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Market snapshot

Nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS
G0104 Colorectal cancer screening; flexible sigmoidoscopy HCPCS · Procedure
Classification Procedure Digestive/Gastrointestinal Lower GI Endoscopy - Other (CMS RBCS)
First observed 2013 — start of our 12-year window; the code predates it
National scale 270 services ▼ 33.3% YoY · 269 beneficiaries (CY2024, Medicare FFS)
Medicare paid $29K · $107.17 avg / service, national
CMS descriptor · RBCS classification · Medicare Part B physician/supplier claims, 12-year window
Billing groups
4
Named-group FFS services
51
FFS of Medicare
49%
Services YoY
-33.3%
FFS enrollment -2.2%
Estimated all-Medicare volume FFS + estimated MA estimate
~120 services

51 observed fee-for-service (42%) · ~69 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 — G0104 (CY2024)

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

Named-group submitted charges
$36K
Named-group allowed amount
$4K
Named-group Medicare payments
$4K
Avg charge / svc
$712
Avg allowed / svc
$85
Avg payment / svc
$85
Average charge per group
$325 4 groups · avg submitted charge / service $1,000
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Data year: CY2024 CY2023 CY2022 locked column CY2021 locked column CY2020 locked column
Physician groups ranked by G0104 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 G0104 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 FLORIDA HOSPITAL MEDICAL GROUP INC MAITLAND FL PHYSICIAN ASSISTANT 1634 16 $8,736 $546 premium 13.1% (407) 200-2700
2 GASTROENTEROLOGY ASSOCIATES OF PENSACOLA PA PENSACOLA FL NURSE PRACTITIONER 39 13 $13,000 $1,000 premium 10.7% (850) 436-4563
3 SAGINAW COOPERATIVE HOSPITALS INC SAGINAW MI INTERNAL MEDICINE 82 11 $3,575 $325 premium 100.0% (989) 583-6800
4 GASTRO HEALTH, LLC MIAMI FL GASTROENTEROLOGY 256 11 $11,000 $1,000 premium 9.0% (305) 913-0666

*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 →