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Market snapshot

Nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS
43999 Other procedure on stomach CPT · Procedure
Classification Procedure › Digestive/Gastrointestinal (CMS RBCS)
First observed 2013 — start of our 12-year window; the code predates it
National scale 1,268 services ▼ 23.4% YoY · 842 beneficiaries (CY2024, Medicare FFS)
Medicare paid $210K · $166.01 avg / service, national
CMS descriptor · RBCS classification · Medicare Part B physician/supplier claims, 12-year window
Billing groups
24
Named-group FFS services
865
FFS of Medicare
49%
Services YoY
-23.4%
FFS enrollment -2.2%
Estimated all-Medicare volume FFS + estimated MA estimate
~1,801 services

865 observed fee-for-service (48%) · ~936 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 — 43999 (CY2024)
NY 389 IL 199 KY 103 MA 97 NE 72

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

Named-group submitted charges
$1.1M
Named-group allowed amount
$195K
Named-group Medicare payments
$152K
Avg charge / svc
$1,284
Avg allowed / svc
$226
Avg payment / svc
$176
Average charge per group
$200 24 groups · avg submitted charge / service $8,258
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Data year: CY2024 CY2023 CY2022  CY2021  CY2020 
# Physician group City St Specialty Providers 43999 svcs Submitted charges Avg charge Medicare $ Share* Phone
1 NEW YORK UNIVERSITY NEW YORK NY DIAGNOSTIC RADIOLOGY 5704 347 $139,255 $401 89.2% (212) 263-9700
2 CARTERET MEDICAL GROUP LLC MOREHEAD CITY NC PHYSICIAN ASSISTANT 54 48 $14,400 $300 80.0% (252) 247-2013
3 UNIVERSITY OF LOUISVILLE PHYSICIANS INC LOUISVILLE KY NURSE PRACTITIONER 1442 46 $15,502 $337 44.7% (502) 629-2398
4 NORTH SHORE-LIJ MEDICAL PC MANHASSET NY PHYSICIAN ASSISTANT 6294 42 $17,216 $410 10.8% —
5 COMMUNITY MEDICAL ASSOCIATES INC LOUISVILLE KY NURSE PRACTITIONER 1377 40 $9,392 $235 38.8% (502) 937-2209
6 SUTTER BAY MEDICAL FOUNDATION PALO ALTO CA INTERNAL MEDICINE 3716 40 $138,906 $3,473 72.7% (415) 600-1020
7 LEE HEALTH SYSTEM INC FORT MYERS FL NURSE PRACTITIONER 1370 31 $50,788 $1,638 52.5% (239) 343-9888
8 WASHINGTON UNIVERSITY SAINT LOUIS MO NURSE PRACTITIONER 3070 24 $9,120 $380 100.0% (314) 747-3000
9 HACKENSACK MERIDIAN HEALTH MEDICAL GROUP - SPECIALTY CARE PC NEPTUNE NJ NURSE PRACTITIONER 1878 23 $15,870 $690 100.0% (732) 362-3663
10 VIRGINIA MASON MEDICAL CENTER SEATTLE WA PHYSICIAN ASSISTANT 879 22 $70,221 $3,192 100.0% (206) 223-6600
11 RUSH UNIVERSITY MEDICAL GROUP CHICAGO IL PHYSICIAN ASSISTANT 1496 19 $25,327 $1,333 9.5% (312) 563-2875
12 BRIGHAM AND WOMENS PHYSICIANS ORGANIZATION INC BOSTON CT PHYSICIAN ASSISTANT 2942 19 $101,305 $5,332 100.0% (617) 732-5500
13 SOUTH TEXAS SURGEONS PA SAN ANTONIO TX GENERAL SURGERY 2 18 $3,600 $200 100.0% (210) 220-1726
14 JEFFERSON UNIVERSITY PHYSICIANS PHILADELPHIA PA DIAGNOSTIC RADIOLOGY 1570 16 $42,990 $2,687 100.0% —
15 TIESENGA SURGICAL ASSOCIATES SC ELMWOOD PARK IL GENERAL SURGERY 7 16 $16,800 $1,050 8.0% (708) 453-6800
16 STANFORD HEALTH CARE STANFORD CA DIAGNOSTIC RADIOLOGY 3039 15 $86,705 $5,780 27.3% (650) 723-4000
17 TAMPA GENERAL PROVIDER NETWORK INC WEST PALM BEACH FL UROLOGY 31 15 $6,075 $405 25.4% (561) 621-0012
18 BON SECOURS MEDICAL GROUP HAMPTON ROADS SPECIALTY CARE LLC PORTSMOUTH VA NURSE PRACTITIONER 200 15 $7,650 $510 100.0% (757) 215-3565
19 FLORIDA HOSPITAL MEDICAL GROUP INC MAITLAND FL PHYSICIAN ASSISTANT 1634 13 $34,617 $2,663 22.0% (407) 200-2700
20 MCLEOD REGIONAL MEDICAL CENTER OF THE PEE DEE INC FLORENCE SC NURSE PRACTITIONER 409 12 $20,989 $1,749 100.0% (843) 777-2000
21 UNIVERSITY OF WISCONSIN MEDICAL FOUNDATION INC MADISON WI PHYSICIAN ASSISTANT 2523 11 $80,530 $7,321 100.0% (608) 287-2050
22 MAYO CLINIC ROCHESTER MN NURSE PRACTITIONER 4896 11 $77,649 $7,059 100.0% (507) 284-2511
23 HONORHEALTH AMBULATORY SCOTTSDALE AZ PHYSICIAN ASSISTANT 601 11 $34,602 $3,146 100.0% —
24 LOYOLA UNIVERSITY MEDICAL CENTER MAYWOOD IL NURSE PRACTITIONER 933 11 $90,834 $8,258 5.5% (708) 216-8372

*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 →