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Market snapshot

Nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS
43220 Balloon dilation of esophagus using a flexible endoscope, less than 3.0 cm CPT · Procedure
Classification Procedure Digestive/Gastrointestinal Upper GI Endoscopy (CMS RBCS)
First observed 2013 — start of our 12-year window; the code predates it
National scale 146 services · est. · 56 FFS beneficiaries (CY2024, all-Medicare estimate) — 68 observed fee-for-service services
CMS descriptor · RBCS classification · Medicare Part B physician/supplier claims, 12-year window
Data year: CY2024 CY2023 CY2022 locked column CY2021 locked column CY2020 locked column
Market overview

Nationally, 3 billing groups and 4 clinicians bill 43220 — ~146 all-Medicare services · est. (68 observed FFS), and volume is up 371.0% year over year.

TX, KY, UT and OH lead the state markets — together 100% of state-market volume.

Market Brief 43220
The whole of 43220, written up and sourced.

The Brief is a national document for 43220. Its findings page carries one finding per chapter, each opening the chapter that prints its figure and the table behind it — like these, from the United States, CY2024, the market on this page.

  1. 1Size and growth. The national market for 43220 ran ~146 all-Medicare services (estimated), 68 observed fee-for-service in CY2024. The market is up 371.0% year over year. 3 billing groups and 4 clinicians bill it.
  2. 2Payment. Half the field lists between $1,386 and $4,992 per service; the median group lists $2,400. Submitted charges are provider-set list amounts, not payments.
  3. 3Geography. TX, KY, UT and OH lead the state markets — together 100% of state-market volume.
Estimated all-Medicare volume estimate
FFS + estimated MA

~146 services

68 observed fee-for-service (47%) · ~78 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
Average charge

$3,749

per service, submitted list amounts — not payments · observed FFS basis
Charge-to-payment ratio

12.0×

average list $3,749 vs average Medicare payment $311 per service · basis-independent
Billing groups

3

3 at the ≥11-service disclosure floor
What they charge

Half the field lists between $1,386 and $4,992

Submitted charges are provider-set list amounts, not payments · median $2,400 (named groups)
Every group, one dot3 billing groups · median $2,400

Each dot is one billing group — 3 of them list this code

$0$4,000$8,000average submitted charge per service, per billing groupmedian $2,400
One dot per billing group, 43220 nationwide CY2024 — average submitted charge per service, provider-set list amounts, not payments. The axis caps near the 95th percentile so the cluster is legible; groups beyond it draw at the cap in accent and are counted on the chart.
Where the market isobserved FFS services by state · CY2024
MEVTNHWAIDMTNDMNWIILMINYMARIORNVWYSDIAINOH: 12OHPANJCTCAUT: 15UTCONEMOKY: 19KYWVVAMDDEAZNMKSARTNNCSCDCOKLAMSALGAHIAKTX: 22TXFL
Shaded low→high on observed fee-for-service services billed from each state · the /stats tile grid, at national scope. Shading ranks the states rather than spacing them along the range, so neighbouring shades mean adjacent RANKS, not equal gaps — the key names the lowest and highest; each tile carries its own figure.

Open a state market: TX · KY · UT · OH — the group ranking lives in the Provider groups tab. Territories bill too; the tile grid draws the 50 states and DC.

Every group in this market, placed by list charge against volume

The whole field, one canvas3 groups · bubble = services
One billing groupOne billing groupOne billing group$1,000$2,500$5,000$7,500$10,000+Average submitted charge per service — list amounts, not paymentsServices per group — 43220, CY2024
One mark per physician group, 43220 nationwide CY2024 — marks are unnamed here: a mark’s position is its average list charge, and that figure is part of the platform. Submitted charges are provider-set list amounts, not payments.