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 Michigan for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Michigan 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. Michigan (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.

Anil Gupta (NPI 1487635801)

Anil Gupta is a otolaryngology physician provider located in Royal Oak, Michigan. This profile covers 10 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	Anil Gupta
Address	32121 Woodward
City	Royal Oak
State	MI
ZIP	48073
Taxonomy	Otolaryngology Physician
NPI Enumerated	November 11, 2005

Payer Source	Total Paid
Medicare	$70.5K
Medicaid	$0

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

10 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…	380	$60	$23.8K
69210	The provider uses an instrument such as a curette, vacuum evacuation, or forceps to remove entrapped wax from a patient's external auditory canal.	360	$40	$12.5K
99204	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the provider…	80	$120	$10.2K
99203	The provider sees a new 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 provider…	90	$80	$6.9K
99214	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…	60	$100	$5.8K
92557	The provider assesses a patient’s hearing with a series of tones at varying intensities to identify the softest level at which the patient can hear. He also measures the patient’s ability to…	110	$30	$3.1K
92588	The provider performs this noninvasive, diagnostic test to help detect inner ear abnormalities to identify such conditions as functional hearing loss or differentiate between sensory and neural…	110	$30	$3K
31575	The provider uses a flexible laryngoscope to look inside the larynx, or voice box, to detect the presence of any abnormalities. This code applies to diagnostic services.	30	$100	$2.6K
92567	In this procedure, the provider measures the functioning of the middle ear by varying the pressure of air presented to the ear to identify the reason for hearing loss.	120	$10	$1.4K
G0268	Removal of impacted cerumen (one or both ears) by physician on same date of service as audiologic function testing	30	$40	$1.4K

Anil Gupta — Billing Profile & Reimbursement Data

Sign up for Anil Gupta — Billing Profile & Reimbursement Data policy alerts

Anil Gupta — Billing Profile & Reimbursement Data

Sign up for Anil Gupta — Billing Profile & Reimbursement Data policy alerts

Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Frequently Asked Questions

References

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99214	9,232	15,470	80	$80	$11.4K
99213	882	14,810	60	$60	$6.6K
31575	176	240	40	$80	$4.5K
99204	548	6,280	30	$110	$4.2K
99203	491	4,560	30	$70	$3K
92557	78	290	70	$30	$2.3K
69210	6	360	40	$30	$2.1K
G0268	27	50	30	$30	$1.8K
92588	2	10	30	$20	$1.5K
92567	59	240	50	$10	$920