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Market snapshot

43252 nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS

43252 — Microscopic exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope

Billing groups
24
Named-group FFS services
1,978
FFS of Medicare
49%
Services YoY
-2.7%
FFS enrollment -2.2%
Estimated all-Medicare volume FFS + estimated MA estimate
~3,896 services

1,978 observed fee-for-service (51%) · ~1,918 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 — 43252 (CY2024)

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

Named-group submitted charges
$1.9M
Named-group allowed amount
$271K
Named-group Medicare payments
$209K
Avg charge / svc
$969
Avg allowed / svc
$137
Avg payment / svc
$106
Average charge per group
$344 24 groups · avg submitted charge / service $4,819
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Data year: CY2024 CY2023 CY2022 🔒 CY2021 🔒 CY2020 🔒
Physician groups ranked by 43252 services, CY2024
#Physician group City St Specialty Providers 43252 svcs Submitted charges Avg charge Medicare $ locked column Share* Phone
1 PREMIER MEDICAL GROUP, LLC BLOOMINGTON IL NURSE PRACTITIONER 10 434 $281,573 $649 premium 38.2% (309) 663-9424
2 FIRST MEDICAL CENTER INC CERRITOS CA DIAGNOSTIC RADIOLOGY 3 337 $372,100 $1,104 premium 33.0% (562) 809-8082
3 GASTROENTEROLOGY SPECIALISTS OF SOUTHWEST FLORIDA PA NAPLES FL GASTROENTEROLOGY 4 217 $129,115 $595 premium 20.3% (239) 436-5000
4 FLORIDA DIGESTIVE HEALTH SPECIALISTS, LLP BRADENTON FL GASTROENTEROLOGY 86 138 $47,472 $344 premium 12.9% (941) 794-1980
5 MAGNOLIA GASTROENTEROLOGY CLINIC LLC CORINTH MS NURSE PRACTITIONER 5 135 $135,000 $1,000 premium 49.5% (662) 284-9902
6 CENTER FOR GASTROINTESTINAL HEALTH SC FAIRVIEW HEIGHTS IL GASTROENTEROLOGY 4 72 $346,968 $4,819 premium 6.3% (618) 239-0678
7 MILLENNIUM PHYSICIAN GROUP LLC PORT CHARLOTTE FL PHYSICIAN ASSISTANT 953 66 $45,570 $690 premium 6.2% (941) 255-3535
8 BASS MEDICAL GROUP WALNUT CREEK CA OTOLARYNGOLOGY 318 66 $86,724 $1,314 premium 6.5%
9 UC REGENTS ORANGE CA INTERNAL MEDICINE 296 62 $47,182 $761 premium 6.1% (714) 456-7002
10 ALBANY SURGICAL, P.C. ALBANY GA GENERAL SURGERY 5 56 $78,568 $1,403 premium 31.8% 2294344200114
11 GI ASSOCIATES OF DELAWARE PA DOVER DE PATHOLOGY 4 46 $71,000 $1,543 premium 50.0% (302) 678-5008
12 MADHU K. KRIS, M.D., INC. MERCED CA GASTROENTEROLOGY 3 40 $14,000 $350 premium 3.9% (209) 384-3115
13 SAINT FRANCIS PHYSICIAN NETWORK, LLC MEMPHIS TN PHYSICIAN ASSISTANT 75 38 $26,600 $700 premium 34.2% (901) 680-9205
14 LEWIS GALE PHYSICIANS LLC SALEM VA PHYSICIAN ASSISTANT 196 36 $22,212 $617 premium 100.0%
15 JEONG H KIM MD PLLC HONOLULU HI GASTROENTEROLOGY 2 34 $31,806 $935 premium 40.0% (808) 486-0449
16 PRIME HEALTHCARE PHYSICIAN SERVICES - PROVIDENCE INC KANSAS CITY KS NURSE PRACTITIONER 56 32 $29,760 $930 premium 50.8%
17 MEDSTAR MEDICAL GROUP II LLC WASHINGTON DC PHYSICIAN ASSISTANT 3707 28 $12,936 $462 premium 100.0% (202) 429-2401
18 OSU INTERNAL MEDICINE LLC COLUMBUS OH NURSE PRACTITIONER 1155 23 $13,570 $590 premium 100.0% (614) 293-8000
19 SUTTER BAY MEDICAL FOUNDATION PALO ALTO CA INTERNAL MEDICINE 3716 23 $27,362 $1,190 premium 2.3% (415) 600-1020
20 ENDEAVOR HEALTH MEDICAL GROUP EVANSTON IL NURSE PRACTITIONER 3380 22 $22,066 $1,003 premium 1.9%
21 GASTROENTEROLOGY CLINIC, A PROFESSIONAL MEDICAL CORPORATION MONROE LA GASTROENTEROLOGY 13 19 $13,205 $695 premium 30.2% (318) 325-2634
22 H LEE MOFFITT CANCER CTR AND RES INST LIFE TIME CANCER SCRN CTR INC TAMPA FL PHYSICIAN ASSISTANT 1103 19 $17,630 $928 premium 1.8% (813) 745-4673
23 HOAG CLINIC NEWPORT BEACH OR PHYSICIAN ASSISTANT 436 18 $21,078 $1,171 premium 100.0% (949) 791-3370
24 KOFI NUAKO MD PC UNION CITY TN NURSE PRACTITIONER 4 17 $23,328 $1,372 premium 15.3%

*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 →