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.

Gastrointestinal Specialists Foundation, Inc (NPI 1942546452)

Gastrointestinal Specialists Foundation, Inc is a gastroenterology physician provider located in Memphis, Tennessee. This profile covers 0 Medicare and 33 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	Gastrointestinal Specialists Foundation, Inc
Address	80 Humphreys Center Dr Ste 200
City	Memphis
State	TN
ZIP	38120
Taxonomy	Gastroenterology Physician
NPI Enumerated	January 2, 2013

Payer Source	Total Paid
Medicaid	$2.5M
Medicare	$0

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

33 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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.	7,170	$80	$595.3K
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…	36,790	$20	$551.8K
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…	5,440	$60	$348.4K
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…	7,740	$30	$263K
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…	4,920	$40	$196.7K
00731	The anesthesia provider performs anesthesia services for an unspecified type of upper gastrointestinal endoscopic procedure during which another provider introduces the endoscope to but not beyond…	1,750	$70	$119.1K
88312	The lab analyst performs the technical lab steps to stain a specimen with a special stain. This code applies to Group I for microorganisms. A qualified provider, typically a pathologist, interprets…	2,740	$30	$79.5K
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…	620	$110	$66.7K
00811	The provider performs anesthesia services for a patient undergoing an unspecified lower intestinal endoscopic procedure where the surgical provider introduces an endoscope into the intestines up to…	960	$60	$52.7K
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…	2,150	$20	$49.4K

Showing 1–10 of 33

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Tennessee Distribution

Gastrointestinal Specialists Foundation, Inc — 3 of 24 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Tennessee

Full comparison — all codes billed, vs. Tennessee median

33 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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.	8	170	340	$190	$206.8K
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…	393	3,760	610	$40	$202.3K
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…	1,361	4,050	620	$30	$183.9K
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…	35	200	600	$30	$168.3K
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…	21	80	70	$200	$121.4K
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…	34	1,080	120	$80	$90.7K
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	413	550	290	$30	$77K
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…	26	840	440	$20	$73K
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…	478	1,240	120	$60	$53.1K
88312	The lab analyst performs the technical lab steps to stain a specimen with a special stain. This code applies to Group I for microorganisms. A qualified provider, typically a pathologist, interprets…	8	60	120	$30	$37.9K

Showing 1–10 of 33

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Baptist Memorial Hospital	TN	General Acute Care Hospital	$0	$51.4M
East Memphis Neonatology Associates P.C	TN	Neonatal-Perinatal Medicine Physician	$0	$20.7M
Semmes-murphey Clinic PC	TN	Ambulatory Surgical Clinic/Center	$4.1M	$11K
Lebonheur East Surgery Center Ii LP	TN	Ambulatory Surgical Clinic/Center	$0	$3M
Ridge Lake Asc, LLC	TN	Ophthalmologic Surgery Clinic/Center	$2.4M	$390.5K
Vrf Eye Specialty Group, Plc	TN	Ophthalmology Physician	$0	$2.5M
George Woodman	TN	Surgery Physician	$1.1K	$2.3M
Otolaryngology Consultants Of Memphis, P.C.	TN	Specialist	$0	$2.1M
Obgyn Consultants Of Memphis	TN	Obstetrics & Gynecology Physician	$0	$2.1M
Mays & Schnapp Pain Clinic & Rehabilitation Center	TN	Ambulatory Surgical Clinic/Center	$1.5M	$0

Gastrointestinal Specialists Foundation, Inc — Billing Profile & Reimbursement Data

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Gastrointestinal Specialists Foundation, Inc — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Kenneth Fields	TN	Gastroenterology Physician	$215.9K	$0
Paul Bierman	IL	Gastroenterology Physician	$168.7K	$0
Gaurav Kistangari	TN	Gastroenterology Physician	$156.8K	$0
Edward Friedman	TN	Gastroenterology Physician	$129.6K	$0
Randelon Smith	TN	Gastroenterology Physician	$125K	$0
Abdullah Al-rashdan	TN	Gastroenterology Physician	$52.8K	$4.8K