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    OpenPayerNPI Medicare & MedicaidJustin Gooden
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    Justin Gooden — Billing Profile & Reimbursement Data

    NPI 1205127982 · Wichita, KS · Undersea and Hyperbaric Medicine (Preventive Medicine) Physician

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    Justin Gooden is a undersea and hyperbaric medicine (preventive medicine) physician provider located in Wichita, Kansas. This profile covers 26 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
    OrganizationJustin Gooden
    Address10346 E Stonegate Ln Ste 100
    CityWichita
    StateKS
    ZIP67206
    TaxonomyUndersea and Hyperbaric Medicine (Preventive Medicine) Physician
    NPI EnumeratedApril 28, 2011

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

    Payer SourceTotal Paid
    Medicare$4.3M
    Medicaid$0

    Key Findings

    This provider is highly specialized in skin-substitute and wound-care products and procedures: the top revenue codes are Q4205, Q4197, and Q4158, which are membrane/skin graft or skin substitute add-on products and together account for 75.7% of the provider’s total Medicare revenue. The CPT mix, including multiple debridement codes (11042, 11045, 11044) and skin substitute graft codes (15271, 15275), indicates a practice focused on advanced wound management rather than general primary care or broad outpatient services.

    Revenue concentration is extreme within Medicare: the three highest-revenue Medicare codes (Q4205, Q4197, Q4158) make up 75.7% of the provider’s lifetime Medicare revenue, showing the practice’s financial reliance on a narrow set of wound-care product codes. Because top-3 concentration is so large, changes in reimbursement or utilization for these specific add-on products would materially affect the provider’s Medicare revenue.

    Payer mix is effectively single-payer: the provider reports Total Medicare revenue of $4.3M and has no Medicaid billing on file, making Medicare the sole public payer exposure in the dataset. This lack of Medicaid activity suggests the provider operates in a Medicare-dominant market segment or is not credentialed/billing to state Medicaid for the services in this profile.

    The provider is an outlier nationally on several skin substitute/product codes, signaling a highly concentrated competitive position for those items. Specifically, Q4197 ranks #1 of 82 providers nationally and is labeled an extreme outlier, and Q4159 similarly ranks #1 of 43 providers (extreme outlier). Other skin substitute and graft-related codes (15271, 15275, 11042, 11045) also rank in very high percentiles (many at or near the 99th percentile), indicating materially higher national volumes for these procedures compared with most peers.

    For some codes the provider’s volume is unremarkable or typical relative to national peers, highlighting that dominance is specific to certain products rather than across all services. For example, Q4205 (rank #23 of 63, 65th percentile) and Q4158 (rank #3 of 36, 94th percentile but described as typical/unremarkable volume) sit at mid-to-high percentiles but are not uniformly dominant across every code in the top-25 list.

    Tenure is long enough to establish a stable billing footprint: the provider’s NPI was enumerated on 2011-04-28 (~15 years ago), indicating roughly a decade and a half of billing activity to build the reported Medicare revenue and specializations in wound-care product use. That duration supports the interpretation that the current coding and revenue patterns reflect an established practice model rather than a transient episode.

    Clinical-service implications point to procedural, device-driven revenue rather than traditional evaluation-and-management dependency: E/M codes such as 99213, 99214, and 99232 together account for relatively small shares of revenue (each under 1% of Medicare revenue), while high-dollar add-on product codes drive the majority of payments. This suggests the practice’s economics rely on product utilization and procedural interventions for chronic or complex wounds.

    Operational risk and contracting implications for payers: because a large share of lifetime Medicare revenue is concentrated in a few add-on skin substitute/product codes, payers negotiating rates, utilization management, or coverage policies for Q4197, Q4205, and Q4158 could disproportionately influence this provider’s revenue. The extreme national rankings on some product codes (e.g., Q4197 and Q4159 at rank #1) make the provider a critical target for product-level oversight, network contracting, or focused medical policy reviews.

    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.

    26 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    Q4205Membrane graft or membrane wrap, per square centimeter (add-on, list separately in addition to primary procedure)1,280$1,160$1.5M
    Q4197Puraply xt, per square centimeter (add-on, list separately in addition to primary procedure)8,240$130$1.1M
    Q4158Kerecis omega3, per square centimeter (add-on, list separately in addition to primary procedure)4,620$150$697.2K
    Q4159Affinity, per square centimeter (add-on, list separately in addition to primary procedure)1,670$300$491.8K
    Q4186Epifix, per square centimeter (add-on, list separately in addition to primary procedure)1,690$120$198.2K
    15271The provider uses a skin substitute, such as an allograft or xenograft, to cover wounds on the patient’s trunk, arms, and/or legs up to an area of 100 cm2. This code covers up to the first 25 cm2.730$110$77.6K
    11042The provider uses surgical instruments to remove the dead tissue in skin down to the subcutaneous layer and including the epidermis and dermis, up to the first 20 cm2.1,230$50$64K
    15275The provider uses a skin substitute, such as an allograft or xenograft, to cover wounds on the face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, up to…550$110$62.9K
    11045The provider uses surgical instruments to remove dead tissue from the subcutaneous layer, as well as the epidermis and dermis if needed. She performs this service at the same session as a separately…1,450$20$30.4K
    11044The provider uses surgical instruments to remove the dead, infected tissue in bone, also including the epidermis, dermis, subcutaneous tissue, muscle, and/or fascia as needed. This code covers the…120$160$19.3K

    Showing 1–10 of 26

    Medicare: Competitive Analysis & Benchmarks

    How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 26 CPT/HCPCS codes.

    View: State1 / 2

    Full comparison — all codes billed, vs. state median

    26 rows

    CPT/HCPCS CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    Q4205110740$1,160$857.5K
    Q41971101,570$130$294K
    Q41862101,060$120$248K
    Q4159110410$300$211.7K
    Q4158110430$150$161.1K
    992141,8064,310120$70$16.4K
    9934911013080$80$15.8K
    992323231,69070$60$10.1K
    11042210090$50$10K
    992138114,33090$50$8.7K

    Showing 1–10 of 26

    Related Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Carepoint Emergency Medicine Kansas LLCKSEmergency Medicine Physician$0$11.8M
    David DyerKSOphthalmology Physician$7.5M$0
    Bassam MattarKSHematology & Oncology Physician$7.2M$0
    Pavan ReddyKSHematology & Oncology Physician$6.7M$0
    Jeremy DeutschKSHematology & Oncology Physician$5.7M$0
    Thomas FinleyOKOphthalmology Physician$4.8M$0
    Daniel FeilerKSOphthalmology Physician$4.8M$0
    Travis KoenekeKSHematology & Oncology Physician$4.4M$0
    Christopher DakhilKSHematology & Oncology Physician$4.4M$0
    Stephen WilesMOOphthalmology Physician$4.4M$0

    Nearby Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Childrens Dentistry Of WichitaKSPediatric Dentistry$0$32.8M
    Trust Homecare, LLCKSHome Health Agency$0$28.4M
    Good Shepherd Hospice Wichita LLCKSCommunity Based Hospice Care Agency$0$17.7M
    Grene Vision Group LLCKSOphthalmology Physician$0$6.3M
    Anthem Wichita Management, LLCKSAlzheimer Center (Dementia Center)$0$4.3M
    Timothy ShaverKSRheumatology Physician$3M$0
    Jonas LichtyKSOral and Maxillofacial Surgery (Dentist)$2.6K$2.9M
    Homestead Of Crestview Operations LLCKSAssisted Living Facility$0$2.8M
    Kansas Kids Heart Center, PAKSPediatric Cardiology Physician$0$2.7M
    Remy BlanchaertKSOral and Maxillofacial Surgery (Dentist)$4.1K$2.4M

    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. Kansas Distribution
    Justin Gooden — 10 of 25 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Kansas