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Market snapshot

Nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS
43195 Balloon dilation of esophagus using a rigid endoscope, less than 3.0 cm CPT · Procedure
Classification Procedure Digestive/Gastrointestinal Upper GI Endoscopy (CMS RBCS)
First observed 2014
National scale 84 services ▲ 100.0% YoY · 70 beneficiaries (CY2024, Medicare FFS)
Medicare paid $11K · $130.15 avg / service, national
CMS descriptor · RBCS classification · Medicare Part B physician/supplier claims, 12-year window
Billing groups
4
Named-group FFS services
84
FFS of Medicare
49%
Services YoY
+100.0%
FFS enrollment -2.2%
Estimated all-Medicare volume FFS + estimated MA estimate
~167 services

84 observed fee-for-service (50%) · ~83 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 — 43195 (CY2024)

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

Named-group submitted charges
$93K
Named-group allowed amount
$14K
Named-group Medicare payments
$11K
Avg charge / svc
$1,107
Avg allowed / svc
$166
Avg payment / svc
$130
Average charge per group
$380 4 groups · avg submitted charge / service $1,846
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Data year: CY2024 CY2023 CY2022 locked column CY2021 locked column CY2020 locked column
Physician groups ranked by 43195 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 43195 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 STANFORD HEALTH CARE STANFORD CA DIAGNOSTIC RADIOLOGY 3039 40 $73,840 $1,846 premium 100.0% (650) 723-4000
2 SARAH BUSH LINCOLN HEALTH CENTER MATTOON IL NURSE PRACTITIONER 405 18 $8,442 $469 premium 100.0%
3 SMH PHYSICIAN SERVICES INC SARASOTA FL PHYSICIAN ASSISTANT 766 15 $5,700 $380 premium 100.0%
4 ARKANSAS HEALTH GROUP LITTLE ROCK AR CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) 666 11 $5,028 $457 premium 100.0% (501) 202-2093

*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 →