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

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

Andrew Scanga (NPI 1912016650)

Andrew Scanga is a transplant hepatology physician provider located in Nashville, Tennessee. 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	Andrew Scanga
Address	3601 The Vanderbilt Clinic
City	Nashville
State	TN
ZIP	37232
Taxonomy	Transplant Hepatology Physician
NPI Enumerated	August 29, 2006

Payer Source	Total Paid
Medicare	$32.5K
Medicaid	$0

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

10 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	90	$100	$8.9K
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…	40	$150	$5.1K
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…	70	$60	$4.2K
43244	The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum and treats enlarged blood vessels in the esophagus or stomach with band ligation, i.e.,…	20	$180	$2.6K
43235	The provider inserts an endoscope through the mouth and down into the esophagus, stomach, and duodenum for diagnostic purposes; the provider may collect specimens by brushing or washing.	30	$80	$2.4K
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…	20	$120	$2.4K
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…	10	$170	$2.2K
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…	20	$100	$2K
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…	10	$120	$1.7K
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…	10	$70	$870

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
45385	308	320	60	$260	$27.1K
45380	297	320	40	$190	$15.3K
99232	2,342	3,990	100	$60	$11.4K
99215	603	2,710	40	$110	$8.3K
99223	2,785	3,130	40	$120	$8K
99204	3,790	5,490	30	$100	$5.3K
99205	414	1,300	20	$140	$4.9K
43235	89	220	30	$110	$4.4K
99222	1,683	2,630	30	$90	$3.9K
43244	2	10	20	$170	$2.9K

Andrew Scanga — Billing Profile & Reimbursement Data

Sign up for Andrew Scanga — Billing Profile & Reimbursement Data policy alerts

Andrew Scanga — Billing Profile & Reimbursement Data

Sign up for Andrew Scanga — 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