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 Texas for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Texas 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. Texas (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.

Presley Mock (NPI 1013963172)

Presley Mock is a otolaryngology physician provider located in Dallas, Texas. This profile covers 18 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.

Provider details (source: NPPES NPI Registry)

Medicare: Complete Services Breakdown

Field	Value
Entity Type	Individual
Organization	Presley Mock
Address	8440 Walnut Hill Ln
City	Dallas
State	TX
ZIP	75231
Taxonomy	Otolaryngology Physician
NPI Enumerated	May 26, 2006

Payer Source	Total Paid
Medicare	$149.1K
Medicaid	$0

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

18 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	590	$70	$38.9K
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…	210	$80	$17.5K
95165	In this procedure, the provider mixes and prepares the antigens for allergen immunotherapy. Use this code when the provider prepares one or more antigens.	1,060	$10	$12.7K
G0268	Removal of impacted cerumen (one or both ears) by physician on same date of service as audiologic function testing	310	$40	$12.5K
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…	90	$120	$10.9K
31231	In this procedure, the provider inserts an endoscope into the nasal cavity to examine the structures of the nasal cavity on one or both sides.	80	$140	$10.7K
92511	The provider examines the nasal passages and throat with an endoscope, a tubular instrument with a light source and camera.	110	$90	$9.5K
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…	100	$90	$8.7K
31237	In this procedure, the provider inserts an endoscope into the nasal cavity. She examines the nasal contents. The provider then performs a nasal biopsy, polypectomy, or debridement.	40	$200	$7.1K
92557	The provider assesses a patient’s hearing with a series of tones at varying intensities to identify the softest level at which the patient can hear. He also measures the patient’s ability to…	180	$30	$5K

Showing 1–10 of 18

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
95165	176	390	940	$10	$18.9K
31267	20	40	20	$800	$18.3K
99214	17,484	32,500	110	$80	$17.6K
31237	55	120	40	$270	$12.8K
31231	139	450	50	$130	$10.2K
30520	51	60	20	$430	$9K
99213	1,170	29,790	70	$60	$8.4K
92511	5	40	60	$80	$5.6K
99204	2,347	16,380	30	$110	$5.6K
95024	134	200	490	$10	$3.8K

Presley Mock — Billing Profile & Reimbursement Data

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Presley Mock — Billing Profile & Reimbursement Data

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Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Frequently Asked Questions

References