Gastroenterology

Revenue benchmarks for Gastroenterology practices. E&M coding optimization, care management opportunities, and procedure-adjacent billing.

$86K

Avg Missed/Year

17K

US Providers

460

Avg Patients

2.8

Avg Chronic Dx

Specialty Overview

Gastroenterology practices generate significant procedure revenue but often overlook E&M coding optimization for office visits. With moderate chronic disease prevalence, GI practices have a meaningful but often ignored care management opportunity, particularly for patients with IBD, liver disease, and comorbid conditions.

Key Insight: GI practices focused on procedures often neglect E&M optimization for office visits — where $28K+ in annual coding gap exists before any new programs are added.

E&M Coding Distribution

National benchmark for Gastroenterology E&M code distribution. Compare your practice against these targets to identify coding optimization opportunities.

99213

28%

$92/visit

99214

50%

$130/visit

99215

22%

$176/visit

Revenue Gap Breakdown

#1

E&M Coding Gap

$28.8K/yr

Office visits for complex GI conditions support moderate-to-high MDM. Benchmark: 28% 99213 / 50% 99214 / 22% 99215.

#2

CCM (99490)

$26.4K/yr

8% adoption. IBD patients with comorbid conditions are strong CCM candidates.

#3

RPM (99453-99458)

$14.6K/yr

Weight monitoring for liver disease and nutrition tracking are emerging RPM use cases. 4% adoption.

#4

AWV (G0438/G0439)

$10.2K/yr

12% AWV rate. Proactive screening identification during colonoscopy follow-ups can increase AWV referrals.

#5

BHI (99484)

$6.2K/yr

IBS, IBD, and chronic GI conditions are strongly associated with anxiety and depression. 16% prevalence.

Care Management Adoption Rates

CCM

8%

Target: 15%

RPM

4%

Target: 10%

BHI

3%

Target: 10%

AWV

12%

Target: 70%

Common Chronic Conditions

Hypertension (50%)Diabetes (28%)Depression (16%)COPD (10%)Heart Failure (10%)

Gastroenterology Provider? See Your Gaps

These are national averages. Scan your NPI to see how your billing compares to Gastroenterology benchmarks and get a personalized revenue roadmap.

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