Gastroenterology
Procedure-heavy. ASC fee schedules. Endless modifiers.
GI revenue lives in colonoscopy, EGD, and the ASC fee schedule layered underneath them. Modifier and bundling disputes are where commercial payers quietly underpay. Aroris benchmarks every code, payer by payer, and signs new rates.
The four code families we see leaking most.
GI revenue concentrates in a handful of high-volume procedures layered on top of an ASC fee schedule. That layering is exactly where commercial payers quietly underpay. These are the code families we most often find drifting.
Colonoscopy, dx + biopsy
The backbone of GI volume. A few points below the contracted rate here outweighs almost any other single correction because of how often it is billed.
Colonoscopy w/ polyp removal
Routinely subject to bundling and modifier logic that pays the diagnostic rate when the therapeutic rate was earned.
EGD, diagnostic + biopsy
High-frequency endoscopy codes where biopsy add-ons are a common silent downcode against the contracted schedule.
Capsule endoscopy
Lower volume but high per-unit value, and one of the codes most exposed when a payer fee schedule lags the national benchmark.
Office E/M
The same compounding E/M drift seen across every specialty, amplified in GI by high pre- and post-procedure visit volume.
Modifier handling
Screening-vs-diagnostic colonoscopy is the single most disputed modifier scenario in GI. Aroris tracks the -PT and -33 denial pattern by payer and builds it into the rate case.
ASC + professional, every modifier accounted for.
1. GI-specific benchmark
Your codes priced against the GI-only subset of the Aroris dataset, including ASC vs. office vs. hospital outpatient differentials.
2. Modifier-aware rate cases
Screening-to-diagnostic conversions and the -PT/-33 modifier disputes get specific case treatment.
3. Live monitoring after
Once new rates are signed, every claim is reconciled daily — modifier downcoding flagged the day it shows up.
What we’ve signed for GI groups.
GI groups carry more revenue per procedure than almost any office-based specialty, and more modifier exposure. Here is the shape of a typical Aroris engagement.
+7–13%
Typical blended commercial lift across the colonoscopy and EGD families after corrected rates are signed.
2–4 mo
Benchmark to signed rate amendment for a mid-size GI group with an ASC.
$260K–$610K
Illustrative annualized recovery range for a multi-physician GI practice. Modeled per contract in the free assessment.
For GI groups
See what your contracts are owed.
The free Aroris assessment models your dollar range of opportunity at code-modifier-plan level.