA HEALTH SERVICES FOUNDATION, PC BIRMINGHAM AL NURSE PRACTITIONER 2788 11 $18,700 $1,700 33.3% (205) 934-3460

*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 →