I'm running highest 39ppd option, with higher "ish" settings (not everything set the highest, but a bunch of it) and I'm getting anywhere between 50-90fps depending on the situation. On medium busy MP servers I'm pulling 50-70's. 90 is offline empty mission. I mostly don't have some stuff set high for spotting reasons since I do play MP, and the settings are more optimized for spotting than "eye candy" since we can't have both in DCS.
12900k/4090 no OC on either.