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NPI 1952555666 · Germantown, TN · Vascular Surgery Physician
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Prateek Gupta is a vascular surgery physician provider located in Germantown, Tennessee. This profile covers 36 Medicare and 1 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 | Prateek Gupta |
| Address | 1355 W Brierbrook Rd |
| City | Germantown |
| State | TN |
| ZIP | 38138 |
| Taxonomy | Vascular Surgery Physician |
| NPI Enumerated | November 7, 2008 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $2.5M |
| Medicaid | $400 |
This provider’s revenue is overwhelmingly Medicare-driven: lifetime Medicare revenue is $2.5M compared with lifetime Medicaid revenue of $402, indicating the practice is effectively single-payer in scale with negligible Medicaid receipts. The Medicaid total of $402 represents a very small portion of the payer mix and should be treated as immaterial for capacity or reimbursement strategy analysis.
Medicare revenue is highly concentrated: the precomputed top three Medicare codes (37227, 37229, 37231) together account for 74.8% of the provider’s total Medicare revenue. That concentration signals dependence on a narrow set of high-reimbursement endovascular procedures as the primary revenue engine.
The CPT mix and code descriptions point to a focused vascular interventional practice: leading codes 37227, 37229, and 37231 align with endovascular peripheral interventions and stent/angioplasty activity, while add-on intravascular ultrasound codes (37252, 37253) and multiple duplex/physiologic ultrasound codes (93925, 93922, 93926, 93970) indicate integrated image-guided interventions and in-house vascular diagnostic services. Coupled with the provider taxonomy of Vascular Surgery Physician, the pattern is consistent with an operator performing image-guided peripheral vascular interventions supported by high diagnostic throughput.
For specific high-revenue procedures the provider is a national high-volume outlier: 37227 accounts for $1.1M (43.7% of Medicare revenue) and ranks #6 of 363 providers nationally (99th percentile; extreme outlier), indicating far higher national volume for that procedure than typical peers. By contrast, 37229 ($396K, 16.1% of Medicare revenue) ranks #101 of 603 (83th percentile) and 37231 ($368.3K, 15.0% of Medicare revenue) ranks #6 of 45 (86th percentile), which are high but more typical relative to the very extreme standing of 37227.
The provider also shows unusually high volume for noninvasive vascular diagnostics and procedure guidance: 93922 (688 claims, $32.3K) ranks 31 of 8082 providers nationally (100th percentile; extreme outlier), 93926 (348 claims, $29.9K) ranks 16 of 4305 (100th percentile; extreme outlier), and 76937 (295 claims, $8.3K) ranks 37 of 12234 (100th percentile; extreme outlier). These extreme outlier positions suggest a heavy case mix of vascular lab studies and ultrasound-guided vascular access or interventions relative to national peers.
Several imaging and angiographic supervision codes are notably above typical national volume, supporting a practice that performs and interprets imaging-intensive procedures: 37252 (204 claims, $137.7K) ranks #45 of 1088 providers (96th percentile; notably above typical), 75710 and 75716 (angiography supervision/interpretation) and 75625 also rank in the high percentiles (notably above typical). That pattern reinforces that the practice combines interventional procedures with radiologic supervision and interpretation services.
Medicaid participation is minimal and low-ranked in-state: Medicaid billing is limited to 15 claims for 99214 totaling $405 (100.0% of Medicaid revenue) with an average paid/claim of $27, and the code ranks #3582 of 3759 providers in-state (4th percentile). This low Medicaid rank and dollar volume suggest the provider is not a significant Medicaid participant and that contracting or network inclusion strategies should be driven by the Medicare-dominant business profile rather than Medicaid activity.
The provider has long-tenure in federal enrollment, which supports an established practice footprint: NPI enumerated 2008-11-07 (~18 years ago). Combined with the concentrated, procedure-heavy Medicare revenue and multiple high-percentile ranks, the tenure and billing pattern are consistent with an established, specialized vascular surgery practice that operates at high volume for particular endovascular procedures while maintaining minimal Medicaid exposure.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
36 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 37227 | N/A | 150 | $7,310 | $1.1M |
| 37229 | N/A | 70 | $5,430 | $396K |
| 37231 | N/A | 40 | $8,370 | $368.3K |
| 37225 | N/A | 30 | $4,970 | $139.3K |
| 37252 | In this add–on procedure, the provider inserts a specially designed catheter with an ultrasound transducer, a device that sends high–frequency sound waves through the tissues and detects their… | 200 | $680 | $137.7K |
| 37228 | N/A | 20 | $1,690 | $38.8K |
| 93925 | The provider performs a duplex ultrasound scan of the lower extremity arteries or bypass grafts on both sides. Providers perform noninvasive arterial diagnostic procedures to examine the rate of… | 230 | $160 | $36.7K |
| 93922 | Noninvasive physiologic studies of upper or lower extremity arteries, single level, bilateral | 690 | $50 | $32.3K |
| 93926 | The provider performs a duplex ultrasound scan of the lower extremity arteries or bypass grafts. Providers perform noninvasive arterial diagnostic procedures to examine the rate of blood flow and to… | 350 | $90 | $29.9K |
| 93970 | The provider performs an ultrasound scanning procedure called a duplex scan to characterize the pattern and direction of blood flow in extremity veins (arms or legs). This is a complete, bilateral… | 200 | $130 | $25.1K |
Showing 1–10 of 36
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 36 CPT/HCPCS codes.
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Full comparison — all codes billed, vs. state median
36 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| 37227 | 1 | 20 | 20 | $7,550 | $279.3K |
| 37229 | 3 | 20 | 30 | $5,280 | $195.5K |
| 37231 | 1 | 10 | 20 | $8,320 | $191.3K |
| 37225 | 8 | 30 | 20 | $4,380 | $114K |
| 36482 | 17 | 20 | 40 | $1,190 | $92K |
| 36475 | 26 | 40 | 40 | $750 | $49.6K |
| 37252 | 1 | 20 | 30 | $590 | $30.7K |
| 37221 | 7 | 10 | 20 | $1,050 | $17.9K |
| 99214 | 5,595 | 11,370 | 120 | $80 | $16.6K |
| 37228 | 2 | 10 | 20 | $790 | $13.4K |
Showing 1–10 of 36
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
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Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
1 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 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… | 20 | $30 | $410 |
How this provider's Medicaid billing volume and revenue compare to other Tennessee providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Tennessee median
1 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 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… | 3,582 | 3,760 | 610 | $40 | $202.3K |
Other providers in the same ZIP code as Prateek Gupta, ranked by combined Medicare and Medicaid revenue.
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