Medicare procedure market data by CPT code & state

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Market snapshot

Nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS

43229 Destruction of polyp or growth of esophagus using a flexible endoscope CPT · Procedure

Classification Procedure › Digestive/Gastrointestinal › Upper GI Endoscopy (CMS RBCS)

First observed 2014

National scale 467 services ▲ 27.9% YoY · 352 beneficiaries (CY2024, Medicare FFS)

Medicare paid $298K · $638.65 avg / service, national

CMS descriptor · RBCS classification · Medicare Part B physician/supplier claims, 12-year window

Billing groups

Named-group FFS services

316

FFS of Medicare

49%

Services YoY

+27.9%

FFS enrollment -2.2%

Estimated all-Medicare volume FFS + estimated MA estimate

~712 services

316 observed fee-for-service (44%) · ~396 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 — 43229 (CY2024)

FL 155 MN 87 NC 65 MI 56 TN 28

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

Named-group submitted charges

$465K

Named-group allowed amount

$58K

Named-group Medicare payments

$43K

Avg charge / svc

$1,472

Avg allowed / svc

$185

Avg payment / svc

$138

Average charge per group

$403–806

$806–1,210

$1,210–1,613

$1,613–2,017

$2,017–2,420

$2,420–2,823

$2,823–3,227

$3,227+

$403 11 groups · avg submitted charge / service $4,227

Market analyticsPlatform

a taste of the twelve-year trend layer

Market position — where this market sits on volume and growth among all state markets, and its rank.
Worth a look — every state market for this search, ranked by a published score: size, growth, fragmentation, below-expected volume.
Lookalike opportunities — groups billing below what peers of the same specialty, size, and state predict, with the expected figure shown.
National benchmarks — where each group's volume sits nationally and within its specialty.
Market structure — how concentrated this market is, and who owns the volume.
Medicare-wide scaling — the payer split, and this market total scaled to all of Medicare, labeled as an estimate.

Or just look at it: nuclear heart imaging (78452) in Arizona is open as a live example — the full paid view, real data.

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Nevvi's market analytics platform — code baskets, market structure and share, the twelve-year trend layer — is built and not launched yet. We're gathering interest in it.

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Data year: CY2024 CY2023 CY2022 CY2021 CY2020

Physician groups ranked by 43229 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	43229 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	GASTRO-INTESTINAL CONSULTANTS OF CENTRAL FLORIDA, LLC	TAVARES	FL	CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA)	2	50	$93,954	$1,879	premium	32.3%	(352) 383-7703
2	UNIVERSITY OF NORTH CAROLINA AT CHAPEL HILL	CHAPEL HILL	NC	NURSE PRACTITIONER	2120	46	$93,840	$2,040	premium	70.8%	(984) 215-5556
3	MNGI DIGESTIVE HEALTH PA	MINNEAPOLIS	MN	GASTROENTEROLOGY	277	37	$32,523	$879	premium	42.5%	(612) 871-1145
4	TROY GASTROENTEROLOGY PC	ROCHESTER HILLS	MI	GASTROENTEROLOGY	44	32	$16,736	$523	premium	57.1%	(248) 844-9710
5	FLORIDA DIGESTIVE HEALTH SPECIALISTS, LLP	BRADENTON	FL	GASTROENTEROLOGY	86	32	$12,896	$403	premium	20.6%	(941) 794-1980
6	GASTROINTESTINAL ASSOCIATES PC	KNOXVILLE	TN	GASTROENTEROLOGY	32	28	$33,152	$1,184	premium	100.0%	(865) 558-0606
7	BORLAND GROOVER CLINIC, PA	JACKSONVILLE	FL	GASTROENTEROLOGY	125	23	$15,249	$663	premium	14.8%	(904) 398-7205
8	RUTGERS HEALTH-RWJ SCLERODERMA PROGRAM	NEW BRUNSWICK	NJ	NURSE PRACTITIONER	387	20	$84,540	$4,227	premium	100.0%	—
9	PIEDMONT HEALTHCARE PA	STATESVILLE	NC	PHYSICIAN ASSISTANT	226	19	$27,930	$1,470	premium	29.2%	(704) 838-8210
10	SCRIPPS HEALTH	LA JOLLA	CA	PHYSICIAN ASSISTANT	1431	15	$45,499	$3,033	premium	100.0%	(858) 455-9100
11	WASHINGTON UNIVERSITY	SAINT LOUIS	MO	NURSE PRACTITIONER	3070	14	$8,988	$642	premium	100.0%	(314) 747-3000

*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 →