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Market snapshot

Nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS
43233 Balloon dilation of esophagus, stomach, and/or upper small bowel using a flexible endoscope, 3.0 cm or more CPT · Procedure
Classification Procedure Digestive/Gastrointestinal Upper GI Endoscopy (CMS RBCS)
First observed 2014
National scale 312 services ▲ 57.6% YoY · 249 beneficiaries (CY2024, Medicare FFS)
Medicare paid $85K · $271.52 avg / service, national
CMS descriptor · RBCS classification · Medicare Part B physician/supplier claims, 12-year window
Billing groups
7
Named-group FFS services
120
FFS of Medicare
49%
Services YoY
+57.6%
FFS enrollment -2.2%
Estimated all-Medicare volume FFS + estimated MA estimate
~230 services

120 observed fee-for-service (52%) · ~110 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 — 43233 (CY2024)

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

Named-group submitted charges
$86K
Named-group allowed amount
$25K
Named-group Medicare payments
$19K
Avg charge / svc
$721
Avg allowed / svc
$206
Avg payment / svc
$159
Average charge per group
$212 7 groups · avg submitted charge / service $971
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Data year: CY2024 CY2023 CY2022 locked column CY2021 locked column CY2020 locked column
Physician groups ranked by 43233 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 43233 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 UNIVERSITY HOSPITALS MEDICAL GROUP INC CLEVELAND CA NURSE PRACTITIONER 2232 31 $30,101 $971 premium 72.1%
2 AVERA ST LUKES ABERDEEN SD NURSE PRACTITIONER 169 18 $3,809 $212 premium 23.4% (605) 622-5100
3 RICHMOND GASTROENTEROLOGY ASSOCIATES, INC. NORTH CHESTERFIELD VA GASTROENTEROLOGY 37 16 $14,000 $875 premium 100.0% (804) 330-4021
4 PINELAKE PHYSICIAN PRACTICE LLC MAYFIELD KY NURSE PRACTITIONER 46 16 $7,300 $456 premium 100.0% (270) 251-4100
5 VIDALIA MEDICAL ASSOCIATES, PC VIDALIA GA INTERNAL MEDICINE 4 14 $12,026 $859 premium 50.0% (912) 537-9851
6 NATIONAL PARK GI SERVICES LLC HOT SPRINGS AR GASTROENTEROLOGY 5 13 $9,100 $700 premium 46.4% (501) 623-7800
7 SCRIPPS HEALTH LA JOLLA CA PHYSICIAN ASSISTANT 1431 12 $10,149 $846 premium 27.9% (858) 455-9100

*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 →