NEVVI Medicare utilization intelligence
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Market snapshot

Nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS
43244 Tying of dilated veins of stomach and/or esophagus using a flexible endoscope 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 1,028 services ▼ 31.6% YoY · 777 beneficiaries (CY2024, Medicare FFS)
Medicare paid $298K · $289.82 avg / service, national
CMS descriptor · RBCS classification · Medicare Part B physician/supplier claims, 12-year window
Billing groups
27
Named-group FFS services
565
FFS of Medicare
49%
Services YoY
-31.6%
FFS enrollment -2.2%
Estimated all-Medicare volume FFS + estimated MA estimate
~1,101 services

565 observed fee-for-service (51%) · ~536 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 — 43244 (CY2024)
CA 277 TX 80 WA 69 OH 59 LA 59

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

Named-group submitted charges
$533K
Named-group allowed amount
$132K
Named-group Medicare payments
$101K
Avg charge / svc
$943
Avg allowed / svc
$234
Avg payment / svc
$179
Average charge per group
$325 27 groups · avg submitted charge / service $1,835
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Data year: CY2024 CY2023 CY2022  CY2021  CY2020 
# Physician group City St Specialty Providers 43244 svcs Submitted charges Avg charge Medicare $ Share* Phone
1 VANDERBILT UNIVERSITY MEDICAL CENTER NASHVILLE TN NURSE PRACTITIONER 3394 37 $36,889 $997 71.2% (615) 322-5000
2 BON SECOURS-RICHMOND COMMUNITY HOSPITAL LLC RICHMOND VA NURSE PRACTITIONER 40 37 $32,454 $877 100.0% (804) 288-8900
3 STANFORD HEALTH CARE STANFORD CA DIAGNOSTIC RADIOLOGY 3039 34 $62,390 $1,835 12.3% (650) 723-4000
4 PROVIDENCE HEALTH AND SERVICES WASHINGTON SPOKANE WA PHYSICIAN ASSISTANT 771 32 $23,616 $738 46.4% —
5 OSU INTERNAL MEDICINE LLC COLUMBUS OH NURSE PRACTITIONER 1155 28 $23,240 $830 47.5% (614) 293-8000
6 NORTHWESTERN MEDICAL FACULTY FOUNDATION CHICAGO IL NURSE PRACTITIONER 4339 26 $39,130 $1,505 55.3% —
7 HEALTHTEXAS PROVIDER NETWORK DALLAS TX PHYSICIAN ASSISTANT 2482 26 $24,700 $950 32.5% —
8 FAITH REGIONAL PHYSICIAN SERVICES LLC NORFOLK NE NURSE PRACTITIONER 185 25 $15,750 $630 100.0% (402) 371-4880
9 HOAG CLINIC NEWPORT BEACH CA PHYSICIAN ASSISTANT 436 25 $20,525 $821 9.0% (949) 791-3370
10 ST PAUL PLACE SPECIALISTS, INC. BALTIMORE MD PHYSICIAN ASSISTANT 337 24 $19,416 $809 100.0% (410) 663-8100
11 BLUEFIELD GASTROENTEROLOGY PLLC PRINCETON WV NURSE PRACTITIONER 6 22 $7,150 $325 53.7% 30442572431105
12 OSF MULTI-SPECIALTY GROUP PEORIA IL NURSE PRACTITIONER 2091 21 $29,001 $1,381 44.7% (309) 683-5050
13 UNITED HOSPITAL CENTER INC BRIDGEPORT WV PHYSICIAN ASSISTANT 298 19 $18,411 $969 46.3% (681) 342-1842
14 GASTRO CARE INSTITUTE LANCASTER CA GASTROENTEROLOGY 12 19 $10,412 $548 6.9% (661) 529-7550
15 LEO EICKHOFF MD INC REDDING CA GASTROENTEROLOGY 2 19 $13,696 $721 6.9% (530) 243-8667
16 DIGESTIVE ASSOCIATES LLP N LAS VEGAS NV GASTROENTEROLOGY 17 18 $12,618 $701 100.0% (702) 633-0207
17 USC CARE MEDICAL GROUP INC LOS ANGELES CA DIAGNOSTIC RADIOLOGY 1374 17 $17,510 $1,030 6.1% (800) 872-2273
18 HARVARD MEDICAL FACULTY PHYS AT BETH ISRAEL DEACONESS MED CTR INC BOSTON NY INTERNAL MEDICINE 1689 16 $18,528 $1,158 55.2% (781) 983-9088
19 MAURY REGIONAL MEDICAL GROUP, INC COLUMBIA TN INTERNAL MEDICINE 119 15 $15,000 $1,000 28.8% (931) 381-1111
20 HILL COUNTRY DIGESTIVE HEALTH PLLC KERRVILLE TX NURSE PRACTITIONER 4 15 $15,000 $1,000 18.8% (830) 257-0375
21 BOCACARE INC BOCA RATON MA PHYSICIAN ASSISTANT 199 15 $14,947 $996 100.0% (561) 955-7100
22 ZUHDI TRANSPLANT PHYSICIANS OKLAHOMA CITY OK NURSE PRACTITIONER 51 14 $7,399 $528 100.0% (405) 947-5557
23 CATHOLIC HEALTH INITIATIVES COLORADO WOODLAND PARK CO PHYSICIAN ASSISTANT 1266 13 $8,450 $650 100.0% (719) 776-4780
24 NORTH SHORE-LIJ MEDICAL PC MANHASSET NY PHYSICIAN ASSISTANT 6294 13 $18,096 $1,392 44.8% —
25 SOMC MEDICAL CARE FOUNDATION, INC. PORTSMOUTH OH NURSE PRACTITIONER 349 12 $10,740 $895 20.3% (740) 356-7290
26 FIRST CHOICE PHYSICIAN PARTNERS PALM SPRINGS CA PHYSICIAN ASSISTANT 148 12 $9,324 $777 4.3% —
27 MONUMENT HEALTH RAPID CITY HOSPITAL INC RAPID CITY NC PHYSICIAN ASSISTANT 559 11 $8,294 $754 42.3% (605) 755-7200

*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 →