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

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

Rocky Mountain Gastroenterology Associates, PLLC (NPI 1669414272)

Rocky Mountain Gastroenterology Associates, PLLC is a gastroenterology physician provider located in Lakewood, Colorado. This profile covers 0 Medicare and 20 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Medicaid: Complete Services Breakdown

Field	Value
Entity Type	Organization
Organization	Rocky Mountain Gastroenterology Associates, PLLC
Address	3333 S Wadsworth Blvd
City	Lakewood
State	CO
ZIP	80227
Taxonomy	Gastroenterology Physician
NPI Enumerated	June 11, 2006

Payer Source	Total Paid
Medicaid	$3.7M
Medicare	$0

Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.

20 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
88305	The physician, typically a pathologist, performs a level IV examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally…	23,950	$50	$1.3M
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.	6,760	$90	$581.5K
88342	The lab analyst applies an initial single antibody stain on a slide or slides prepared from a single patient specimen, such as tumor tissue. Then a qualified provider, typically a pathologist,…	9,840	$30	$324.8K
45378	The provider examines the colon and rectum using a colonoscope, a flexible tube with a camera at its inserted end. If he sees any areas of abnormal mucosa or tissue, he takes samples using a brush…	1,510	$190	$284.4K
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…	3,690	$80	$284.4K
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…	4,650	$60	$255.8K
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…	1,410	$150	$216.4K
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…	610	$210	$128.3K
88313	The lab analyst performs the technical lab steps to stain a specimen for Group II identification, for example an iron stain or trichrome stain. A qualified provider, typically a pathologist,…	7,310	$20	$109.6K
99222	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	540	$70	$40.2K

Showing 1–10 of 20

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other Colorado providers billing the same CPT/HCPCS codes.

Claims Volume vs. Colorado Distribution

Rocky Mountain Gastroenterology Associates, PLLC — 6 of 20 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Colorado

Full comparison — all codes billed, vs. Colorado median

20 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…	903	2,520	330	$100	$352K
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…	361	2,630	430	$90	$268.2K
88305	The physician, typically a pathologist, performs a level IV examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally…	4	130	670	$50	$192.3K
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.	2	110	170	$180	$126.2K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	103	260	280	$40	$123.2K
45378	The provider examines the colon and rectum using a colonoscope, a flexible tube with a camera at its inserted end. If he sees any areas of abnormal mucosa or tissue, he takes samples using a brush…	2	30	90	$270	$96.3K
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…	8	50	50	$270	$81.1K
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	132	170	100	$110	$74.1K
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…	188	880	110	$80	$64.9K
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…	4	60	90	$200	$62.9K

Showing 1–10 of 20

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Christopher Morgan	AZ	Anatomic Pathology & Clinical Pathology Physician	$572.5K	$0
Michael Gilger	CO	Anatomic Pathology & Clinical Pathology Physician	$478.4K	$0
William Kinn	CO	Anatomic Pathology & Clinical Pathology Physician	$141.5K	$0
Spencer Woolen	CO	Gerontology Nurse Practitioner	$117.8K	$0
Frederick Harris	TN	Gastroenterology Physician	$108.7K	$0
Michael Mccabe	VA	Gastroenterology Physician	$82K	$0
John Goff	CO	Gastroenterology Physician	$70.8K	$0
Patrice Michaletz Onody	CO	Gastroenterology Physician	$57K	$0
Maria Aguirre	AZ	Anatomic Pathology & Clinical Pathology Physician	$52.9K	$0
Andrew Korson	CO	Gastroenterology Physician	$46.8K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Spectra Human Services, Inc.	CO	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$94M
Rocky Mountain Medical Equipment, Inc.	CO	Oxygen Equipment & Supplies (DME)	$0	$26.9M
Integrated Life Choices	CO	Developmentally Disabled Services Day Training Agency	$0	$16.3M
Hall Medical, LLC	CO	Family Medicine Physician	$0	$3.6M
David Hurt	CO	Dermatology Physician	$285.5K	$0
Michaela Mcdonnell	CO	Dermatology Physician	$188.3K	$0
Kelly Richardson	CO	Family Nurse Practitioner	$77.3K	$0
Kyle Odvody	CO	Family Nurse Practitioner	$68.2K	$0
Mary Brady	CO	MOHS-Micrographic Surgery Physician	$59.3K	$0
Christian Jones	CO	Physical Therapist	$24.2K	$0

Rocky Mountain Gastroenterology Associates, PLLC — Billing Profile & Reimbursement Data

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Rocky Mountain Gastroenterology Associates, PLLC — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

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