Loading...

    Explore
    • Policy Monitoring
    • Live Policy Feed
    • Billing Codes
    • NPI Medicare & Medicaid
    • Healthcare Providers
    • Health Insurance Payers
    • States
    • Service Lines
    • Taxonomy Codes
    Lookup tools
    • Billing Code Lookup
    • CPT Modifier Lookup
    • Provider Taxonomy Code Lookup
    • Healthcare Provider & Facility Lookup
    • Health Insurance Payer Lookup
    • Payer Contact Directory

    Policy & Benchmark Tools

    • Prior Authorization Lookup
    • Coverage Criteria Lookup
    • Timely Filing Lookup
    • Billing Code Reimbursement Rates
    • Payer Comparison Dashboard
    • Facility Comparison Dashboard
    • All tools

    Company

    • About OpenPayer
    • Data Sources
    • Trek Health
    OpenPayerby Trek Health
    LinkedInYouTube

    © 2026 Trek Health. All rights reserved.

    OpenPayer is built and maintained by Trek Health.

    v1.0.28
    OpenPayerNPI Medicare & MedicaidJaroslav Zivny
    Ask Trek AI about this page

    Jaroslav Zivny — Billing Profile & Reimbursement Data

    NPI 1144203076 · Worcester, MA · Gastroenterology Physician

    Customize your policy alerts

    Sign up for Jaroslav Zivny — Billing Profile & Reimbursement Data policy alerts

    Get alerted when relevant policies change without checking for updates manually.

    Monitor payer policy activity

    Receive email alerts as soon as relevant payer policies are published or updated.

    Jaroslav Zivny is a gastroenterology physician provider located in Worcester, Massachusetts. This profile covers 15 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.

    Table of contents

    Progress1 / 8

    Explore openpayer tools

    • Billing CodesCPT, HCPCS, DRG & more
    • Reimbursement RatesCommercial vs. Medicare rate reports
    • ProvidersHospitals & facilities
    • PayersPlans & market footprint
    • Taxonomy CodesNUCC specialty codes
    • ModifiersCPT modifiers & usage
    • Prior AuthorizationPA policies by payer & drug
    • Timely FilingFiling deadlines by payer
    • Coverage CriteriaMedical necessity by payer
    • Payer ContactsClaims, PA & appeals contacts
    View all tools

    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeIndividual
    OrganizationJaroslav Zivny
    Address55 Lake Ave N
    CityWorcester
    StateMA
    ZIP01655
    TaxonomyGastroenterology Physician
    NPI EnumeratedNovember 23, 2005

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

    Payer SourceTotal Paid
    Medicare$83.9K
    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.

    15 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    43274The physician performs an ERCP (a diagnostic procedure that combines upper endoscopy and retrograde (reverse or backward) injection of contrast material, a type of dye, into the biliary ducts to…60$300$16.4K
    43276Endoscopic retrograde cholangiopancreatography (ERCP) is endoscopic inspection of the duodenum, the papilla of vater, followed by radiologic assessment of the pancreatic duct and the biliary…30$310$10K
    43237The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum; he also inserts an ultrasound transducer through the scope to examine these same…50$130$6.8K
    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…40$160$6.7K
    43238The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he carries out an ultrasound–guided, intramural or transmural fine needle…40$160$6.2K
    43275Endoscopic retrograde cholangiopancreatography (ERCP) is endoscopic inspection of the duodenum, the papilla of vater, followed by radiologic assessment of the pancreatic duct and the biliary…20$290$5.9K
    43264The provider performs a diagnostic procedure that combines upper endoscopy and retrograde (reverse) injection of contrast material, a type of dye, into the biliary ducts to obtain fluoroscopic images…70$80$5.6K
    43254An esophagogastroduodenoscopy is a procedure to view the esophagus, stomach, and duodenum by means of flexible endoscope passed through the mouth. During the procedure, the provider uses an…30$210$5.5K
    45390The provider performs flexible colonoscopy along with excision of mucous membrane tissue using an endoscope.20$270$5.4K
    43270An esophagogastroduodenoscopy (EGD) is a procedure to view the esophagus, stomach, and duodenum by means of flexible endoscope passed through the mouth. During the EGD, the provider passes guidewires…30$150$5K

    Showing 1–10 of 15

    Medicare: Competitive Analysis & Benchmarks

    How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 15 CPT/HCPCS codes.

    View: State1 / 2

    Full comparison — all codes billed, vs. state median

    15 rows

    CPT/HCPCS CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    4538529746060$260$23.8K
    4327661030$330$13.1K
    4327443030$320$10.6K
    4323910947050$120$8.4K
    43242232030$190$7.4K
    4327071040$170$6.5K
    45390113020$290$6.2K
    4325421030$220$6.1K
    4327532010$270$5.2K
    4326465030$140$4.6K

    Showing 1–10 of 15

    Related Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Mainegeneral Medical CenterMEGeneral Acute Care Hospital$0$168.1M
    Lakeland Regional Medical Center, Inc.FLGeneral Acute Care Hospital$0$62.1M
    Catholic Medical CenterNHGeneral Acute Care Hospital$0$19.8M
    Lakeland Regional Health Systems, Inc.FLMulti-Specialty Clinic/Center$0$12.1M
    Appledore Medical Group, IncNHInternal Medicine Physician$0$1.4M
    Catholic Healthcare TrustNHFederally Qualified Health Center (FQHC)$0$1.3M
    Brian DaikhMESpecialist$1.2M$0
    Todd DaughertyNHRheumatology Physician$1.1M$0
    Yoko FukudaNHHematology & Oncology Physician$945K$0
    Rachit KumarVAHematology & Oncology Physician$802.4K$0

    Nearby Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Umass Memorial Medical Center, Inc.MAGeneral Acute Care Hospital$0$490.8M
    Umass Memorial Medical Group IncMAInternal Medicine Physician$0$98.5M
    Hesham MalikMADiagnostic Radiology Physician$3.9M$0
    Bradley SwitzerMAInternal Medicine Physician$524.2K$0
    Ilsa GrunderMANurse Practitioner$419.2K$0
    Erica GhoshMADiagnostic Radiology Physician$286.3K$110K
    Matthew PeckhamMADiagnostic Radiology Physician$348.3K$1.1K
    Umass Memorial Mri & Imaging Center, LLCMAMagnetic Resonance Imaging (MRI) Clinic/Center$102.9K$216.4K
    Thomas FitzgeraldMARadiation Oncology Physician$293.9K$0
    Ryan HolsteadMAHematology & Oncology Physician$270.2K$7.6K

    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. Massachusetts Distribution
    Jaroslav Zivny — 0 of 15 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Massachusetts