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Market snapshot

43254 nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS

43254 — Removal of tissue lining of esophagus, stomach, and/or upper small bowel using a flexible endoscope

Billing groups
56
Named-group FFS services
1,279
FFS of Medicare
49%
Services YoY
+12.2%
FFS enrollment -2.2%
Estimated all-Medicare volume FFS + estimated MA estimate
~2,517 services

1,279 observed fee-for-service (51%) · ~1,238 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 — 43254 (CY2024)
CA 222 FL 173 MA 159 IL 112 VA 98

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
$335K
Named-group Medicare payments
$259K
Avg charge / svc
$1,205
Avg allowed / svc
$262
Avg payment / svc
$202
Average charge per group
$604 56 groups · avg submitted charge / service $4,297
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Data year: CY2024 CY2023 CY2022 🔒 CY2021 🔒 CY2020 🔒
#Physician group City St Specialty Providers 43254 svcs Submitted charges Avg charge Medicare $ Share* Phone
1 MAYO CLINIC ROCHESTER MN NURSE PRACTITIONER 4896 65 $115,428 $1,776 82.3% (507) 284-2511
2 HONORHEALTH AMBULATORY SCOTTSDALE AZ PHYSICIAN ASSISTANT 601 65 $49,209 $757 84.4% —
3 UNIVERSITY MEDICAL ASSOCIATES OF THE MEDICAL UNIVERSITY OF SOUTH CAROL CHARLESTON SC PHYSICIAN ASSISTANT 1692 55 $99,740 $1,813 62.5% (843) 792-1414
4 BOCACARE INC BOCA RATON MA PHYSICIAN ASSISTANT 199 54 $59,296 $1,098 34.0% (561) 955-7100
5 LEE HEALTH SYSTEM INC FORT MYERS FL NURSE PRACTITIONER 1370 51 $67,564 $1,325 29.5% (239) 343-9888
6 UC REGENTS ORANGE CA INTERNAL MEDICINE 296 38 $46,474 $1,223 17.1% (714) 456-7002
7 BORLAND GROOVER CLINIC, PA JACKSONVILLE FL GASTROENTEROLOGY 125 33 $29,601 $897 19.1% (904) 398-7205
8 ORLANDO HEALTH MEDICAL GROUP INC ORLANDO FL PHYSICIAN ASSISTANT 2145 32 $26,080 $815 18.5% (407) 896-1100
9 NORTHWESTERN MEDICAL FACULTY FOUNDATION CHICAGO IL NURSE PRACTITIONER 4339 30 $49,230 $1,641 26.8% —
10 SUTTER BAY MEDICAL FOUNDATION PALO ALTO CA INTERNAL MEDICINE 3716 29 $42,412 $1,462 13.1% (415) 600-1020
11 GASTRO CARE INSTITUTE LANCASTER CA GASTROENTEROLOGY 12 27 $16,308 $604 12.2% (661) 529-7550
12 JOHNS HOPKINS UNIVERSITY BALTIMORE MD NURSE PRACTITIONER 2900 26 $23,482 $903 31.7% (410) 502-4340
13 ARKANSAS HEALTH GROUP LITTLE ROCK AR CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) 666 26 $111,730 $4,297 65.0% (501) 202-2093
14 WASHINGTON UNIVERSITY SAINT LOUIS MO NURSE PRACTITIONER 3070 25 $28,060 $1,122 31.6% (314) 747-3000
15 LEHIGH VALLEY PHYSICIAN GROUP ALLENTOWN PA PHYSICIAN ASSISTANT 2389 25 $20,960 $838 36.2% —
16 CEDARS-SINAI MEDICAL CENTER WEST HOLLYWOOD CA NURSE PRACTITIONER 802 25 $24,290 $972 11.3% (310) 423-3277
17 ST LUKES PHYSICIAN GROUP INC BETHLEHEM PA PHYSICIAN ASSISTANT 2164 24 $19,752 $823 34.8% (484) 526-2400
18 GENESIS HEALTH SYSTEM DAVENPORT IA NURSE PRACTITIONER 265 24 $33,069 $1,378 100.0% (563) 421-1000
19 ENDEAVOR HEALTH MEDICAL GROUP EVANSTON IL NURSE PRACTITIONER 3380 23 $22,569 $981 20.5% —
20 LEWIS GALE PHYSICIANS LLC SALEM VA PHYSICIAN ASSISTANT 196 21 $19,362 $922 21.4% —
21 CLEVELAND CLINIC CLEVELAND OH PHYSICIAN ASSISTANT 6828 21 $43,470 $2,070 42.9% —
22 INOVA HEALTH CARE SERVICES FALLS CHURCH VA NURSE PRACTITIONER 1818 20 $16,120 $806 20.4% —
23 SANFORD MEDICAL CENTER FARGO FARGO ND NURSE PRACTITIONER 1198 19 $15,290 $805 100.0% (701) 234-2000
24 CITY OF HOPE MEDICAL FOUNDATION DUARTE CA NURSE PRACTITIONER 942 19 $16,031 $844 8.6% (626) 256-4673
25 SUTTER VALLEY MEDICAL FOUNDATION SACRAMENTO CA DIAGNOSTIC RADIOLOGY 2420 18 $22,849 $1,269 8.1% (916) 681-8852
26 ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI NEW YORK NY PHYSICIAN ASSISTANT 2818 18 $18,600 $1,033 58.1% (212) 241-4812
27 ENDEAVOR HEALTH MEDICAL GROUP EVANSTON WA NURSE PRACTITIONER 3380 18 $13,786 $766 100.0% —
28 KANSAS UNIVERSITY PHYSICIANS INC KANSAS CITY MO NURSE PRACTITIONER 1815 17 $10,814 $636 21.5% (913) 588-1227
29 RUSH UNIVERSITY MEDICAL GROUP CHICAGO IL PHYSICIAN ASSISTANT 1496 17 $16,728 $984 15.2% (312) 563-2875
30 HENRY FORD HEALTH SYSTEM DETROIT MI PHYSICIAN ASSISTANT 2536 17 $15,750 $926 56.7% (313) 916-2600
31 VIRTUA MEDICAL GROUP, PA VOORHEES NJ PHYSICIAN ASSISTANT 1662 16 $14,320 $895 35.6% (856) 247-7260
32 CLEVELAND CLINIC FLORIDA WESTON FL NURSE PRACTITIONER 720 16 $21,152 $1,322 9.2% (954) 659-5000
33 RIVERSIDE PHYSICIAN SERVICES INC NEWPORT NEWS VA PHYSICIAN ASSISTANT 793 16 $9,760 $610 16.3% —
34 DEACONESS CLINIC INC EVANSVILLE IN NURSE PRACTITIONER 403 16 $16,408 $1,026 100.0% (812) 450-6700
35 UNIVERSITY OF TOLEDO PHYSICIANS LLC TOLEDO OH PHYSICIAN ASSISTANT 405 15 $9,825 $655 30.6% (419) 383-5550
36 PHYSICIANS REFERRAL SERVICE HOUSTON TX NURSE PRACTITIONER 2696 15 $36,990 $2,466 17.6% (713) 592-5433
37 THE REGENTS OF THE UNIVERSITY OF CALIFORNIA LOS ANGELES CA INTERNAL MEDICINE 1424 15 $20,026 $1,335 6.8% (310) 825-7922
38 YALE UNIVERSITY NEW HAVEN CT PHYSICIAN ASSISTANT 2649 14 $34,930 $2,495 100.0% (203) 688-4242
39 MNGI DIGESTIVE HEALTH PA MINNEAPOLIS MN GASTROENTEROLOGY 277 14 $16,870 $1,205 17.7% (612) 871-1145
40 DUPAGE MEDICAL GROUP LTD GLEN ELLYN IL PHYSICIAN ASSISTANT 1323 14 $10,822 $773 12.5% (630) 469-9200
41 UNIVERSITY HEALTH SYSTEM, INC. KNOXVILLE TN NURSE PRACTITIONER 561 14 $8,960 $640 56.0% (865) 305-6333
42 UNIVERSITY OF ARKANSAS FOR MEDICAL SCIENCES LITTLE ROCK AR NURSE PRACTITIONER 1241 14 $12,908 $922 35.0% (501) 686-8000
43 BOCACARE INC BOCA RATON FL PHYSICIAN ASSISTANT 199 14 $15,381 $1,099 8.1% (561) 955-7100
44 REGENTS OF THE UNIV OF CA SACRAMENTO CA DIAGNOSTIC RADIOLOGY 1608 14 $14,126 $1,009 6.3% (877) 827-7463
45 UNIVERSITY OF MARYLAND PHYSICIANS PA BALTIMORE MD NURSE PRACTITIONER 396 14 $13,370 $955 17.1% (410) 328-7877
46 STONY BROOK INTERNISTS UNIVERSITY FACULTY PRACTICE CORPORATION STONY BROOK NY HOSPITALIST 414 13 $13,300 $1,023 41.9% (631) 444-1560
47 MCLEOD REGIONAL MEDICAL CENTER OF THE PEE DEE INC FLORENCE SC NURSE PRACTITIONER 409 13 $12,355 $950 14.8% (843) 777-2000
48 BAYCARE MEDICAL GROUP, INC. CLEARWATER FL CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) 1526 13 $9,026 $694 7.5% (727) 725-5060
49 OSU INTERNAL MEDICINE LLC COLUMBUS OH NURSE PRACTITIONER 1155 13 $11,960 $920 26.5% (614) 293-8000
50 BRIGHAM AND WOMENS PHYSICIANS ORGANIZATION INC BOSTON MA PHYSICIAN ASSISTANT 2942 13 $15,626 $1,202 8.2% (617) 732-5500
51 TEXAS DIGESTIVE DISEASE CONSULTANTS, PLLC DALLAS TX GASTROENTEROLOGY 613 13 $14,859 $1,143 15.3% —
52 CHRISTUS TRINITY CLINIC TYLER TX NURSE PRACTITIONER 1495 13 $11,882 $914 15.3% (903) 606-5560
53 KANSAS GASTROENTEROLOGY LLC WICHITA KS PHYSICIAN ASSISTANT 20 13 $13,975 $1,075 100.0% (316) 928-8930
54 SANFORD MEDICAL CENTER SIOUX FALLS SD NURSE PRACTITIONER 831 12 $14,908 $1,242 100.0% (605) 332-2883
55 CLEVELAND CLINIC FLORIDA WESTON VA NURSE PRACTITIONER 720 12 $15,864 $1,322 12.2% (954) 659-5000
56 HARVARD MEDICAL FACULTY PHYS AT BETH ISRAEL DEACONESS MED CTR INC BOSTON MA INTERNAL MEDICINE 1689 12 $15,204 $1,267 7.5% (781) 983-9088
57 MIDWEST GASTROINTESTINAL ASSOCIATES PC OMAHA NE GASTROENTEROLOGY 53 12 $16,128 $1,344 29.3% —
58 REGENTS OF THE UNIVERSITY OF CALIFORNIA SAN DIEGO CA DIAGNOSTIC RADIOLOGY 2057 12 $14,716 $1,226 5.4% (800) 926-8273
59 GASTROENTEROLOGY ASSOCIATES OF NORTHERN VIRGINIA, LLC FAIRFAX VA GASTROENTEROLOGY 92 12 $11,628 $969 12.2% (703) 698-8960

*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 →