Why are Medicare and Medicaid shown separately instead of combined?

They come from two different CMS data sources with no shared claim identifier, so they can't be reconciled into one number without double-counting or guessing. Every table and chart on this page keeps them fully separate.

Why is there no private/commercial revenue figure?

Private and commercial payer data comes from Transparency in Coverage files, which only publish negotiated rates — not claims or utilization volume. Without a volume figure, no revenue number can be computed for any provider from that data.

What does "Rank" mean in the Competitive Analysis & Benchmarks tables?

For a given CPT/HCPCS code, it's this provider's position by claims volume among all providers billing that same code at that geography level (State, National, or Texas for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Texas only?

Medicaid is administered per-state with no single national fee schedule, so a state or national comparison the way Medicare has one isn't available. Texas (this provider's own state) is the only grouping that's conceptually meaningful.

Why are the numbers rounded to the nearest 10?

To avoid implying more precision than the underlying data supports at a single-provider level. Ratios are kept precise since they're a relative comparison, not a volume or dollar figure.

How current is this data?

The Medicare and Medicaid tables are both single current snapshots, not refreshed on a recurring schedule yet.

William Ross (NPI 1477635787)

William Ross is a gastroenterology physician provider located in Houston, Texas. This profile covers 13 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.

Provider details (source: NPPES NPI Registry)

Medicare: Complete Services Breakdown

Field	Value
Entity Type	Individual
Organization	William Ross
Address	1515 Holcombe Blvd
City	Houston
State	TX
ZIP	77030
Taxonomy	Gastroenterology Physician
NPI Enumerated	October 19, 2006

Payer Source	Total Paid
Medicare	$57.6K
Medicaid	$0

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

13 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	60	$200	$12K
43274	The 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…	40	$270	$10K
43276	Endoscopic 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	$290	$9.9K
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.	120	$50	$5.2K
43248	The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum; then through the scope, he passes a guidewire over which he passes dilators through the…	50	$110	$5.2K
43238	The 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…	30	$170	$4.6K
43237	The 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…	20	$140	$3.1K
45380	The 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…	50	$60	$2.8K
43264	The 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…	20	$60	$1.5K
43249	The 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.	20	$60	$1.3K

Showing 1–10 of 13

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
45385	523	1,130	50	$280	$26.4K
99214	32,276	32,500	110	$80	$17.6K
45380	579	1,160	50	$190	$16.4K
43239	300	1,210	70	$120	$11.3K
43276	6	20	30	$340	$10.5K
43249	166	310	20	$290	$9.6K
43274	8	60	20	$310	$7.5K
43248	55	230	30	$160	$6.8K
43238	12	30	20	$190	$4.8K
43237	13	50	20	$160	$3.8K

William Ross — Billing Profile & Reimbursement Data

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William Ross — Billing Profile & Reimbursement Data

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Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Frequently Asked Questions

References