Medicare procedure market data by CPT code & state

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Market snapshot

Nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS

44360 Diagnostic exam of small bowel (excluding lower small intestine) using an endoscope CPT · Procedure

Classification Procedure › Digestive/Gastrointestinal (CMS RBCS)

First observed 2013 — start of our 12-year window; the code predates it

National scale 549 services ▼ 8.0% YoY · 536 beneficiaries (CY2024, Medicare FFS)

Medicare paid $82K · $149.81 avg / service, national

CMS descriptor · RBCS classification · Medicare Part B physician/supplier claims, 12-year window

Billing groups

Named-group FFS services

279

FFS of Medicare

49%

Services YoY

-8.0%

FFS enrollment -2.2%

Estimated all-Medicare volume FFS + estimated MA estimate

~541 services

279 observed fee-for-service (52%) · ~262 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 — 44360 (CY2024)

CA 126 NY 73 FL 73 IA 55 ND 38

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

Named-group submitted charges

$162K

Named-group allowed amount

$35K

Named-group Medicare payments

$27K

Avg charge / svc

$579

Avg allowed / svc

$124

Avg payment / svc

$97

Average charge per group

$278–405

$405–532

$532–659

$659–786

$786–913

$913–1,040

$1,040–1,167

$1,167+

$278 11 groups · avg submitted charge / service $1,849

Market analyticsPlatform

a taste of the twelve-year trend layer

Market position — where this market sits on volume and growth among all state markets, and its rank.
Worth a look — every state market for this search, ranked by a published score: size, growth, fragmentation, below-expected volume.
Lookalike opportunities — groups billing below what peers of the same specialty, size, and state predict, with the expected figure shown.
National benchmarks — where each group's volume sits nationally and within its specialty.
Market structure — how concentrated this market is, and who owns the volume.
Medicare-wide scaling — the payer split, and this market total scaled to all of Medicare, labeled as an estimate.

Or just look at it: nuclear heart imaging (78452) in Arizona is open as a live example — the full paid view, real data.

View the live example →

Nevvi's market analytics platform — code baskets, market structure and share, the twelve-year trend layer — is built and not launched yet. We're gathering interest in it.

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Data year: CY2024 CY2023 CY2022 CY2021 CY2020

Physician groups ranked by 44360 services, highest first, CY2024
#	Physician group activate to sort	City activate to sort	St activate to sort	Specialty activate to sort	Providers activate to sort	44360 svcs sorted descending — activate to reverse	Submitted charges activate to sort	Avg charge activate to sort	Medicare $ locked column	Share* activate to sort	Phone
1	NORTH SHORE-LIJ MEDICAL PC	MANHASSET	NY	PHYSICIAN ASSISTANT	6294	73	$54,020	$740	premium	100.0%	—
2	GENESIS HEALTH SYSTEM	DAVENPORT	IA	NURSE PRACTITIONER	265	55	$28,435	$517	premium	100.0%	(563) 421-1000
3	GASTRO-INTESTINAL CONSULTANTS OF CENTRAL FLORIDA, LLC	TAVARES	FL	CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA)	2	27	$8,186	$303	premium	37.0%	(352) 383-7703
4	GASTROENTEROLOGY PARTNERS OF NORTH HOUSTON PLLC	SHENANDOAH	TX	GASTROENTEROLOGY	10	27	$12,366	$458	premium	100.0%	9363215440135
5	AIKEN PROFESSIONAL ASSOCIATION LLC	AIKEN	SC	NURSE PRACTITIONER	52	17	$4,726	$278	premium	100.0%	(803) 226-0589
6	WINCHESTER GASTROENTEROLOGY ASSOCIATES	WINCHESTER	VA	PHYSICIAN ASSISTANT	15	16	$5,680	$355	premium	100.0%	5406671244234
7	HONORHEALTH AMBULATORY	SCOTTSDALE	AZ	PHYSICIAN ASSISTANT	601	15	$6,038	$403	premium	100.0%	—
8	STATE OF MISSISSIPPI - UNIVERSITY OF MISSISSIPPI MEDICAL CENTER	JACKSON	MS	NURSE PRACTITIONER	951	13	$6,721	$517	premium	100.0%	(601) 815-4775
9	KINGS DAUGHTERS MEDICAL SPECIALTIES INC	ASHLAND	KY	NURSE PRACTITIONER	392	12	$4,974	$414	premium	100.0%	(606) 325-6888
10	MAYO CLINIC JACKSONVILLE	JACKSONVILLE	FL	NURSE PRACTITIONER	1587	12	$22,184	$1,849	premium	16.4%	(904) 953-2000
11	HARVARD MEDICAL FACULTY PHYS AT BETH ISRAEL DEACONESS MED CTR INC	BOSTON	MA	INTERNAL MEDICINE	1689	12	$8,256	$688	premium	100.0%	(781) 983-9088

*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 →