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Market snapshot

Nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS
43245 Dilation of stomach outlet 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 2,339 services ▲ 20.6% YoY · 2,136 beneficiaries (CY2024, Medicare FFS)
Medicare paid $383K · $163.83 avg / service, national
CMS descriptor · RBCS classification · Medicare Part B physician/supplier claims, 12-year window
Billing groups
50
Named-group FFS services
1,512
FFS of Medicare
49%
Services YoY
+20.6%
FFS enrollment -2.2%
Estimated all-Medicare volume FFS + estimated MA estimate
~2,943 services

1,512 observed fee-for-service (51%) · ~1,431 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 — 43245 (CY2024)
NE 367 CA 254 MS 198 MI 153 FL 126

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

Named-group submitted charges
$1.5M
Named-group allowed amount
$193K
Named-group Medicare payments
$150K
Avg charge / svc
$981
Avg allowed / svc
$128
Avg payment / svc
$99
Average charge per group
$141 50 groups · avg submitted charge / service $2,527
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Data year: CY2024 CY2023 CY2022  CY2021  CY2020 
# Physician group City St Specialty Providers 43245 svcs Submitted charges Avg charge Medicare $ Share* Phone
1 FAITH REGIONAL PHYSICIAN SERVICES LLC NORFOLK NE NURSE PRACTITIONER 185 245 $344,715 $1,407 66.8% (402) 371-4880
2 ANDERSON PHYSICIAN ALLIANCE INC MERIDIAN MS NURSE PRACTITIONER 70 143 $91,058 $637 72.2% (601) 553-6399
3 ALLEGHENY CLINIC PITTSBURGH PA PHYSICIAN ASSISTANT 2293 90 $45,060 $501 78.3% —
4 COMMUNITY MEDICAL ASSOCIATES INC LOUISVILLE KY NURSE PRACTITIONER 1377 79 $45,504 $576 100.0% (502) 937-2209
5 IHC HEALTH SERVICES INC MURRAY UT PHYSICIAN ASSISTANT 3944 71 $35,997 $507 85.5% (801) 261-8346
6 ST PETERS HEALTH HELENA ID PHYSICIAN ASSISTANT 204 53 $50,579 $954 60.9% (406) 447-2828
7 PIONEER MEDICAL ASSOCIATES PC WARREN MI INTERNAL MEDICINE 23 47 $35,250 $750 30.7% (586) 573-5890
8 LITCHFIELD FAMILY PRACTICE CENTER LITCHFIELD IL FAMILY PRACTICE 18 44 $27,912 $634 57.9% (217) 324-6127
9 CLEVELAND CLINIC CLEVELAND OH PHYSICIAN ASSISTANT 6828 37 $48,433 $1,309 35.2% —
10 FLORIDA HOSPITAL HEALTHCARE PARTNERS, INC DAYTONA BEACH FL PHYSICIAN ASSISTANT 588 35 $18,725 $535 27.8% (386) 231-6000
11 ENLOE MEDICAL CENTER CHICO CA DIAGNOSTIC RADIOLOGY 362 25 $9,575 $383 9.8% (530) 332-4470
12 CLEVELAND CLINIC CLEVELAND PA PHYSICIAN ASSISTANT 6828 25 $32,725 $1,309 21.7% —
13 BRIGHAM AND WOMENS PHYSICIANS ORGANIZATION INC BOSTON MA PHYSICIAN ASSISTANT 2942 23 $31,671 $1,377 57.5% (617) 732-5500
14 TEXAS DIGESTIVE DISEASE CONSULTANTS, PLLC DALLAS TX GASTROENTEROLOGY 613 23 $17,043 $741 46.0% —
15 COMMUNITY FOUNDATION MEDICAL GROUP FRESNO CA PHYSICIAN ASSISTANT 292 23 $46,782 $2,034 9.1% —
16 GCGA PHYSICIANS INC. CINCINNATI OH GASTROENTEROLOGY 76 22 $38,397 $1,745 21.0% (513) 751-6667
17 BORLAND GROOVER CLINIC, PA JACKSONVILLE FL GASTROENTEROLOGY 125 21 $15,320 $730 16.7% (904) 398-7205
18 SANFORD MEDICAL CENTER FARGO FARGO ND NURSE PRACTITIONER 1198 20 $36,860 $1,843 100.0% (701) 234-2000
19 UC REGENTS ORANGE CA INTERNAL MEDICINE 296 20 $15,840 $792 7.9% (714) 456-7002
20 SJHMC PHYSICIAN SERVICES PHOENIX AZ NURSE PRACTITIONER 690 20 $9,960 $498 40.8% (602) 406-6017
21 VIDANT MEDICAL GROUP LLC KENANSVILLE NC PHYSICIAN ASSISTANT 956 20 $8,680 $434 100.0% (910) 296-0941
22 PLATINUM DIGESTIVE HEALTH RANCHO CUCAMONGA CA GASTROENTEROLOGY 8 19 $28,500 $1,500 7.5% (909) 655-0300
23 HOAG CLINIC NEWPORT BEACH MI PHYSICIAN ASSISTANT 436 19 $30,953 $1,629 12.4% (949) 791-3370
24 UNIVERSITY MEDICAL SERVICE ASSOCIATION INC TAMPA FL NURSE PRACTITIONER 814 18 $9,756 $542 14.3% —
25 GRAND JUNCTION GASTROENTEROLOGY PLLC GRAND JUNCTION CO GASTROENTEROLOGY 12 18 $14,184 $788 100.0% (970) 242-6600
26 VIRGINIA MASON MEDICAL CENTER SEATTLE WA PHYSICIAN ASSISTANT 879 17 $31,747 $1,867 18.7% (206) 223-6600
27 SINGING RIVER HEALTH SYSTEM PASCAGOULA MS NURSE PRACTITIONER 282 17 $39,950 $2,350 8.6% (228) 818-0563
28 ENDEAVOR HEALTH MEDICAL GROUP EVANSTON IL NURSE PRACTITIONER 3380 16 $10,384 $649 21.1% —
29 WASHINGTON UNIVERSITY SAINT LOUIS MO NURSE PRACTITIONER 3070 15 $27,900 $1,860 19.0% (314) 747-3000
30 MAYO CLINIC ARIZONA PHOENIX AZ PHYSICIAN ASSISTANT 1635 15 $16,065 $1,071 30.6% (800) 603-0558
31 SUTTER BAY MEDICAL FOUNDATION PALO ALTO CA INTERNAL MEDICINE 3716 15 $17,176 $1,145 5.9% (415) 600-1020
32 MEMORIAL HOSPITAL AT GULFPORT GULFPORT MS NURSE PRACTITIONER 462 15 $15,300 $1,020 7.6% —
33 CORAL RIDGE GASTROENTEROLOGY ASSOCIATES LLC OAKLAND PARK FL GASTROENTEROLOGY 9 15 $9,750 $650 11.9% (954) 771-9920
34 PROVIDENCE HEALTH AND SERVICES WASHINGTON SPOKANE WA PHYSICIAN ASSISTANT 771 15 $7,980 $532 16.5% —
35 HONORHEALTH AMBULATORY SCOTTSDALE AZ PHYSICIAN ASSISTANT 601 14 $6,899 $493 28.6% —
36 GASTRO HEALTH, LLC MIAMI FL GASTROENTEROLOGY 256 14 $25,256 $1,804 11.1% (305) 913-0666
37 HARRISONVILLE FAMILY MEDICINE, INC. HARRISONVILLE MO NURSE PRACTITIONER 9 14 $4,900 $350 17.7% (816) 380-3582
38 INTERNAL MEDICINE ASSOCIATES P.C. OPELIKA AL INTERNAL MEDICINE 41 14 $8,358 $597 100.0% (334) 749-3385
39 AVERA MCKENNAN SIOUX FALLS SD NURSE PRACTITIONER 964 14 $1,978 $141 100.0% (605) 322-5180
40 STATE UNIVERSITY OF IOWA IOWA CITY IA PHYSICIAN ASSISTANT 1902 13 $26,487 $2,037 100.0% (319) 678-8201
41 KANSAS GASTROENTEROLOGY LLC WICHITA KS PHYSICIAN ASSISTANT 20 13 $9,022 $694 100.0% (316) 928-8930
42 LEE HEALTH SYSTEM INC FORT MYERS FL NURSE PRACTITIONER 1370 12 $9,528 $794 9.5% (239) 343-9888
43 HACKENSACK MERIDIAN HEALTH MEDICAL GROUP - SPECIALTY CARE PC NEPTUNE NJ NURSE PRACTITIONER 1878 12 $21,372 $1,781 52.2% (732) 362-3663
44 ENDOSCOPIC SOLUTIONS PC CLARKSTON MI GASTROENTEROLOGY 8 12 $4,800 $400 7.8% (248) 625-4055
45 JOHN MUIR PHYSICIAN NETWORK WALNUT CREEK CA FAMILY PRACTICE 489 12 $29,580 $2,465 4.7% (925) 296-9720
46 WHITE COUNTY MEDICAL CENTER SEARCY AR NURSE PRACTITIONER 187 12 $4,584 $382 50.0% (501) 278-2800
47 TANNER MEMORIAL CLINIC LAYTON UT PHYSICIAN ASSISTANT 249 12 $6,000 $500 14.5% (801) 773-4840
48 SCRIPPS HEALTH LA JOLLA CA PHYSICIAN ASSISTANT 1431 11 $27,792 $2,527 4.3% (858) 455-9100
49 MERCY CLINIC GASTROENTEROLOGY LLC SAINT LOUIS MO GASTROENTEROLOGY 64 11 $7,040 $640 13.9% (314) 251-2880
50 GASTROENTEROLOGY MEDICAL CLINIC FOLSOM CA GASTROENTEROLOGY 8 11 $7,975 $725 4.3% (916) 983-4444
51 MIDWEST GASTROINTESTINAL ASSOCIATES PC OMAHA NE GASTROENTEROLOGY 53 11 $16,577 $1,507 3.0% —

*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 →