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    v1.0.28
    OpenPayerNPI Medicare & MedicaidKenneth Musana
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    Kenneth Musana — Billing Profile & Reimbursement Data

    NPI 1952401697 · Lynchburg, VA · Gastroenterology Physician

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    Kenneth Musana is a gastroenterology physician provider located in Lynchburg, Virginia. This profile covers 16 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.

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    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeIndividual
    OrganizationKenneth Musana
    Address121 Nationwide Dr
    CityLynchburg
    StateVA
    ZIP24502
    TaxonomyGastroenterology Physician
    NPI EnumeratedSeptember 23, 2006

    Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)

    Payer SourceTotal Paid
    Medicare$132.6K
    Medicaid$0

    Medicare: Total Revenue Breakdown by CPT/HCPCS Code

    Medicare revenue breakdown by CPT/HCPCS procedure code.

    View: Bar Chart1 / 2

    Medicare: Complete Services Breakdown

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

    16 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    45385The 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…150$200$30.6K
    99213The 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…380$70$25.5K
    99223The 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…130$140$17.1K
    45380The 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…160$80$11.9K
    43239The 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.190$60$11.5K
    99203The 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…90$80$7.1K
    99233The 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…70$100$6.3K
    45378The 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…30$140$4.4K
    43252An esophagogastroduodenoscopy is a procedure to view the esophagus, stomach, and duodenum by means of a flexible endoscope passed through the mouth. The provider uses an endomicroscopy system to…40$110$4K
    43248The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum; then through the scope, he passes a guidewire over which he passes dilators through the…30$110$3.7K

    Showing 1–10 of 16

    Medicare: Competitive Analysis & Benchmarks

    How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 16 CPT/HCPCS codes.

    View: State1 / 2

    Full comparison — all codes billed, vs. state median

    16 rows

    CPT/HCPCS CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    453857440070$260$24.7K
    9921412,45612,890140$80$21K
    992331,8503,29080$90$13.7K
    453804140060$160$12.9K
    992324,0124,46080$60$11K
    992131,34612,44090$60$10K
    432392839070$110$9.3K
    992235103,66040$130$9.2K
    4325192020$230$8K
    G012115519020$250$7.2K

    Showing 1–10 of 16

    Related Providers

    Other providers that share a Tax Identification Number (TIN) with Kenneth Musana, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Clinch Professional Physician Services LLCVASurgery Physician$0$5.7M
    Carl GableMDAnatomic Pathology & Clinical Pathology Physician$1.6M$0
    Advance Endoscopy Center LLCDEAmbulatory Surgical Clinic/Center$480.9K$191.8K
    Jonathon HenningsIANurse Practitioner$483.7K$0
    Kathryn KirkMDGastroenterology Physician$431.9K$0
    Brian PlasilMDAnatomic Pathology & Clinical Pathology Physician$428.2K$0
    Gi Associates Of Delaware PADEInternal Medicine Physician$0$397.5K
    Robert RichardsVAGastroenterology Physician$305.7K$0
    Laura SpinelliVAAnatomic Pathology & Clinical Pathology Physician$262.4K$1.5K
    Ralph WisniewskiVAGastroenterology Physician$243.4K$0

    Nearby Providers

    Other providers in the same ZIP code as Kenneth Musana, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    The Madeline Centre IncorporatedVAMental Health Counselor$0$18M
    Team Nurse, Inc.VAPersonal Care Attendant$0$10.3M
    Sponsored Residential Services Of Central Virginia, LLCVAIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility$0$9.8M
    Immanuel Residential Services LLCVAHome Health Agency$0$9.1M
    Links To Life, LLCVADevelopmentally Disabled Services Day Training Agency$0$8.7M
    Sisters Heavenly Homes Residential Services, LLCVAExclusive Provider Organization$0$8.5M
    Anderson Mediation Services, IncVACounselor$0$7.5M
    Shannon Sawyer Dmd, Inc.VAPediatric Dentistry$0$7M
    Strategic Therapy Associates, Inc.VACommunity/Behavioral Health Agency$0$6.8M
    Strategic Therapy Associates, Inc.VACommunity/Behavioral Health Agency$0$6.3M

    Frequently Asked Questions

    References

    1. 1.Medicare Physician & Other Practitioner by Provider and Service. CMS.gov.Provider-level Medicare Part B utilization and payment data.
    2. 2.NPPES NPI Registry. CMS.gov.National Provider Identifier registry used for provider enumeration and taxonomy metadata.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

    Medicare Revenue by CPT/HCPCS Code
    Claims Volume vs. Virginia Distribution
    Kenneth Musana — 0 of 16 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Virginia