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Market snapshot

91038 nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS

91038 — Prolonged monitoring and recording of esophageal function through nasal tube with electrode

Billing groups
51
Named-group FFS services
1,449
FFS of Medicare
49%
Services YoY
-6.9%
FFS enrollment -2.2%
Estimated all-Medicare volume FFS + estimated MA estimate
~2,917 services

1,449 observed fee-for-service (50%) · ~1,468 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 — 91038 (CY2024)
CA 197 NC 174 TX 163 NY 133 PA 127

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
$203K
Named-group Medicare payments
$159K
Avg charge / svc
$761
Avg allowed / svc
$140
Avg payment / svc
$110
Average charge per group
$53 51 groups · avg submitted charge / service $2,650
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Data year: CY2024 CY2023 CY2022 🔒 CY2021 🔒 CY2020 🔒
#Physician group City St Specialty Providers 91038 svcs Submitted charges Avg charge Medicare $ Share* Phone
1 EAST CAROLINA UNIVERSITY GREENVILLE NC NURSE PRACTITIONER 491 99 $151,470 $1,530 56.9% (252) 744-1406
2 NORTHWESTERN MEDICAL FACULTY FOUNDATION CHICAGO IL NURSE PRACTITIONER 4339 67 $20,703 $309 59.8% —
3 NEW YORK UNIVERSITY NEW YORK NY DIAGNOSTIC RADIOLOGY 5704 67 $177,550 $2,650 50.4% (212) 263-9700
4 STANFORD HEALTH CARE STANFORD CA DIAGNOSTIC RADIOLOGY 3039 57 $120,099 $2,107 28.9% (650) 723-4000
5 WASHINGTON GASTROENTEROLOGY PLLC TACOMA WA PHYSICIAN ASSISTANT 139 49 $74,725 $1,525 69.0% (253) 272-5127
6 UNIVERSITY MEDICAL ASSOCIATES OF THE MEDICAL UNIVERSITY OF SOUTH CAROL CHARLESTON SC PHYSICIAN ASSISTANT 1692 46 $23,997 $522 75.4% (843) 792-1414
7 UNIVERSITY HOSPITALS MEDICAL GROUP INC CLEVELAND OH NURSE PRACTITIONER 2232 46 $6,808 $148 46.0% —
8 UNIVERSITY MEDICAL SERVICE ASSOCIATION INC TAMPA FL NURSE PRACTITIONER 814 45 $53,145 $1,181 59.2% —
9 LOUDOUN MEDICAL GROUP, PC LEESBURG VA NURSE PRACTITIONER 293 41 $30,750 $750 100.0% (703) 437-0001
10 UNIVERSITY OF ALABAMA HEALTH SERVICES FOUNDATION, PC BIRMINGHAM AL NURSE PRACTITIONER 2788 39 $7,800 $200 100.0% (205) 934-3460
11 ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI NEW YORK NY PHYSICIAN ASSISTANT 2818 38 $71,440 $1,880 28.6% (212) 241-4812
12 HENRY FORD HEALTH SYSTEM DETROIT MI PHYSICIAN ASSISTANT 2536 38 $7,942 $209 70.4% (313) 916-2600
13 GASTROENTEROLOGY SPECIALTIES PC LINCOLN NE GASTROENTEROLOGY 51 35 $44,800 $1,280 66.0% (402) 465-4545
14 BRIGHAM AND WOMENS PHYSICIANS ORGANIZATION INC BOSTON MA PHYSICIAN ASSISTANT 2942 35 $8,225 $235 32.7% (617) 732-5500
15 BRIGHAM AND WOMENS PHYSICIANS ORGANIZATION INC BOSTON IL PHYSICIAN ASSISTANT 2942 34 $8,014 $236 30.4% (617) 732-5500
16 VIRTUA MEDICAL GROUP, PA VOORHEES PA PHYSICIAN ASSISTANT 1662 32 $5,792 $181 25.2% (856) 247-7260
17 DIGESTIVE HEALTH PARTNERS PA ASHEVILLE NC GASTROENTEROLOGY 65 30 $15,000 $500 17.2% (828) 254-0881
18 ST LUKES PHYSICIAN GROUP INC BETHLEHEM PA PHYSICIAN ASSISTANT 2164 29 $4,186 $144 22.8% (484) 526-2400
19 REGENTS OF THE UNIVERSITY OF CALIFORNIA SAN DIEGO CA DIAGNOSTIC RADIOLOGY 2057 29 $10,865 $375 14.7% (800) 926-8273
20 DUKE HEALTH INTEGRATED PRACTICE INC DURHAM NC PHYSICIAN ASSISTANT 3051 28 $6,412 $229 16.1% (919) 684-8111
21 UNIVERSITY OF MARYLAND PHYSICIANS PA BALTIMORE MD NURSE PRACTITIONER 396 27 $20,115 $745 31.4% (410) 328-7877
22 UNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL CENTER AT DALLAS DALLAS TX PHYSICIAN ASSISTANT 3200 27 $6,561 $243 16.6% (214) 633-5555
23 WASHINGTON UNIVERSITY SAINT LOUIS MO NURSE PRACTITIONER 3070 26 $5,552 $214 48.1% (314) 747-3000
24 MONTANA GASTROENTEROLOGY, PLLC MISSOULA MT GASTROENTEROLOGY 24 25 $30,936 $1,237 100.0% (406) 541-6844
25 REGENTS OF THE UNIV OF CA SACRAMENTO CA DIAGNOSTIC RADIOLOGY 1608 25 $5,850 $234 12.7% (877) 827-7463
26 SUTTER VALLEY MEDICAL FOUNDATION SACRAMENTO CA DIAGNOSTIC RADIOLOGY 2420 24 $6,072 $253 12.2% (916) 681-8852
27 UNIVERSITY OF PENN - MEDICAL GROUP PHILADELPHIA PA PHYSICIAN ASSISTANT 3505 24 $4,560 $190 18.9% (215) 662-2777
28 TRIHEALTH H LLC CINCINNATI OH OBSTETRICS/GYNECOLOGY 853 24 $4,080 $170 24.0% (513) 246-7000
29 THE ASSOCIATION OF UNIVERSITY PHYSICIANS SEATTLE WA PHYSICIAN ASSISTANT 3612 22 $3,710 $169 31.0% (206) 364-0500
30 AVERA MCKENNAN SIOUX FALLS IA NURSE PRACTITIONER 964 20 $1,057 $53 100.0% (605) 322-5180
31 UNMC PHYSICIANS OMAHA NE PHYSICIAN ASSISTANT 1514 18 $3,157 $175 34.0% (402) 559-4000
32 GASTRO HEALTH, LLC MIAMI FL GASTROENTEROLOGY 256 17 $25,500 $1,500 22.4% (305) 913-0666
33 UNIVERSITY OF NORTH CAROLINA AT CHAPEL HILL CHAPEL HILL NC NURSE PRACTITIONER 2120 17 $3,077 $181 9.8% (984) 215-5556
34 MAINEHEALTH PORTLAND MI NURSE PRACTITIONER 2574 16 $2,178 $136 29.6% (207) 885-9905
35 UNIVERSITY OF CINCINNATI PHYSICIANS COMPANY LLC CINCINNATI OH NURSE PRACTITIONER 1504 16 $2,560 $160 16.0% (513) 584-1000
36 CEDARS-SINAI MEDICAL CENTER WEST HOLLYWOOD CA NURSE PRACTITIONER 802 16 $3,004 $188 8.1% (310) 423-3277
37 BANNER - UNIVERSITY PHYSICIAN SPECIALISTS LLC PHOENIX AZ PHYSICIAN ASSISTANT 349 15 $2,205 $147 37.5% (602) 839-3927
38 KENTUCKY MEDICAL SERVICES FOUNDATION, INC LEXINGTON KY DIAGNOSTIC RADIOLOGY 989 15 $2,535 $169 100.0% (859) 257-1412
39 WAKE FOREST UNIVERSITY HEALTH SCIENCES WINSTON SALEM SC PHYSICIAN ASSISTANT 2609 15 $3,015 $201 24.6% (336) 713-9800
40 CHESAPEAKE DIGESTIVE ASSOCIATES, PC ANNAPOLIS MD GASTROENTEROLOGY 37 14 $21,000 $1,500 16.3% 4102244887421
41 CLEVELAND CLINIC CLEVELAND OH PHYSICIAN ASSISTANT 6828 14 $5,012 $358 14.0% —
42 BEACON MEDICAL GROUP INC SOUTH BEND IN NURSE PRACTITIONER 575 14 $18,032 $1,288 100.0% (574) 647-7275
43 FLORIDA CLINICAL PRACTICE ASSOCIATION INC GAINESVILLE FL NURSE PRACTITIONER 1912 14 $4,340 $310 18.4% (352) 265-8990
44 AUSTIN GASTROENTEROLOGY PLLC AUSTIN TX GASTROENTEROLOGY 80 13 $11,973 $921 8.0% (512) 454-4588
45 SAINTS MEDICAL GROUP, LLC OKLAHOMA CITY KS PHYSICIAN ASSISTANT 435 13 $15,925 $1,225 100.0% —
46 SJHMC PHYSICIAN SERVICES PHOENIX AZ NURSE PRACTITIONER 690 13 $2,067 $159 32.5% (602) 406-6017
47 UT PHYSICIANS HOUSTON TX NURSE PRACTITIONER 1758 12 $2,748 $229 7.4% (713) 566-5000
48 ARIZONA DIGESTIVE HEALTH PC GLENDALE AZ GASTROENTEROLOGY 132 12 $7,920 $660 30.0% (602) 843-1265
49 GASTROENTEROLOGY CONSULTANTS LTD RENO NV CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) 38 12 $4,212 $351 100.0% (775) 329-4600
50 AVERA MCKENNAN SIOUX FALLS SD NURSE PRACTITIONER 964 12 $636 $53 100.0% (605) 322-5180
51 SCOTT AND WHITE CLINIC TEMPLE TX PHYSICIAN ASSISTANT 2435 11 $2,167 $197 6.7% (254) 724-2663
52 ILLINOIS GASTROENTEROLOGY GROUP LLC ELGIN IL GASTROENTEROLOGY 114 11 $5,049 $459 9.8% (847) 888-1300
53 THE OREGON CLINIC, PC PORTLAND OR PHYSICIAN ASSISTANT 347 11 $15,961 $1,451 39.3% (503) 239-6673

*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 →