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Market snapshot

42975 nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS

42975 — Evaluation of sleep-disordered breathing by examination of upper airway using an endoscope

Billing groups
187
Named-group FFS services
4,574
FFS of Medicare
49%
Services YoY
+2.9%
FFS enrollment -2.2%
Estimated all-Medicare volume FFS + estimated MA estimate
~9,189 services

4,574 observed fee-for-service (50%) · ~4,615 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 — 42975 (CY2024)
FL 735 TX 546 AZ 430 CA 346 GA 302

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

Named-group submitted charges
$1.6M
Named-group allowed amount
$382K
Named-group Medicare payments
$291K
Avg charge / svc
$345
Avg allowed / svc
$83
Avg payment / svc
$64
Average charge per group
$88 187 groups · avg submitted charge / service $2,250
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Data year: CY2024 CY2023 CY2022 🔒 CY2021 🔒 CY2020 🔒
#Physician group City St Specialty Providers 42975 svcs Submitted charges Avg charge Medicare $ Share* Phone
1 EAR, NOSE AND THROAT PHYSICIANS OF NORTH MISS., P.A TUPELO MS QUALIFIED AUDIOLOGIST 22 106 $31,800 $300 36.3% (662) 840-7034
2 NORTH FLORIDA SURGEONS PA JACKSONVILLE FL PHYSICIAN ASSISTANT 331 100 $34,900 $349 13.6% (904) 396-1725
3 VALLEY ENT PC SCOTTSDALE AZ OTOLARYNGOLOGY 71 86 $16,340 $190 20.0% (480) 847-1193
4 INTEGRIS AMBULATORY CARE CORPORATION OKLAHOMA CITY OK PHYSICIAN ASSISTANT 698 74 $17,520 $237 49.7% (405) 751-5555
5 MASSACHUSETTS EYE AND EAR ASSOCIATES, INC BOSTON MA OPHTHALMOLOGY 406 65 $31,892 $491 39.6% (617) 523-7900
6 UNIVERSITY MEDICAL ASSOCIATES OF THE MEDICAL UNIVERSITY OF SOUTH CAROL CHARLESTON SC PHYSICIAN ASSISTANT 1692 56 $26,168 $467 22.4% (843) 792-1414
7 COMMUNITY CARE NETWORK INC MUNSTER IN NURSE PRACTITIONER 379 55 $12,650 $230 19.8% (219) 836-4563
8 CANDLER ENT PRACTICE LLC SAVANNAH GA OTOLARYNGOLOGY 7 54 $18,630 $345 17.9% —
9 PHYSICIANS CLINIC OF IOWA PC CEDAR RAPIDS IA NURSE PRACTITIONER 132 51 $19,700 $386 17.6% (319) 247-3010
10 RYAN M GUILLORY MD PA LONGVIEW TX OTOLARYNGOLOGY 6 51 $22,950 $450 9.3% (903) 212-9456
11 CHI HEALTH CLINIC SPECIALTY LLC LINCOLN NE NURSE PRACTITIONER 309 49 $12,985 $265 52.7% (402) 219-8000
12 UNIVERSITY OF ALABAMA HEALTH SERVICES FOUNDATION, PC BIRMINGHAM AL NURSE PRACTITIONER 2788 44 $18,832 $428 21.4% (205) 934-3460
13 PRESCOTT EAR NOSE AND THROAT PLLC PRESCOTT AZ OTOLARYNGOLOGY 5 42 $10,164 $242 9.8% —
14 SAINT FRANCIS MEDICAL CENTER CAPE GIRARDEAU MO NURSE PRACTITIONER 435 41 $13,243 $323 14.8% (573) 331-3000
15 REGENTS OF THE UNIV OF CA SACRAMENTO CA DIAGNOSTIC RADIOLOGY 1608 41 $16,851 $411 11.8% (877) 827-7463
16 CHARLESTON AREA MEDICAL CENTER INC CHARLESTON WV NURSE PRACTITIONER 970 41 $13,653 $333 55.4% (304) 388-5432
17 WASHINGTON UNIVERSITY SAINT LOUIS MO NURSE PRACTITIONER 3070 40 $40,000 $1,000 14.4% (314) 747-3000
18 IU HEALTH MEDICAL GROUP, LLC INDIANAPOLIS IN NURSE PRACTITIONER 4250 40 $9,560 $239 14.4% (888) 484-3258
19 UNIVERSITY HEAD AND NECK SURGEONS ORANGE CA OTOLARYNGOLOGY 27 40 $23,120 $578 11.6% (714) 456-5731
20 LESTER E COX MEDICAL CENTERS SPRINGFIELD MO PHYSICIAN ASSISTANT 251 40 $14,545 $364 14.4% (417) 875-3000
21 WELLSPAN MEDICAL GROUP YORK PA PHYSICIAN ASSISTANT 2312 40 $10,080 $252 14.3% —
22 KANSAS UNIVERSITY PHYSICIANS INC KANSAS CITY MO NURSE PRACTITIONER 1815 39 $8,962 $230 14.1% (913) 588-1227
23 OHI WEST MEDICAL GROUP LLC ST PETERSBURG FL PHYSICIAN ASSISTANT 193 39 $11,466 $294 5.3% (727) 823-1234
24 ENT AND ALLERGY ASSOCIATES OF FLORIDA, LLC BOCA RATON FL OTOLARYNGOLOGY 231 38 $9,500 $250 5.2% (561) 391-3333
25 SOUTHWESTERN COLORADO EAR NOSE AND THROAT DURANGO CO PHYSICIAN ASSISTANT 7 37 $17,868 $483 20.1% (970) 385-7272
26 THE REGENTS OF THE UNIVERSITY OF CALIFORNIA LOS ANGELES CA OTOLARYNGOLOGY 34 36 $42,066 $1,168 10.4% (310) 794-1110
27 EAR NOSE AND THROAT AND FACIAL PLASTIC SURGERY CENTER OF FREDERICK FREDERICKSBURG VA OTOLARYNGOLOGY 11 35 $7,135 $204 18.5% (540) 371-1226
28 THE IOWA CLINIC PC WEST DES MOINES IA PHYSICIAN ASSISTANT 302 35 $10,940 $313 12.1% (515) 343-1000
29 MID-SOUTH EAR NOSE AND THROAT PC GERMANTOWN TN NURSE PRACTITIONER 32 35 $10,500 $300 16.3% (901) 755-5300
30 SMH PHYSICIAN SERVICES INC SARASOTA FL PHYSICIAN ASSISTANT 766 35 $8,050 $230 4.8% —
31 NORTH IDAHO DAY SURGERY LLC POST FALLS ID PHYSICIAN ASSISTANT 87 35 $11,585 $331 53.8% —
32 ASCENTIST PHYSICIANS GROUP LLC LEES SUMMIT KS OTOLARYNGOLOGY 104 34 $8,054 $237 17.5% (816) 478-4200
33 MCV ASSOCIATED PHYSICIANS RICHMOND VA NURSE PRACTITIONER 1791 34 $17,204 $506 18.0% (804) 828-9000
34 EASTERN SHORE EAR, NOSE AND THROAT CLINIC, PC FAIRHOPE AL OTOLARYNGOLOGY 3 34 $9,051 $266 16.5% (251) 928-0300
35 STATE OF MISSISSIPPI - UNIVERSITY OF MISSISSIPPI MEDICAL CENTER JACKSON MS NURSE PRACTITIONER 951 34 $8,024 $236 11.6% (601) 815-4775
36 FLORIDA GULF COAST EAR NOSE AND THROAT LLC NAPLES KY OTOLARYNGOLOGY 12 34 $6,953 $204 20.0% (239) 514-2225
37 ENT SURGICAL GROUP PLLC MADISON MS OTOLARYNGOLOGY 5 33 $13,728 $416 11.3% (601) 982-0611
38 TEXAS EAR, NOSE AND THROAT SPECIALISTS, PLLC HOUSTON TX OTOLARYNGOLOGY 122 33 $7,755 $235 6.0% (281) 492-7827
39 BAPTIST HEALTH MEDICAL GROUP INC LOUISVILLE KY NURSE PRACTITIONER 2448 33 $8,052 $244 19.4% (502) 928-1050
40 TENNESSEE EAR, NOSE AND THROAT CONSULTANTS, PC KNOXVILLE TN QUALIFIED AUDIOLOGIST 26 33 $7,722 $234 15.3% (865) 693-6065
41 CHRISTOPHER TIU MD PLLC WHEELING WV NURSE PRACTITIONER 2 33 $9,933 $301 44.6% (304) 234-2060
42 SANFORD MEDICAL CENTER SIOUX FALLS AL NURSE PRACTITIONER 831 32 $9,562 $299 15.5% (605) 332-2883
43 DUKE HEALTH INTEGRATED PRACTICE INC DURHAM NC PHYSICIAN ASSISTANT 3051 31 $13,299 $429 20.3% (919) 684-8111
44 OUR LADY OF THE LAKE PHYSICIAN GROUP LLC BATON ROUGE LA NURSE PRACTITIONER 628 31 $8,301 $268 19.9% (225) 765-1765
45 EAR, NOSE, AND THROAT SPECIALIST- CHEROKEE SINUS CENTER CANTON GA NURSE PRACTITIONER 11 30 $19,500 $650 9.9% (770) 345-6600
46 PRISMA HEALTH UNIVERSITY MEDICAL GROUP GREENVILLE SC NURSE PRACTITIONER 2447 30 $7,890 $263 12.0% —
47 MCLEOD PHYSICIAN ASSOCIATES II FLORENCE SC PHYSICIAN ASSISTANT 534 30 $8,310 $277 12.0% —
48 GEM STATE ENT PLLC TWIN FALLS ID NURSE PRACTITIONER 6 30 $7,310 $244 46.2% (208) 804-1717
49 UMASS MEMORIAL MEDICAL GROUP INC WORCESTER MA PHYSICIAN ASSISTANT 2483 30 $16,440 $548 18.3% (508) 334-1000
50 EAR NOSE AND THROAT SPECIALTY CARE OF MINNESOTA PA ST LOUIS PARK MN OTOLARYNGOLOGY 47 30 $8,460 $282 40.5% (612) 871-1144
51 SOUTHWEST OHIO ENT SPECIALISTS INC DAYTON OH QUALIFIED AUDIOLOGIST 43 30 $12,000 $400 17.3% 9374962620437
52 ACCENT PHYSICIAN SPECIALISTS PA GAINESVILLE FL PHYSICIAN ASSISTANT 16 29 $7,113 $245 3.9% 3523729414265
53 EAR NOSE AND THROAT ASSOCIATES PC FORT WAYNE IN QUALIFIED AUDIOLOGIST 37 29 $7,801 $269 10.4% (260) 426-8117
54 COLQUITT REGIONAL EAR NOSE AND THROAT MOULTRIE GA OTOLARYNGOLOGY 2 29 $6,931 $239 9.6% (229) 891-3325
55 MEDICAL FOUNDATION OF CENTRAL MISSISSIPPI INC JACKSON MS NURSE PRACTITIONER 266 29 $5,423 $187 9.9% (601) 292-4261
56 WELLSTAR MEDICAL GROUP LLC MARIETTA GA NURSE PRACTITIONER 3060 28 $7,018 $251 9.3% (770) 422-2004
57 SAINT LUKES PHYSICIAN GROUP INC KANSAS CITY MO NURSE PRACTITIONER 1228 28 $7,616 $272 10.1% —
58 COLORADO OTOLARYNGOLOGY ASSOCIATES, LLC COLORADO SPRINGS CO OTOLARYNGOLOGY 20 28 $8,036 $287 15.2% (719) 867-7800
59 BURLINGTON EAR NOSE AND THROAT CLINIC PC WEST BURLINGTON IA OTOLARYNGOLOGY 4 27 $12,150 $450 9.3% (319) 752-2725
60 MIDWEST ENT ALLIANCE PLLC PARK RIDGE IL OTOLARYNGOLOGY 95 27 $11,486 $425 13.2% (847) 674-5585
61 NEW MEXICO ONCOLOGY HEMATOLOGY CONSULTANTS LTD ALBUQUERQUE FL DIAGNOSTIC RADIOLOGY 67 27 $10,266 $380 3.7% (505) 842-8171
62 ENT CENTERS OF EXCELLENCE FOLEY AL NURSE PRACTITIONER 4 27 $8,586 $318 13.1% (251) 943-1117
63 MANNING,JOHNSON AND SPENCER, PA SPRINGDALE AR OTOLARYNGOLOGY 10 26 $2,286 $88 40.6% (479) 750-2080
64 UNIVERSITY OTOLARYNGOLOGY ASSOCIATES ROCHESTER NY OTOLARYNGOLOGY 34 26 $10,660 $410 19.3% (585) 276-4480
65 ENT CARE PC DOTHAN AL OTOLARYNGOLOGY 8 26 $7,800 $300 12.6% (334) 793-4788
66 WATSON CLINIC LLP LAKELAND FL NURSE PRACTITIONER 363 26 $7,566 $291 3.5% (863) 680-7780
67 WEST COAST EAR, NOSE AND THROAT, INC CLEARWATER FL OTOLARYNGOLOGY 22 26 $6,042 $232 3.5% (727) 791-1368
68 QUINCY PHYSICIANS AND SURGEONS CLINIC, PLLC QUINCY IL NURSE PRACTITIONER 230 26 $13,577 $522 12.7% —
69 SANFORD BISMARCK BISMARCK ND NURSE PRACTITIONER 563 25 $6,900 $276 56.8% (701) 323-8300
70 SOUTH CAROLINA ENT ALLERGY AND SLEEP MEDICINE PA COLUMBIA SC PHYSICIAN ASSISTANT 24 25 $6,490 $260 10.0% (803) 408-3277
71 ENT PROFESSIONAL ASSOCIATION SERVICES SALT LAKE CITY UT PHYSICIAN ASSISTANT 17 24 $8,643 $360 17.8% (801) 268-4141
72 WICHITA SURGICAL SPECIALISTS PA WICHITA KS GENERAL SURGERY 60 24 $6,600 $275 12.4% (316) 263-0296
73 THE EMORY CLINIC INC ATLANTA GA NURSE PRACTITIONER 3484 23 $10,166 $442 7.6% (404) 778-7525
74 GEISINGER CLINIC DANVILLE PA PHYSICIAN ASSISTANT 3426 23 $6,509 $283 8.2% (570) 271-6144
75 ALBANY ENT AND ALLERGY SERVICES PC ALBANY NY PHYSICIAN ASSISTANT 48 23 $2,576 $112 17.0% (518) 701-2000
76 COLORADO WEST OTOLARYNGOLOGISTS PC GRAND JUNCTION CO PHYSICIAN ASSISTANT 23 23 $7,061 $307 12.5% —
77 PROVIDENCE EAR NOSE AND THROAT ASSOCIATES INC CHESTER PA OTOLARYNGOLOGY 13 23 $4,600 $200 8.2% (610) 874-5366
78 MERCY CLINIC OKLAHOMA COMMUNITIES OKLAHOMA CITY OK PHYSICIAN ASSISTANT 642 23 $6,210 $270 15.4% (405) 254-9690
79 UNIVERSITY OTOLARYNGOLOGISTS INC COLUMBUS OH OTOLARYNGOLOGY 58 22 $6,830 $310 12.7% (614) 538-2424
80 LOUGH HAUSER AND TOMLINSON LTD RENO NV OTOLARYNGOLOGY 5 22 $5,754 $262 100.0% (775) 323-2157
81 RUSH UNIVERSITY MEDICAL GROUP CHICAGO IL PHYSICIAN ASSISTANT 1496 22 $8,245 $375 10.8% (312) 563-2875
82 HEATON EAR NOSE AND THROAT ASSOCIATES OF EAST TEXAS P A TYLER TX OTOLARYNGOLOGY 8 22 $7,700 $350 4.0% (903) 592-5601
83 NORTH SHORE-LIJ MEDICAL PC MANHASSET NY PHYSICIAN ASSISTANT 6294 22 $20,262 $921 16.3% —
84 UTMB FACULTY GROUP PRACTICE GALVESTON FL NURSE PRACTITIONER 1068 22 $6,116 $278 3.0% (409) 772-2222
85 FREEMAN-OAK HILL HEALTH SYSTEM JOPLIN MO NURSE PRACTITIONER 382 21 $6,167 $294 7.6% (417) 347-8200
86 BAYLOR COLLEGE OF MEDICINE HOUSTON TX CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) 1222 21 $10,416 $496 3.8% —
87 SPARTANBURG EAR, NOSE AND THROAT - HEAD AND NECK SURGERY, PA GREER SC OTOLARYNGOLOGY 12 21 $9,135 $435 8.4% (864) 582-2900
88 THE ENT CENTER OF CENTRAL GEORGIA, PC MACON GA OTOLARYNGOLOGY 18 21 $6,867 $327 7.0% (912) 743-8953
89 THE MILTON S HERSHEY MEDICAL CENTER PHYSICIANS GROUP HERSHEY PA PHYSICIAN ASSISTANT 1599 21 $8,715 $415 7.5% (717) 531-5638
90 BON SECOURS MEDICAL GROUP RICHMOND SPECIALTY CARE LLC RICHMOND VA NURSE PRACTITIONER 352 20 $3,660 $183 10.6% (804) 764-6000
91 MERCY HEALTH PHYSICIANS LIMA SPECIALTY CARE LLC LIMA OH NURSE PRACTITIONER 251 20 $3,660 $183 11.6% (419) 227-3361
92 PRACTICE ASSOCIATES MEDICAL GROUP MORRISTOWN NJ NURSE PRACTITIONER 1404 20 $8,320 $416 17.9% (973) 971-5596
93 VANDERBILT UNIVERSITY MEDICAL CENTER NASHVILLE TN NURSE PRACTITIONER 3394 20 $4,240 $212 9.3% (615) 322-5000
94 MOUNTAIN EAR NOSE AND THROAT ASSOCIATES PA SYLVA NC PHYSICIAN ASSISTANT 9 20 $6,000 $300 13.1% (828) 586-7474
95 ADVENTIST HEALTH SYSTEM GEORGIA INC CALHOUN GA NURSE PRACTITIONER 229 20 $5,760 $288 6.6% —
96 ADVOCARE, LLC HADDONFIELD NJ NURSE PRACTITIONER 384 20 $7,600 $380 17.9% (856) 354-2211
97 CHARLOTTE EYE EAR NOSE AND THROAT ASSOCIATES PA CHARLOTTE SC QUALIFIED AUDIOLOGIST 158 20 $5,600 $280 8.0% (704) 295-3414
98 ALPINE EAR NOSE AND THROAT PC FORT COLLINS CO OTOLARYNGOLOGY 26 19 $5,415 $285 10.3% (970) 221-1177
99 AHS OKLAHOMA PHYSICIAN GROUP LLC TULSA OK FAMILY PRACTICE 308 19 $4,408 $232 12.8% —
100 SANFORD MEDICAL CENTER FARGO FARGO ND NURSE PRACTITIONER 1198 19 $6,289 $331 43.2% (701) 234-2000

Showing the top 100 of 187 groups — the full ranking is part of the market analytics platform — built, not launched yet. Notify me at launch →

*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 →