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Market snapshot

43241 nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS

43241 — Insertion of tube or tube in esophagus, stomach, and/or upper small bowel using a flexible endoscope

Billing groups
16
Named-group FFS services
339
FFS of Medicare
49%
Services YoY
+29.1%
FFS enrollment -2.2%
Estimated all-Medicare volume FFS + estimated MA estimate
~687 services

339 observed fee-for-service (49%) · ~348 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 — 43241 (CY2024)

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

Named-group submitted charges
$322K
Named-group allowed amount
$35K
Named-group Medicare payments
$27K
Avg charge / svc
$949
Avg allowed / svc
$103
Avg payment / svc
$79
Average charge per group
$361 16 groups · avg submitted charge / service $3,013
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Data year: CY2024 CY2023 CY2022 🔒 CY2021 🔒 CY2020 🔒
Physician groups ranked by 43241 services, CY2024
#Physician group City St Specialty Providers 43241 svcs Submitted charges Avg charge Medicare $ locked column Share* Phone
1 STANFORD HEALTH CARE STANFORD CA DIAGNOSTIC RADIOLOGY 3039 75 $90,525 $1,207 premium 47.5% (650) 723-4000
2 SUTTER VALLEY MEDICAL FOUNDATION SACRAMENTO CA DIAGNOSTIC RADIOLOGY 2420 31 $21,204 $684 premium 19.6% (916) 681-8852
3 JOHNS HOPKINS UNIVERSITY BALTIMORE MD NURSE PRACTITIONER 2900 24 $23,232 $968 premium 68.6% (410) 502-4340
4 WASHINGTON UNIVERSITY SAINT LOUIS MO NURSE PRACTITIONER 3070 23 $29,348 $1,276 premium 100.0% (314) 747-3000
5 HONORHEALTH AMBULATORY SCOTTSDALE AZ PHYSICIAN ASSISTANT 601 21 $8,154 $388 premium 100.0%
6 TRI-STATE GASTROENTEROLOGY ASSOCIATES, PSC CRESTVIEW HILLS KY GASTROENTEROLOGY 18 19 $7,600 $400 premium 100.0% (859) 341-3575
7 THE MEDICAL COLLEGE OF WISCONSIN INC MILWAUKEE WI DIAGNOSTIC RADIOLOGY 2137 18 $54,234 $3,013 premium 100.0% (414) 955-4263
8 EAST CAROLINA UNIVERSITY GREENVILLE NC NURSE PRACTITIONER 491 18 $14,290 $794 premium 100.0% (252) 744-1406
9 DIGESTIVE DISEASE CONSULTANTS OF ORANGE COUNTY INC IRVINE CA PHYSICIAN ASSISTANT 14 14 $5,615 $401 premium 8.9% (949) 612-9090
10 SUTTER VALLEY MEDICAL FOUNDATION SACRAMENTO TX DIAGNOSTIC RADIOLOGY 2420 13 $8,892 $684 premium 54.2% (916) 681-8852
11 UC REGENTS ORANGE CA INTERNAL MEDICINE 296 13 $8,372 $644 premium 8.2% (714) 456-7002
12 THE REGENTS OF THE UNIVERSITY OF CALIFORNIA LOS ANGELES CA INTERNAL MEDICINE 1424 13 $11,089 $853 premium 8.2% (310) 825-7922
13 IU HEALTH MEDICAL GROUP, LLC INDIANAPOLIS IN NURSE PRACTITIONER 4250 12 $4,512 $376 premium 100.0% (888) 484-3258
14 MAYO CLINIC ROCHESTER MN NURSE PRACTITIONER 4896 12 $13,182 $1,099 premium 100.0% (507) 284-2511
15 TEXAS DIGESTIVE DISEASE CONSULTANTS, PLLC DALLAS TX GASTROENTEROLOGY 613 11 $6,611 $601 premium 45.8%
16 SAINT THOMAS MEDICAL PARTNERS NASHVILLE TN NURSE PRACTITIONER 591 11 $3,971 $361 premium 100.0% (615) 269-4545
17 ATLANTIC DIGESTIVE SPECIALISTS PLLC SOMERSWORTH NH GASTROENTEROLOGY 18 11 $10,967 $997 premium 100.0% (603) 692-2228

*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 →