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

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

Banner Gateway Medical Center (NPI 1699884858)

Field	Value
Entity Type	Organization
Organization	Banner Gateway Medical Center
Address	1900 N Higley Rd
City	Gilbert
State	AZ
ZIP	85234
Taxonomy	General Acute Care Hospital
NPI Enumerated	August 30, 2006

Payer Source	Total Paid
Medicaid	$55.8M
Medicare	$0

Key Findings

BANNER GATEWAY MEDICAL CENTER has no Medicare billing on file and reports $55.8M in lifetime Medicaid revenue, making its billing profile effectively single‑payer (Medicaid) based on available data. This means the provider’s revenue exposure and utilization patterns in the dataset are concentrated in state Medicaid programs rather than Medicare.

Revenue concentration is high: the top three Medicaid revenue drivers — 99285 (16.8%), 99284 (16.1%), and J9271 (12.8%) — together account for 45.8% of this provider’s total Medicaid revenue. That level of concentration indicates that a small set of ED evaluation-and-management codes plus a high-cost oncology drug dominate Medicaid receipts.

The code mix points to an ED-centered acute care operation with substantial imaging and inpatient support. High-volume ED codes 99285 (23.4K claims, $357 avg paid/claim, $8.3M revenue) and 99284 (37.4K claims, $214 avg paid/claim, $8M revenue) combined with CT abdomen/pelvis 74177 (10.8K claims, $489 avg paid/claim, $5.3M revenue) and CT head 70450 (5.9K claims, $97 avg paid/claim, $572.9K revenue) suggest frequent emergent presentations supported by advanced imaging.

The provider also shows a meaningful oncology/infusion footprint: J9271 (pembrolizumab) generated $6.4M (12.8% of Medicaid revenue) and ranks #3 of 6 providers in-state (60th percentile), while J9144 (daratumumab) produced $1.3M and ranks #1 of 2 providers in-state (100th percentile). Complementary oncology signals include J9299 (nivolumab), 81455 (large multigene panel, $927.5K), and PET/CT 78815, indicating integrated high-cost drug administration, advanced imaging, and genomic testing services.

Operational throughput is supported by very high laboratory and infusion procedure counts: CMP 80053 shows 95.2K claims ($20 avg paid/claim, $1.9M revenue) and IV push/infusion sequencing 96375 has 42.2K claims ($13 avg paid/claim, $548.1K revenue) with the latter labeled notably above typical state volume. The transfusion placement code 36430 (4.3K claims, $197 avg paid/claim, $844.1K revenue) ranks #3 of 25 in-state (92th percentile) and is also flagged as notably above typical state volume, consistent with substantial inpatient or ED treatment activity.

Competitive standing is mixed by service line: ED E/M codes sit in the upper state percentiles but are described as typical volumes for high-throughput hospitals (e.g., 99285 ranks #52 of 257, 80th percentile; 99284 ranks #38 of 259, 86th percentile). By contrast, certain specialty infusions show stronger local dominance (J9144 #1 of 2, 100th percentile) while others (J9271 at #3 of 6, 60th percentile and J9299 at #3 of 3, 0th percentile) indicate the hospital is active but not always a statewide leader across all oncology agents.

The provider has an established enrollment history: its NPI was enumerated on 2006-08-30 (~20 years ago), consistent with a long-standing general acute care hospital presence. That tenure aligns with the breadth of codes across emergency care, imaging, lab services, transfusion, infusion, and oncology testing observed in the Medicaid billing data.

From a payer and operational perspective, the combination of a single‑payer Medicaid profile and revenue concentration in a few high-impact codes suggests sensitivity to Medicaid reimbursement changes and utilization shifts in ED and oncology services. Analysts should note the dual pressures of high-volume ED throughput and high-cost drug administration when assessing contracting, reimbursement risk, or capacity planning for this hospital.

Medicaid: Complete Services Breakdown

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

423 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	23,390	$360	$8.3M
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	37,360	$210	$8M
J9271	Injection, pembrolizumab, 1 mg	1,030	$6,180	$6.4M
74177	The provider performs computed tomography of the abdomen and pelvis with contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	10,840	$490	$5.3M
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	23,890	$190	$4.4M
80053	The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel.	95,230	$20	$1.9M
88185	The lab analyst performs the technical component of a flow cytometry procedure using cell surface, cytoplasmic, or nuclear markers to characterize cells and aid clinicians in diagnosing patients with…	3,920	$450	$1.8M
74176	The provider performs computed tomography of the abdomen and pelvis without contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	4,300	$350	$1.5M
J9144	Injection, daratumumab, 10 mg and hyaluronidase‑fihj	320	$4,090	$1.3M
J9299	Injection, nivolumab, 1 mg	320	$3,690	$1.2M

Showing 1–10 of 423

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Arizona Distribution

Banner Gateway Medical Center — 1 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Arizona

Full comparison — all codes billed, vs. Arizona median

423 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J9271	Injection, pembrolizumab, 1 mg	3	10	770	$7,180	$7.1M
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	52	260	1,330	$240	$3.5M
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	38	260	3,030	$190	$3.4M
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	53	260	2,600	$170	$2.6M
74177	The provider performs computed tomography of the abdomen and pelvis with contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	35	180	1,490	$320	$2.2M
U0003	Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high…	53	110	960	$70	$1.7M
J9355	Injection, trastuzumab, excludes biosimilar, 10 mg	4	10	410	$1,540	$1.6M
J9299	Injection, nivolumab, 1 mg	3	10	390	$3,740	$1.4M
J2505	Injection, pegfilgrastim, 6 mg	4	10	450	$3,170	$1.3M
J9144	Injection, daratumumab, 10 mg and hyaluronidase‑fihj	1	10	240	$5,070	$1.2M

Showing 1–10 of 423

Nearby Providers

Other providers in the same ZIP code as Banner Gateway Medical Center, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Banner Hospital Based Physicians Arizona LLC	AZ	Multi-Specialty Clinic/Center	$0	$77.8M
Elite Community Services, LLC	AZ	In Home Supportive Care Agency	$0	$48.2M
Not Only Words Therapy, LLC	AZ	Home Health Agency	$0	$13.1M
Elhadi Osman	AZ	Non-emergency Medical Transport (VAN)	$0	$8.6M
Canyon Pediatrics, Inc	AZ	Primary Care Clinic/Center	$0	$7.9M
David Goldenberg	AZ	Retina Specialist (Ophthalmology) Physician	$4.7M	$15.8K
Sachin Mehta	AZ	Retina Specialist (Ophthalmology) Physician	$4.4M	$11.8K
Surgery Center Of Scottsdale, LLC	AZ	Ambulatory Surgical Clinic/Center	$1.1M	$1.9M
Southwest Endoscopy LLC	AZ	Ambulatory Surgical Clinic/Center	$1.8M	$1M
Kelsey Resler	AZ	Adult Health Nurse Practitioner	$1.4M	$0

Banner Gateway Medical Center — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References