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Market snapshot

43277 nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS

43277 — Balloon dilation of pancreatic or bile duct or sphincter using a flexible endoscope

Billing groups
48
Named-group FFS services
1,224
FFS of Medicare
49%
Services YoY
+28.7%
FFS enrollment -2.2%
Estimated all-Medicare volume FFS + estimated MA estimate
~2,485 services

1,224 observed fee-for-service (49%) · ~1,261 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 — 43277 (CY2024)
CA 473 NC 160 WA 143 SC 137 MA 125

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

Named-group submitted charges
$1.7M
Named-group allowed amount
$279K
Named-group Medicare payments
$220K
Avg charge / svc
$1,358
Avg allowed / svc
$228
Avg payment / svc
$179
Average charge per group
$600 48 groups · avg submitted charge / service $2,687
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Data year: CY2024 CY2023 CY2022 🔒 CY2021 🔒 CY2020 🔒
#Physician group City St Specialty Providers 43277 svcs Submitted charges Avg charge Medicare $ Share* Phone
1 CEDARS-SINAI MEDICAL CENTER WEST HOLLYWOOD CA NURSE PRACTITIONER 802 80 $108,112 $1,351 16.9% (310) 423-3277
2 MAYO CLINIC ROCHESTER MN NURSE PRACTITIONER 4896 71 $152,324 $2,145 57.7% (507) 284-2511
3 SUTTER BAY MEDICAL FOUNDATION PALO ALTO CA INTERNAL MEDICINE 3716 66 $90,577 $1,372 14.0% (415) 600-1020
4 UNIVERSITY MEDICAL ASSOCIATES OF THE MEDICAL UNIVERSITY OF SOUTH CAROL CHARLESTON SC PHYSICIAN ASSISTANT 1692 59 $154,734 $2,623 43.1% (843) 792-1414
5 SUTTER VALLEY MEDICAL FOUNDATION SACRAMENTO CA DIAGNOSTIC RADIOLOGY 2420 57 $96,048 $1,685 12.1% (916) 681-8852
6 IU HEALTH MEDICAL GROUP, LLC INDIANAPOLIS IN NURSE PRACTITIONER 4250 54 $57,672 $1,068 74.0% (888) 484-3258
7 FLORIDA HOSPITAL MEDICAL GROUP INC MAITLAND FL PHYSICIAN ASSISTANT 1634 43 $49,063 $1,141 41.0% (407) 200-2700
8 VIDANT MEDICAL GROUP LLC KENANSVILLE NC PHYSICIAN ASSISTANT 956 40 $29,520 $738 25.0% (910) 296-0941
9 UC REGENTS ORANGE CA INTERNAL MEDICINE 296 34 $58,140 $1,710 7.2% (714) 456-7002
10 LEWIS GALE PHYSICIANS LLC SALEM VA PHYSICIAN ASSISTANT 196 33 $42,904 $1,300 73.3% —
11 SCRIPPS HEALTH LA JOLLA CA PHYSICIAN ASSISTANT 1431 32 $44,891 $1,403 6.8% (858) 455-9100
12 MAYO CLINIC ARIZONA PHOENIX AZ PHYSICIAN ASSISTANT 1635 32 $46,848 $1,464 100.0% (800) 603-0558
13 ZUHDI TRANSPLANT PHYSICIANS OKLAHOMA CITY OK NURSE PRACTITIONER 51 26 $19,422 $747 55.3% (405) 947-5557
14 BANNER PHYSICIAN SPECIALISTS ARIZONA LLC SUN CITY WA PHYSICIAN ASSISTANT 354 25 $28,100 $1,124 17.5% (623) 832-4000
15 BSA AMARILLO DIAGNOSTIC CLINIC INC AMARILLO TX NURSE PRACTITIONER 31 25 $22,843 $914 50.0% (806) 358-0200
16 KING COUNTY PUBLIC HOSPITAL DISTRICT NO 2 KIRKLAND WA PHYSICIAN ASSISTANT 588 24 $23,928 $997 16.8% —
17 PRATT MEDICAL GROUP INC BOSTON MA INTERNAL MEDICINE 277 23 $25,600 $1,113 18.4% (617) 636-5000
18 CONSULTANTS IN GASTROENTEROLOGY PA WEST COLUMBIA SC CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) 37 23 $50,531 $2,197 16.8% (803) 794-4585
19 GASTRO-INTESTINAL CONSULTANTS OF CENTRAL FLORIDA, LLC TAVARES FL CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) 2 22 $17,475 $794 21.0% (352) 383-7703
20 SAINT LUKES PHYSICIAN GROUP INC KANSAS CITY MO NURSE PRACTITIONER 1228 21 $21,630 $1,030 31.8% —
21 MEDICAL AFFILIATES OF CAPE COD INC HYANNIS MA NURSE PRACTITIONER 236 20 $20,308 $1,015 16.0% (508) 771-1800
22 MONTROSE MEMORIAL HOSPITAL, INC MONTROSE CO DIAGNOSTIC RADIOLOGY 140 19 $17,828 $938 100.0% (970) 252-2691
23 UNIVERSITY OF UTAH ADULT SERVICES SALT LAKE CITY MI PHYSICIAN ASSISTANT 1783 19 $24,246 $1,276 36.5% (801) 581-2121
24 BEAUMONT MEDICAL GROUP- SPECIALTY SERVICES ROYAL OAK MI PHYSICIAN ASSISTANT 833 18 $15,135 $841 34.6% (248) 898-5058
25 STANFORD HEALTH CARE STANFORD CA DIAGNOSTIC RADIOLOGY 3039 18 $48,366 $2,687 3.8% (650) 723-4000
26 THE MEDICAL CENTER, INC. COLUMBUS GA FAMILY PRACTICE 34 17 $21,726 $1,278 54.8% (706) 571-1000
27 KERN GASTROENTEROLOGY MEDICAL GROUP BAKERSFIELD PA GASTROENTEROLOGY 6 17 $29,750 $1,750 58.6% (661) 324-1203
28 TIDALHEALTH SPECIALTY CARE LLC SALISBURY MD NURSE PRACTITIONER 329 17 $12,668 $745 100.0% —
29 BOCACARE INC BOCA RATON MA PHYSICIAN ASSISTANT 199 17 $26,156 $1,539 13.6% (561) 955-7100
30 HOAG CLINIC NEWPORT BEACH MI PHYSICIAN ASSISTANT 436 15 $18,386 $1,226 28.8% (949) 791-3370
31 HOAG CLINIC NEWPORT BEACH CA PHYSICIAN ASSISTANT 436 15 $18,386 $1,226 3.2% (949) 791-3370
32 OASIS ADVANCED GASTROENTEROLOGY INC RANCHO MIRAGE CA PATHOLOGY 2 15 $9,000 $600 3.2% (760) 205-2081
33 ALEGENT CREIGHTON CLINIC OMAHA NE PHYSICIAN ASSISTANT 942 15 $15,555 $1,037 100.0% —
34 DIGESTIVE CONSULTANTS LLC CHESTERFIELD GA GASTROENTEROLOGY 8 14 $17,892 $1,278 45.2% (636) 685-7795
35 SAINT THOMAS MEDICAL PARTNERS NASHVILLE NY NURSE PRACTITIONER 591 14 $12,040 $860 100.0% (615) 269-4545
36 UNIVERSITY OF NORTH CAROLINA AT CHAPEL HILL CHAPEL HILL MN NURSE PRACTITIONER 2120 14 $18,298 $1,307 11.4% (984) 215-5556
37 PROVIDENCE HEALTH AND SERVICES WASHINGTON SPOKANE WA PHYSICIAN ASSISTANT 771 14 $15,946 $1,139 9.8% —
38 MEDHEALTH DALLAS TX PHYSICIAN ASSISTANT 430 13 $12,335 $949 26.0% (214) 599-8624
39 PROVIDENCE MEDICAL FOUNDATION FULLERTON CA PHYSICIAN ASSISTANT 1455 13 $15,947 $1,227 2.7% (714) 871-3006
40 KANSAS UNIVERSITY PHYSICIANS INC KANSAS CITY KS NURSE PRACTITIONER 1815 13 $11,766 $905 100.0% (913) 588-1227
41 IMC-GULF COAST GASTROENTEROLOGY LLC FAIRHOPE AL GASTROENTEROLOGY 5 13 $9,750 $750 100.0% (251) 990-0360
42 SUTTER VALLEY MEDICAL FOUNDATION SACRAMENTO TX DIAGNOSTIC RADIOLOGY 2420 12 $21,528 $1,794 24.0% (916) 681-8852
43 PACIFIC CENTRAL COAST HEALTH CENTERS SANTA MARIA CA PHYSICIAN ASSISTANT 249 12 $9,740 $812 2.5% (805) 349-8514
44 JOHN MUIR PHYSICIAN NETWORK WALNUT CREEK CA FAMILY PRACTICE 489 12 $20,004 $1,667 2.5% (925) 296-9720
45 MCV ASSOCIATED PHYSICIANS RICHMOND VA NURSE PRACTITIONER 1791 12 $21,192 $1,766 26.7% (804) 828-9000
46 MEDSTAR MEDICAL GROUP II LLC WASHINGTON PA PHYSICIAN ASSISTANT 3707 12 $12,432 $1,036 41.4% (202) 429-2401
47 BMC AFFILIATED PHYSICIANS, INC. BROCKTON MA PHYSICIAN ASSISTANT 525 11 $14,091 $1,281 8.8% (508) 427-3000
48 ORLANDO HEALTH MEDICAL GROUP INC ORLANDO FL PHYSICIAN ASSISTANT 2145 11 $12,551 $1,141 10.5% (407) 896-1100
49 MARY WASHINGTON HEALTHCARE PROVIDERS LLC FREDERICKSBURG MA DIAGNOSTIC RADIOLOGY 267 11 $9,680 $880 8.8% (540) 741-5610
50 SMH PHYSICIAN SERVICES INC SARASOTA FL PHYSICIAN ASSISTANT 766 11 $9,009 $819 10.5% —

*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 →