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NPI 1104975689 · Tamuning, GU · Surgery Physician
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Ronald Kobayashi is a surgery physician provider located in Tamuning, Guam. This profile covers 9 Medicare and 1 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.
Provider details (source: NPPES NPI Registry)
| Field | Value |
|---|---|
| Entity Type | Individual |
| Organization | Ronald Kobayashi |
| Address | 590 South Marine Corps Drive |
| City | Tamuning |
| State | GU |
| ZIP | 96913 |
| Taxonomy | Surgery Physician |
| NPI Enumerated | January 10, 2007 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $33.8K |
| Medicaid | $1.7K |
This provider’s Medicare activity is concentrated in office evaluation-and-management visits and endoscopic GI procedures: top Medicare line items include 99204 ($8.9K, 79 claims; 26.4% of Medicare revenue), 99213 ($6K, 82 claims; 17.7% of Medicare revenue), and G0105 ($4.6K, 25 claims; 13.5% of Medicare revenue). The mix of high-paying new-patient E/M (99204) alongside colonoscopy screening and diagnostic codes (G0105, 45378, 45388) suggests a practice that blends outpatient clinic visits with procedural endoscopy work rather than being exclusively inpatient or hospital-based.
Revenue concentration is moderate on Medicare and absolute on Medicaid: the top three Medicare codes account for 57.6% of this provider’s total Medicare revenue, while the precomputed top-3 share for Medicaid is 100.0%, meaning Medicaid revenue is entirely driven by a single code (99204). For Medicaid that single code (99204) generated $1.7K across 12 claims and represents 100.0% of the provider’s Medicaid receipts, indicating effectively single-code Medicaid billing.
Payer mix is heavily Medicare-weighted in scale: lifetime Medicare revenue is $33.8K compared with lifetime Medicaid revenue of $1.7K, making Medicare the dominant payer by an order of magnitude. Operational and utilization conclusions should therefore be driven primarily by the Medicare detail rather than the minimal Medicaid activity.
Competitive standing is mixed by code: 99204 ranks #39458 of 227068 providers nationally and is listed at the 82th percentile with a “typical, unremarkable volume” label, indicating a relatively stronger national presence for new-patient E/M visits. By contrast, procedure-level ranks are modest or low—45388 ranks #269 of 329 providers (13th percentile), 45385 ranks in the 2th percentile, and 99214 sits at the 10th percentile—suggesting the provider is a modest participant nationally for many endoscopic procedure codes.
The statistical descriptors provided for the listed codes are uniformly neutral: multiple top codes are annotated as “typical, unremarkable volume” in the source, and none of the top-billed codes are flagged as notable outliers. That neutrality, combined with several low-percentile procedure ranks, implies routine clinical volume rather than a highly concentrated or atypical billing footprint in the national data.
Operational detail from claim counts and average paid-per-claim supports the mixed clinic/procedure model: Medicare claims include 79 for 99204 at $113 avg paid/claim, 82 for 99213 at $73 avg paid/claim, and procedural counts like 30 claims for 45378 at $126 avg paid/claim and 49 claims for 43239 at $66 avg paid/claim. These figures reinforce that revenue derives from a combination of office visits and diagnostic/therapeutic endoscopy rather than high-volume surgical episodes.
Medicaid footprint is negligible statewide: the single Medicaid code 99204 ranks #20 of 20 in-state (0th percentile) and accounts for all Medicaid revenue ($1.7K), so the provider has little competitive presence in Guam Medicaid billing. Analysts should treat Medicaid comparisons cautiously because the provider’s Medicaid activity is minimal and concentrated in one code.
The provider has long tenure in the NPI registry (enumerated 2007-01-10, ~19 years ago), indicating an established practice history in TAMUNING, GU; combined with the modest revenue totals ($33.8K Medicare lifetime), this suggests a small to medium sized outpatient surgical/endoscopy practice rather than a large regional center. Longevity plus routine billing patterns point toward an ongoing clinical practice with stable, but limited, payer-scale impact.
Medicare revenue breakdown by CPT/HCPCS procedure code.
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The CPT/HCPCS codes generating the most Medicare revenue for this provider.
9 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 99204 | The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the provider… | 80 | $110 | $8.9K |
| 99213 | The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the… | 80 | $70 | $6K |
| G0105 | Colorectal cancer screening; colonoscopy on individual at high risk | 30 | $180 | $4.6K |
| 45378 | The provider examines the colon and rectum using a colonoscope, a flexible tube with a camera at its inserted end. If he sees any areas of abnormal mucosa or tissue, he takes samples using a brush… | 30 | $130 | $3.8K |
| 43239 | The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis. | 50 | $70 | $3.2K |
| 45388 | In this procedure, the provider performs flexible colonoscopy to destroy one or more tumors, polyps, or other lesions. The procedure includes, but does not require, guide wire passage and dilating… | 10 | $220 | $2.8K |
| 99214 | The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the… | 20 | $100 | $2.2K |
| 45385 | The provider examines the colon and rectum using a colonoscope, a long, thin flexible tubular instrument with a light source and camera. He removes one or more tumors, polyps, or other lesions with a… | 10 | $140 | $1.7K |
| 99203 | The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the provider… | 10 | $60 | $690 |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 9 CPT/HCPCS codes.
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Full comparison — all codes billed, vs. state median
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
View: By Year1 / 3
Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
1 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 99204 | The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the provider… | 10 | $140 | $1.7K |
How this provider's Medicaid billing volume and revenue compare to other Guam providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Guam median
1 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 99204 | The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the provider… | 20 | 20 | 60 | $140 | $20.8K |
Other providers in the same ZIP code as Ronald Kobayashi, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Thomas Lee | GU | Dentist | $0 | $10.9M |
| Guam Memorial Hospital | GU | General Acute Care Hospital | $0 | $3.5M |
| Rsa - Tumon, LLC | GU | End-Stage Renal Disease (ESRD) Treatment Clinic/Center | $0 | $2.9M |
| Robert Yang | GU | Dentist | $0 | $2.4M |
| Antonio Garcia | GU | Pediatrics Physician | $0 | $2.2M |
| Ma Gladys Linsangan | GU | Pediatrics Physician | $0 | $2.2M |
| Ari Katerelos | GU | Radiation Oncology Physician | $2.1M | $0 |
| Guam X-ray | GU | Vascular & Interventional Radiology Physician | $0 | $2.1M |
| Sarah Clegg | GU | General Practice Dentistry | $0 | $1.7M |
| Peter Kh Go | GU | Surgery Physician | $152.8K | $1.5M |
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