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

Why is the Medicaid comparison limited to New York 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. New York (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.

Gavin Gassen (NPI 1508836636)

Field	Value
Entity Type	Individual
Organization	Gavin Gassen
Address	21 Reade Pl Ste 3200
City	Poughkeepsie
State	NY
ZIP	12601
Taxonomy	Otolaryngology Physician
NPI Enumerated	January 23, 2006

Payer Source	Total Paid
Medicare	$57.9K
Medicaid	$0

Key Findings

This provider is effectively single‑payer in the public programs: lifetime Medicare revenue is $57.9K while Medicaid billing is listed as none, so Medicaid does not appear in this provider’s payer mix. That concentration means analyses of public-payer behavior should treat Medicare as the sole source of claims-based insight.

Revenue is highly concentrated in a small set of services: the precomputed top three Medicare codes (99214, 99204, 31575) account for 55.0% of the provider’s total Medicare revenue. Those three codes individually generate $14.3K (99214, 24.7%), $10.3K (99204, 17.8%) and $7.3K (31575, 12.5%), indicating a narrow revenue base driven by a few E/M and diagnostic procedures.

The code mix points to an outpatient otolaryngology practice focused on clinic visits and diagnostic endoscopy rather than high‑volume operative surgery: high-revenue codes include 99214, 99204 and 99203 for new and established E/M visits, plus procedure codes such as 31575 (flexible laryngoscopy) and 31231 (nasal endoscopy). Support services such as audiologic exam 92504 and cerumen removal billed under G0268 appear in the top codes but contribute relatively small dollar amounts.

Competitive standing is modest overall but shows pockets of above-typical activity: 99204 ranks #24849 of 227068 providers nationally (89th percentile) and 31575 ranks #2290 of 7800 providers nationally (70th percentile), both described as typical but toward the upper end of national volume distribution for those codes. Other commonly billed E/M codes such as 99214 (60th percentile) and 99213 (50th percentile) are characterized as typical or unremarkable, placing the provider as a mid‑level participant nationally for routine E/M services.

Absolute scale of Medicare activity is small: total Medicare revenue of $57.9K alongside claim counts such as 149 claims for 99214 and 103 claims for 99204 suggest a low-to-moderate encounter volume relative to national peers. For payers or networks assessing capacity or panel size, this profile is more consistent with a small independent or part‑time outpatient clinician than with a high-volume regional practice.

The practice shows a diagnostic/procedural mix concentrated in clinic-based ENT diagnostics rather than extensive ancillary or surgical revenue: codes like 31575 ($7.3K) and 31231 ($3.3K) appear in the top list while high-revenue surgical CPTs do not appear among the top Medicare codes. Low-dollar ancillary items such as G0268 ($874) and 92504 ($2.2K) further indicate modest use of audiology and cerumen services in the overall revenue picture.

The provider has long tenure in the NPI file, enumerated 2006-01-23 (~20 years ago), which suggests an established individual practitioner. Coupled with the small Medicare revenue base and focused code mix, this tenure profile is consistent with a long-standing, clinic-focused otolaryngologist maintaining a modest Medicare panel rather than a growing high-volume referral center.

Medicare: Complete Services Breakdown

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

12 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	150	$100	$14.3K
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…	100	$100	$10.3K
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.	70	$100	$7.3K
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	$70	$6K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	40	$130	$5.3K
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…	80	$70	$4.9K
31231	In this procedure, the provider inserts an endoscope into the nasal cavity to examine the structures of the nasal cavity on one or both sides.	20	$150	$3.3K
99205	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the provider…	20	$160	$2.4K
92504	In this diagnostic procedure, the provider uses a microscope to examine the ears of a patient. He may also sometimes examine the patient’s nose for direct visualization to help with diagnosis…	100	$20	$2.2K
G0268	Removal of impacted cerumen (one or both ears) by physician on same date of service as audiologic function testing	20	$40	$870

Showing 1–10 of 12

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 12 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. New York Distribution

Gavin Gassen — 0 of 12 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — New York

Full comparison — all codes billed, vs. state median

12 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
31231	2	520	110	$170	$30.4K
99214	31	30,450	90	$100	$19K
99213	46	31,440	80	$70	$12.1K
99215	17	8,280	40	$140	$10.1K
31575	3	580	60	$100	$8.8K
99204	5	14,170	30	$130	$6.6K
99205	12	4,260	30	$180	$6.4K
G0268	1	250	90	$40	$5.5K
99203	8	11,360	30	$90	$4.7K
69210	3	860	60	$30	$4.6K

Showing 1–10 of 12

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Ent And Allergy Associates LLP	NY	Otolaryngology Physician	$0	$117.8M
Cameron Budenz	NY	Otology & Neurotology Physician	$110.7K	$11.3M
Michael Singer	NY	Diagnostic Radiology Physician	$1.2M	$0
Leslie Miller	NY	Diagnostic Radiology Physician	$533.7K	$9.5K
Mayer Adler	NY	Otolaryngology Physician	$501.5K	$8.1K
Dan Moskowitz	NY	Facial Plastic Surgery Physician	$440.3K	$0
Deya Jourdy	NY	Otolaryngology Physician	$402.6K	$2.2K
Craig Zalvan	NY	Otolaryngology Physician	$401.4K	$750
Kevin Braat	NY	Otolaryngology Physician	$388.5K	$0
Edward Rhee	NY	Otolaryngology Physician	$359.8K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Vassar Brothers Hospital	NY	General Acute Care Hospital	$0	$39.3M
Emergency Physician Services Of New York, P.C.	NY	Emergency Medicine Physician	$0	$33.9M
Family Services, Inc.	NY	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$22.6M
Westchester County Health Care Corporation	NY	General Acute Care Hospital	$0	$19.6M
21 Reade Place Asc LLC	NY	Endoscopy Clinic/Center	$859.4K	$1.7M
Ramamohana Kancherla	NY	Hematology & Oncology Physician	$2M	$28.7K
Howard Kaplan	NY	Retina Specialist (Ophthalmology) Physician	$1.9M	$11.9K
Nancy Miller-rivero	NY	Retina Specialist (Ophthalmology) Physician	$1.4M	$0
Central New York Eye Center, Ltd	NY	Clinic/Center	$1.2M	$227.6K
Michael Maresca	NY	Hematology & Oncology Physician	$1.4M	$9.5K

Gavin Gassen — Billing Profile & Reimbursement Data

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Key Findings

Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References