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    OpenPayerNPI Medicare & MedicaidVishal Gupta
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    Vishal Gupta — Billing Profile & Reimbursement Data

    NPI 1114162625 · Martinsburg, WV · Gastroenterology Physician

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    Vishal Gupta is a gastroenterology physician provider located in Martinsburg, West Virginia. This profile covers 16 Medicare and 0 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

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    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeIndividual
    OrganizationVishal Gupta
    Address880 N Tennessee Ave Ste 104
    CityMartinsburg
    StateWV
    ZIP25401
    TaxonomyGastroenterology Physician
    NPI EnumeratedDecember 12, 2008

    Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)

    Payer SourceTotal Paid
    Medicare$108.1K
    Medicaid$0

    Medicare: Total Revenue Breakdown by CPT/HCPCS Code

    Medicare revenue breakdown by CPT/HCPCS procedure code.

    View: Bar Chart1 / 2

    Medicare: Complete Services Breakdown

    The CPT/HCPCS codes generating the most Medicare revenue for this provider.

    16 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    45380The provider examines the rectum and colon using a flexible colonoscope, a tubular instrument with a light source and camera, to look for the cause of a patient's symptoms, which may include…230$120$27.5K
    45385The 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…110$190$21.5K
    43239The 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.170$70$11.2K
    G0105Colorectal cancer screening; colonoscopy on individual at high risk50$180$8.3K
    99222The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…80$100$8.2K
    45378The 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…70$120$8.1K
    99232The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…100$60$6.1K
    G0121Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk20$180$4.2K
    99223The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…20$130$3.1K
    43249The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum and dilates (widens) the esophagus with a balloon less than 30 mm in diameter.30$80$2.9K

    Showing 1–10 of 16

    Medicare: Competitive Analysis & Benchmarks

    How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 16 CPT/HCPCS codes.

    View: State1 / 2

    Full comparison — all codes billed, vs. state median

    16 rows

    CPT/HCPCS CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    992323,0541,34090$60$11.9K
    9921414,6152,740100$70$11.8K
    45385587040$200$10.4K
    992233,33278030$130$7.9K
    G0105533030$190$6.5K
    43239399040$90$5.5K
    45380147030$120$4.8K
    992227191,08030$100$4.5K
    992045,9531,22030$100$4.1K
    43249112020$140$4K

    Showing 1–10 of 16

    Related Providers

    Other providers that share a Tax Identification Number (TIN) with Vishal Gupta, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    West Virginia University Medical CorporationWVFamily Medicine Physician$0$162.1M
    Columbus Radiology CorpOHDiagnostic Radiology Physician$0$49.9M
    W.a. Foote Memorial HospitalMIGeneral Acute Care Hospital$0$41.3M
    W.a. Foote Memorial Hospital, Inc.MIGeneral Acute Care Hospital$0$40M
    Mclaren Northern MichiganMIGeneral Acute Care Hospital$0$20.5M
    Potomac Valley Hospital Of W Va , IncWVCritical Access Hospital$0$11M
    W.a. Foote Memorial Hospital, IncMINurse Practitioner$0$5.3M
    Potomac Valley Hospital Of W Va , IncWVEmergency Medicine Physician$0$2.3M
    Abdulkareem SharafCACardiovascular Disease Physician$1.2M$1.2M
    Inderjit MehmiCAHematology & Oncology Physician$2.3M$0

    Nearby Providers

    Other providers in the same ZIP code as Vishal Gupta, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Shenandoah Valley Medical System, Inc.WVFederally Qualified Health Center (FQHC)$0$61M
    City Hospital, IncWVGeneral Acute Care Hospital$0$41.1M
    Eastern Panhandle Mental Health Center (waiver)WVCommunity/Behavioral Health Agency$0$28.8M
    Stepping Stones Cottages, LLCWVCounseling Psychologist$0$26.6M
    University Healthcare Physicians, Inc.WVFamily Medicine Physician$0$17.5M
    American Family Matters LLCWVCommunity/Behavioral Health Agency$0$16.9M
    Berkeley County Emergency Ambulance AuthorityWVLand Ambulance$864.6K$5.6M
    Eastern Panhandle Mental Health (rehab)WVCommunity/Behavioral Health Agency$0$5.7M
    City Of MartinsburgWVLand Ambulance$222.2K$2.7M
    Lance PittmanWVOrthodontics and Dentofacial Orthopedics Dentistry$0$2.3M

    Frequently Asked Questions

    References

    1. 1.Medicare Physician & Other Practitioner by Provider and Service. CMS.gov.Provider-level Medicare Part B utilization and payment data.
    2. 2.NPPES NPI Registry. CMS.gov.National Provider Identifier registry used for provider enumeration and taxonomy metadata.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

    Medicare Revenue by CPT/HCPCS Code
    Claims Volume vs. West Virginia Distribution
    Vishal Gupta — 2 of 16 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — West Virginia