Loading...
NPI 1235450420 · Merrillville, IN · MOHS-Micrographic Surgery Physician
Customize your policy alerts
Get alerted when relevant policies change without checking for updates manually.
Monitor payer policy activity
Renato Goreshi is a mohs-micrographic surgery physician provider located in Merrillville, Indiana. This profile covers 45 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 | Renato Goreshi |
| Address | 311 E 89th Ave |
| City | Merrillville |
| State | IN |
| ZIP | 46410 |
| Taxonomy | MOHS-Micrographic Surgery Physician |
| NPI Enumerated | June 22, 2010 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $1.6M |
| Medicaid | $870 |
This provider’s Medicare business is substantial relative to Medicaid: Total Medicare revenue is $1.6M compared with total Medicaid revenue of $866, so the portfolio is effectively Medicare‑dominated rather than payer‑diversified. The Medicaid book of business is negligible by revenue and volume, with the entire Medicaid revenue derived from a single code (99213).
Revenue concentration on Medicare is high: the precomputed top three Medicare codes account for 61.0% of the provider’s Medicare revenue, driven primarily by 17311, 77280, and G6001. These three codes together indicate that a majority of Medicare dollars come from a small set of procedural services rather than broad-based evaluation & management billing.
The top Medicare codes suggest dual service lines in practice: 17311 (917 claims, $464.9K revenue) and related Mohs codes (17313, 17312) point to a high-volume Mohs micrographic surgery practice, while 77280 (1.7K claims, $350.1K revenue) and G6001 (1.1K claims, $151.1K revenue) are radiation therapy simulation and ultrasonic guidance services, implying substantial radiation planning/technique billing in addition to Mohs procedures. Together, the code mix is consistent with an operation that bills both surgical skin cancer removal and radiation therapy planning/delivery procedures.
Competitive standing on Mohs-related codes is strong: 17311 ranks #97 of 2969 providers nationally (97th percentile) and 17313 ranks #119 of 2300 providers nationally (95th percentile), described in the source as "notably above typical national volume." Several reconstructive and repair codes (for example 13132 at the 98th percentile and 12031 at the 97th percentile) also rank well, reinforcing that this provider is a high‑volume national performer for procedural dermatologic and complex repair services.
The provider is an extreme outlier on one radiation-planning code: 77280 ranks #45 of 3348 providers nationally (99th percentile) and is labeled an "extreme outlier, far above typical national volume." This indicates unusually large volumes of simulation/planning sessions relative to national peers and suggests a significant operational emphasis on radiation therapy workflows that is atypical for many MOHS‑taxonomy providers.
Other radiation-related codes show mixed standing: G6001 (ultrasonic guidance) has 1.1K claims and $151.1K revenue but ranks #75 of 280 providers nationally (73th percentile) and is described as "typical, unremarkable volume." This implies that while simulation planning (77280) is extreme for this provider, some adjunctive guidance services fall into more expected ranges compared with peers.
Visit-level E/M activity is notable on Medicare but not on Medicaid: 99213 on Medicare accounts for $39K and 591 claims and ranks #19946 of 457151 providers nationally (96th percentile), described as "notably above typical national volume," indicating above‑average office visit billing to Medicare. By contrast, the same code on Medicaid accounts for 27 claims and $864 (100.0% of Medicaid revenue) and ranks #2193 of 2377 in‑state (7th percentile), showing very limited Medicaid visit volume and weak in‑state competitiveness on that payer.
The provider has long standing NPI tenure, which supports stability of the observed billing patterns: NPI enumerated (registered) 2010-06-22 (~16 years ago). Combined with concentrated Medicare revenue and repeat high percentiles across multiple surgical CPTs, the data paint a picture of an established Mohs‑focused practitioner who also bills substantial radiation planning services to Medicare patients.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
45 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 17311 | Mohs surgery is a multi–staged procedure that is performed to excise a malignant lesion layer by layer, along with histo–pathological assessment. The assessment is performed to ensure that the… | 920 | $510 | $464.9K |
| 77280 | The provider uses a simulator or other imaging modality to determine the size and location of ports to be used for radiation therapy. This code describes a simple level service. | 1,680 | $210 | $350.1K |
| G6001 | Ultrasonic guidance for placement of radiation therapy fields | 1,060 | $140 | $151.1K |
| 17313 | Mohs surgery is a multi–staged method of excising a malignant lesion layer by layer, along with histo–pathological assessment, to ensure negative malignancy of the margins. | 220 | $470 | $103.4K |
| 17312 | Mohs surgery is a multi–staged method of excising a malignant lesion layer by layer, along with histo–pathological assessment, to ensure negative malignancy of the margins. | 220 | $320 | $69.5K |
| 13132 | The provider repairs a wound measuring 2.6 cm to 7.5 cm in size of the cheeks, chin, mouth, neck, axillae, genitalia, hands, and/or feet, which may require scar revision, debridement extensive… | 330 | $200 | $64.5K |
| Q4169 | Artacent wound, per square centimeter (add-on, list separately in addition to primary procedure) | 220 | $270 | $60.3K |
| 77401 | Deleted effective Jan. 1, 2026. | 1,600 | $30 | $51.3K |
| Q4190 | Artacent ac, per square centimeter (add-on, list separately in addition to primary procedure) | 120 | $390 | $48.2K |
| 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… | 590 | $70 | $39K |
Showing 1–10 of 45
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 45 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
45 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| Q4190 | 4 | 10 | 1,100 | $500 | $521.5K |
| 17311 | 2 | 40 | 330 | $410 | $153.4K |
| G6001 | 3 | 20 | 570 | $130 | $98.2K |
| Q4169 | 1 | 10 | 220 | $270 | $60.3K |
| 17312 | 15 | 40 | 140 | $290 | $56.2K |
| 77285 | 5 | 10 | 120 | $320 | $43.5K |
| 77280 | 2 | 90 | 50 | $180 | $41.4K |
| 17313 | 3 | 40 | 60 | $420 | $36.5K |
| 77427 | 63 | 110 | 180 | $140 | $28.9K |
| 77401 | 2 | 20 | 710 | $30 | $23.9K |
Showing 1–10 of 45
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 |
|---|---|---|---|---|
| 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… | 30 | $30 | $860 |
How this provider's Medicaid billing volume and revenue compare to other Indiana providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Indiana median
1 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 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… | 2,193 | 2,380 | 920 | $50 | $376.8K |
Other providers in the same ZIP code as Renato Goreshi, ranked by combined Medicare and Medicaid revenue.
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.