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NPI 1891791703 · Barstow, CA · Internal Medicine Physician
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Ravindra Gautam is a internal medicine physician provider located in Barstow, California. This profile covers 48 Medicare and 4 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)
| Field | Value |
|---|---|
| Entity Type | Individual |
| Organization | Ravindra Gautam |
| Address | 930 W Main St |
| City | Barstow |
| State | CA |
| ZIP | 92311 |
| Taxonomy | Internal Medicine Physician |
| NPI Enumerated | June 24, 2005 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $13M |
| Medicaid | $0 |
This provider’s billing is effectively single‑payer Medicare: lifetime Medicare revenue is $13M while Medicaid revenue is $0, indicating the practice’s Medicare mix dominates its public‑payer footprint. The NPI has been enumerated since 2005-06-24 (~21 years ago), so this concentration has developed over a long tenure rather than from a recent enrollment spike.
Revenue is highly concentrated in a very small set of codes: the top 3 Medicare codes by revenue account for 94.5% of the provider’s Medicare receipts, with Q4236 alone generating $11.4M (88.2% of Medicare revenue). That level of concentration implies that changes to coverage, coding guidance, or utilization for those specific codes would have an outsized impact on total Medicare revenue.
The code mix strongly signals a wound‑care and skin‑substitute specialty operation rather than a general internal medicine practice. Dominant codes include Q4236 (Carepatch), Q4188 (Amnioarmor), 15271 (skin substitute), and adjunctive wound‑healing services such as 97610 (low‑frequency ultrasound) and debridement codes (11043/11044/11042), which together reflect repeated use of grafts/patches, device‑assisted wound therapy, and surgical debridement.
For several of the high‑revenue wound and skin substitute codes the provider is positioned as a national volume leader: Q4236 ranks #6 of 79 providers nationally (94th percentile) and 15271 ranks #19 of 1157 providers nationally (98th percentile, classified as an extreme outlier). By contrast, Q4188 (rank #32 of 47, 33th percentile) and 97610 (rank #46 of 320, 86th percentile) are more modest or typical in national standing, so leadership is concentrated in a subset of skin‑substitute/Carepatch activity.
The practice also reports elevated volume for home‑visit and high‑level E/M codes, suggesting substantial in‑home care or chronic wound follow‑up. For example, 99349 (home visit) is at the 96th percentile (#632 of 14284) and 99348 is at the 97th percentile (#305 of 11547), while 99215 is an extreme outlier at the 98th percentile (#2485 of 145531); these placements indicate above‑typical national volumes for intensive E/M and home‑based encounters.
While wound care dominates revenue, procedural breadth is evident through multiple debridement codes and compression therapy: 11043 ($90.7K, 524 claims) ranks at the 90th percentile and 29581 ($42.9K, 752 claims) ranks at the 97th percentile. Several debridement and wound‑care procedure codes are described as typical or unremarkable in volume nationally, suggesting a mix of very high‑volume skin‑substitute work alongside more routine procedural throughput.
Dependence on a narrow set of revenue drivers creates operational and reimbursement risk: with Q4236 contributing $11.4M and the top 3 codes making up 94.5% of Medicare revenue, any payer policy change, prior‑authorization requirement, or clinical guideline shift affecting those products or codes would materially affect the practice’s revenue. Analysts should flag this concentration when modeling revenue resilience or negotiating network arrangements.
The provider performs some in‑house diagnostic and monitoring services that complement wound care, including wearable ECG monitoring 93229 ($27.2K, 38 claims, 57th percentile) and duplex vascular studies such as 93880 ($22.6K, 148 claims, 87th percentile) and 93925 ($18.4K, 95 claims, 87th percentile). These ancillary services support a vertically integrated wound/vascular care workflow and may increase capture of downstream billable procedures.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
48 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| Q4236 | Carepatch, per square centimeter (add-on, list separately in addition to primary procedure) | 11,910 | $960 | $11.4M |
| Q4188 | Amnioarmor, per square centimeter (add-on, list separately in addition to primary procedure) | 770 | $770 | $592.1K |
| 97610 | The provider uses a low–frequency ultrasound device to try to improve wound healing. | 590 | $380 | $225.8K |
| 99349 | The provider sees an established patient for a home or residence visit involving evaluation and management (E/M). The visit involves moderate medical decision making or the provider spends at least… | 960 | $100 | $96.6K |
| 11043 | The provider uses surgical instruments to remove the dead tissue in muscle and/or fascia, including any debridement of the epidermis, dermis, and subcutaneous tissue, for the first or only 20 cm2 or… | 520 | $170 | $90.7K |
| 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… | 450 | $130 | $60.3K |
| 15271 | The provider uses a skin substitute, such as an allograft or xenograft, to cover wounds on the patient’s trunk, arms, and/or legs up to an area of 100 cm2. This code covers up to the first 25 cm2. | 480 | $120 | $59.5K |
| 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… | 700 | $70 | $48.9K |
| 99348 | The provider sees an established patient for a home or residence visit involving evaluation and management (E/M). The visit involves low medical decision making or the provider spends at least 30… | 790 | $60 | $48.3K |
| 29581 | The provider applies a layered bandage to the lower leg, ankle, and foot, to treat venous stasis ulcers and venous insufficiency, the failure of the blood veins immediately below the skin. A… | 750 | $60 | $42.9K |
Showing 1–10 of 48
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 48 CPT/HCPCS codes.
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Full comparison — all codes billed, vs. state median
48 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| Q4236 | 6 | 20 | 3,950 | $960 | $6.2M |
| Q4188 | 23 | 30 | 1,120 | $750 | $1.1M |
| 93229 | 179 | 350 | 40 | $890 | $468.8K |
| 97610 | 15 | 50 | 260 | $390 | $182.8K |
| 11043 | 67 | 370 | 120 | $170 | $52.1K |
| 93306 | 1,661 | 2,400 | 240 | $110 | $34.1K |
| 99349 | 88 | 870 | 110 | $90 | $31.7K |
| 11044 | 28 | 110 | 60 | $240 | $29.1K |
| 99233 | 4,290 | 11,530 | 120 | $100 | $26.2K |
| 11046 | 60 | 160 | 270 | $50 | $24.2K |
Showing 1–10 of 48
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
View: By Year1 / 3
Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
4 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 3074F | No Summary found for this code | 120 | $0 | $0 |
| 3078F | No Summary found for this code | 100 | $0 | $0 |
| 90686 | This code represents a vaccine product administered into the muscle to protect against four strains of influenza (flu). It is preservative free, uses split virus technology, and is given as a 0.5 mL… | 300 | $0 | $0 |
| H0001 | Alcohol and/or drug assessment | 430 | $0 | $0 |
How this provider's Medicaid billing volume and revenue compare to other California providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. California median
4 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| H0001 | Alcohol and/or drug assessment | 28 | 140 | 100 | $160 | $62.6K |
| 90686 | This code represents a vaccine product administered into the muscle to protect against four strains of influenza (flu). It is preservative free, uses split virus technology, and is given as a 0.5 mL… | 1,745 | 3,770 | 240 | $1 | $8.8K |
| 3074F | No Summary found for this code | 2,182 | 3,010 | 450 | $1 | $360 |
| 3078F | No Summary found for this code | 2,294 | 3,040 | 460 | $1 | $230 |
Other providers in the same ZIP code as Ravindra Gautam, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Robert Hutchman | CA | Neurology Physician | $69.3K | $0 |
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