NEVVI Medicare utilization intelligence
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Market snapshot

Nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS
43266 Placement of stent in esophagus, stomach, and/or upper small bowel using a flexible endoscope CPT · Procedure
Classification Procedure › Digestive/Gastrointestinal › Upper GI Endoscopy (CMS RBCS)
First observed 2014
National scale 1,322 services ▲ 28.5% YoY · 1,115 beneficiaries (CY2024, Medicare FFS)
Medicare paid $174K · $131.81 avg / service, national
CMS descriptor · RBCS classification · Medicare Part B physician/supplier claims, 12-year window
Billing groups
39
Named-group FFS services
1,037
FFS of Medicare
49%
Services YoY
+28.5%
FFS enrollment -2.2%
Estimated all-Medicare volume FFS + estimated MA estimate
~1,997 services

1,037 observed fee-for-service (52%) · ~960 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 — 43266 (CY2024)
CA 241 SC 112 WA 106 AZ 101 MA 82

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

Named-group submitted charges
$895K
Named-group allowed amount
$173K
Named-group Medicare payments
$137K
Avg charge / svc
$863
Avg allowed / svc
$167
Avg payment / svc
$132
Average charge per group
$351 39 groups · avg submitted charge / service $2,075
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a taste of the twelve-year trend layer

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Data year: CY2024 CY2023 CY2022  CY2021  CY2020 
# Physician group City St Specialty Providers 43266 svcs Submitted charges Avg charge Medicare $ Share* Phone
1 HONORHEALTH AMBULATORY SCOTTSDALE AZ PHYSICIAN ASSISTANT 601 101 $59,480 $589 100.0% —
2 SUTTER BAY MEDICAL FOUNDATION PALO ALTO CA INTERNAL MEDICINE 3716 82 $87,330 $1,065 34.0% (415) 600-1020
3 BOCACARE INC BOCA RATON MA PHYSICIAN ASSISTANT 199 82 $73,215 $893 100.0% (561) 955-7100
4 THE ASSOCIATION OF UNIVERSITY PHYSICIANS SEATTLE WA PHYSICIAN ASSISTANT 3612 63 $41,302 $656 59.4% (206) 364-0500
5 HACKENSACK MERIDIAN HEALTH MEDICAL GROUP - SPECIALTY CARE PC NEPTUNE NJ NURSE PRACTITIONER 1878 46 $32,045 $697 79.3% (732) 362-3663
6 CEDARS-SINAI MEDICAL CENTER WEST HOLLYWOOD CA NURSE PRACTITIONER 802 46 $35,811 $779 19.1% (310) 423-3277
7 UNIVERSITY MEDICAL ASSOCIATES OF THE MEDICAL UNIVERSITY OF SOUTH CAROL CHARLESTON SC PHYSICIAN ASSISTANT 1692 44 $67,948 $1,544 39.3% (843) 792-1414
8 UNMC PHYSICIANS OMAHA NE PHYSICIAN ASSISTANT 1514 29 $21,773 $751 61.7% (402) 559-4000
9 JOHNS HOPKINS UNIVERSITY BALTIMORE MD NURSE PRACTITIONER 2900 28 $22,455 $802 35.4% (410) 502-4340
10 JEFFERSON UNIVERSITY PHYSICIANS PHILADELPHIA PA DIAGNOSTIC RADIOLOGY 1570 28 $24,090 $860 43.1% —
11 VIRGINIA MASON MEDICAL CENTER SEATTLE WA PHYSICIAN ASSISTANT 879 27 $17,249 $639 25.5% (206) 223-6600
12 PHYSICIANS REFERRAL SERVICE HOUSTON TX NURSE PRACTITIONER 2696 27 $56,034 $2,075 51.9% (713) 592-5433
13 LEE HEALTH SYSTEM INC FORT MYERS FL NURSE PRACTITIONER 1370 23 $21,857 $950 45.1% (239) 343-9888
14 STATE UNIVERSITY OF IOWA IOWA CITY IA PHYSICIAN ASSISTANT 1902 21 $24,067 $1,146 100.0% (319) 678-8201
15 ENDEAVOR HEALTH MEDICAL GROUP EVANSTON IL NURSE PRACTITIONER 3380 21 $12,915 $615 63.6% —
16 VALLEY VIEW HOSPITAL ASSOCIATION GLENWOOD SPGS PA PHYSICIAN ASSISTANT 206 20 $10,600 $530 30.8% (970) 384-7290
17 UNIVERSITY OF UTAH ADULT SERVICES SALT LAKE CITY MI PHYSICIAN ASSISTANT 1783 20 $15,224 $761 100.0% (801) 581-2121
18 REGENTS OF THE UNIV OF CA SACRAMENTO CA DIAGNOSTIC RADIOLOGY 1608 19 $17,309 $911 7.9% (877) 827-7463
19 MIDWEST GASTROINTESTINAL ASSOCIATES PC OMAHA NE GASTROENTEROLOGY 53 18 $19,998 $1,111 38.3% —
20 BANNER-UNIVERSITY MEDICAL GROUP TUCSON PA INTERNAL MEDICINE 1068 17 $9,656 $568 26.2% (520) 694-0111
21 UC REGENTS ORANGE CA INTERNAL MEDICINE 296 17 $16,762 $986 7.1% (714) 456-7002
22 CARILION MEDICAL CENTER ROANOKE VA PHYSICIAN ASSISTANT 964 16 $12,656 $791 22.9% (540) 981-7925
23 DIGESTIVE ASSOCIATES LLP N LAS VEGAS NV GASTROENTEROLOGY 17 16 $9,983 $624 100.0% (702) 633-0207
24 COMMUNITY MEDICAL ASSOCIATES INC LOUISVILLE KY NURSE PRACTITIONER 1377 16 $11,504 $719 100.0% (502) 937-2209
25 SMH PHYSICIAN SERVICES INC SARASOTA FL PHYSICIAN ASSISTANT 766 16 $8,064 $504 31.4% —
26 SWEDISH HEALTH SERVICES SEATTLE WA PHYSICIAN ASSISTANT 1033 16 $10,271 $642 15.1% —
27 SCRIPPS HEALTH LA JOLLA CA PHYSICIAN ASSISTANT 1431 15 $12,079 $805 6.2% (858) 455-9100
28 STANFORD HEALTH CARE STANFORD CA DIAGNOSTIC RADIOLOGY 3039 15 $23,175 $1,545 6.2% (650) 723-4000
29 BON SECOURS MEDICAL GROUP GREENVILLE SPECIALTY CARE LLC GREENVILLE SC NURSE PRACTITIONER 288 14 $4,914 $351 12.5% (864) 255-1901
30 KANSAS UNIVERSITY PHYSICIANS INC KANSAS CITY MO NURSE PRACTITIONER 1815 13 $6,702 $516 100.0% (913) 588-1227
31 MAYO CLINIC ROCHESTER MN NURSE PRACTITIONER 4896 13 $15,579 $1,198 46.4% (507) 284-2511
32 HOAG CLINIC NEWPORT BEACH CA PHYSICIAN ASSISTANT 436 13 $8,736 $672 5.4% (949) 791-3370
33 HACKENSACK MERIDIAN HEALTH MEDICAL GROUP - SPECIALTY CARE PC NEPTUNE NY NURSE PRACTITIONER 1878 12 $8,340 $695 100.0% (732) 362-3663
34 LEWIS GALE PHYSICIANS LLC SALEM VA PHYSICIAN ASSISTANT 196 12 $9,130 $761 17.1% —
35 TEXAS DIGESTIVE DISEASE CONSULTANTS, PLLC DALLAS TX GASTROENTEROLOGY 613 12 $11,064 $922 23.1% —
36 SAINT THOMAS MEDICAL PARTNERS NASHVILLE TN NURSE PRACTITIONER 591 12 $5,352 $446 100.0% (615) 269-4545
37 THE REGENTS OF THE UNIVERSITY OF CALIFORNIA LOS ANGELES CA INTERNAL MEDICINE 1424 12 $14,568 $1,214 5.0% (310) 825-7922
38 FLORIDA HOSPITAL MEDICAL GROUP INC MAITLAND FL PHYSICIAN ASSISTANT 1634 12 $7,932 $661 23.5% (407) 200-2700
39 BARNABAS HEALTH MULTISPECIALTY WEST ORANGE NJ GASTROENTEROLOGY 21 12 $17,676 $1,473 20.7% (973) 731-4600
40 REGENTS OF THE UNIVERSITY OF CALIFORNIA SAN DIEGO CA DIAGNOSTIC RADIOLOGY 2057 11 $10,060 $915 4.6% (800) 926-8273

*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 →