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

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

Joan Sisto (NPI 1033214077)

Field	Value
Entity Type	Individual
Organization	Joan Sisto
Address	10 Market Place Dr # 3
City	York
State	ME
ZIP	03909
Taxonomy	Dermatology Physician
NPI Enumerated	September 14, 2006

Payer Source	Total Paid
Medicare	$420.7K
Medicaid	$0

Key Findings

This provider is effectively single-payer in the public programs on file: Total Medicare revenue is $420.7K and there is no Medicaid billing on file, so Medicare accounts for the entirety of the reported public-payor revenue. This concentration suggests limited Medicaid exposure and that any payer-mix analysis should focus on Medicare and commercial payers (commercial not shown).

Revenue is highly concentrated in a small set of codes: the precomputed top three Medicare codes account for 62.3% of the provider's total Medicare revenue, driven by 99213 ($121.5K, 28.9%), 11102 ($84.2K, 20.0%), and 17000 ($56.1K, 13.3%). These figures indicate most Medicare dollars flow from routine E/M visits and lesion diagnosis/destruction services rather than a broad mix of high-value surgeries.

The code mix is characteristic of an outpatient dermatology practice with a heavy procedural throughput: high-volume office visits (99213) combined with large numbers of skin biopsies (11102, 11103) and lesion destruction services (17000 and the add-on 17003). The presence of 17003 with 5.3K claims at $5 avg paid/claim underscores frequent multiple-lesion treatments per encounter, consistent with high-throughput lesion management.

For competitive standing, the provider is a national volume outlier on core codes: 99213 ranks #728 of 457151 providers nationally (100th percentile; extreme outlier), 11102 ranks #84 of 18797 (100th percentile; extreme outlier), and 17000 ranks #194 of 21879 (99th percentile; extreme outlier). These ranks indicate the provider operates at a much higher national volume for routine dermatology visits and basic procedural codes than typical peers, while many secondary codes remain at more typical percentiles.

Several supporting codes also show notably above-typical volume for additional procedural work: 17003 ranks #286 of 19643 (99th percentile; notably above typical) and 11103 ranks #281 of 13774 (98th percentile; notably above typical), signaling sustained high throughput of multiple lesion treatments and additional biopsy specimens. At the same time, higher-complexity items such as 99214 ($15K, 3.6%) and excisions like 11602 ($2.4K, 0.6%) contribute meaningfully but are not the primary revenue drivers.

Although the practice generates substantial procedural volume, the revenue mix implies many lower-paid, high-count services (for example 17003 at $5 avg paid/claim and large claim counts), complemented by modest numbers of higher-paid procedures such as 12032 ($6.1K) and J7308 ($4.8K). This profile suggests operational emphasis on efficient throughput and lesion-focused care rather than a focus on a small number of high-reimbursement surgical cases.

Tenure is long-standing: the provider’s NPI was enumerated on 2006-09-14 (~20 years ago), indicating an established practice footprint in YORK, ME. That longevity, coupled with the volume outlier status on core codes, supports the assessment of an entrenched local procedural dermatology presence.

From a payer strategy perspective, the absence of Medicaid claims means the provider’s publicly reported revenue base is concentrated in Medicare; contracting or network decisions that target Medicaid populations would be addressing a gap rather than reallocating existing Medicaid volume. Conversely, Medicare-focused network negotiations or utilization-management programs will be most relevant given the $420.7K Medicare revenue and code concentration described above.

Medicare: Complete Services Breakdown

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

26 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…	2,090	$60	$121.5K
11102	The provider biopsies a single skin lesion using a tangential (side–ways) approach; he shaves off the lesion or scoops it out with a knife or curette.	1,260	$70	$84.2K
17000	The provider destroys a premalignant lesion using techniques such as chemosurgery, cryosurgery, electrosurgery, or others. This code reports the destruction of the first or only lesion.	1,600	$40	$56.1K
17110	The provider destroys benign lesions using techniques such as chemosurgery, cryosurgery, electrosurgery, or others. This code reports the destruction of one to 14 lesions other than skin tags or…	340	$80	$26.9K
17003	In this add–on procedure, the provider destroys a premalignant lesion using techniques such as chemosurgery, cryosurgery, electrosurgery, or others. This code is appropriate for the second through…	5,260	$10	$26.3K
11103	The provider biopsies an additional skin lesion using a tangential (side–ways) approach; he shaves off the lesion or scoops it out with a knife or curette. Report +11103 for each separate lesion…	520	$40	$19.6K
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…	180	$80	$15K
17004	The provider destroys 15 or more premalignant lesions using techniques such as chemosurgery, cryosurgery, electrosurgery, or others.	100	$120	$11.6K
17262	The provider destroys a malignant lesion on the trunk, arms, or legs using techniques such as chemosurgery, cryosurgery, electrosurgery, or others. The malignant lesion is 1.1 cm to 2.0 cm in…	80	$110	$9.6K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	250	$40	$9.5K

Showing 1–10 of 26

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 26 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Maine Distribution

Joan Sisto — 9 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Maine

Full comparison — all codes billed, vs. state median

26 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
11102	1	70	90	$60	$9.3K
J7308	2	10	20	$300	$8.4K
17000	1	90	140	$40	$7.5K
17004	4	20	30	$110	$7.4K
99214	444	2,500	70	$70	$7.2K
17110	2	70	70	$70	$6.6K
12032	13	20	30	$180	$6.4K
17262	4	30	30	$110	$5K
99213	1	2,350	50	$50	$4.3K
17282	4	10	20	$140	$3.8K

Showing 1–10 of 26

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Liqiao Ma	TX	Dermatology Physician	$3.1M	$0
Michael Murphy	IN	MOHS-Micrographic Surgery Physician	$1.7M	$0
Francessca Brettschneider	FL	Dermatopathology (Pathology) Physician	$1.6M	$0
John Bernat	OH	Specialist	$1.3M	$0
Brienne Cressey	NH	MOHS-Micrographic Surgery Physician	$1.2M	$0
Alireza Sepehr	MA	Anatomic Pathology & Clinical Pathology Physician	$1.2M	$1000
Jason Rosen	FL	Dermatopathology Physician	$1.1M	$0
Omar Badri	MA	MOHS-Micrographic Surgery Physician	$1M	$0
Navid Bouzari	MA	Dermatology Physician	$979K	$0
Elizabeth Uhlenhake	OH	Dermatology Physician	$966.3K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
York Hospital	ME	General Acute Care Hospital	$0	$5.8M
York Ambulance Association, Inc.	ME	Land Ambulance	$288K	$242.7K
Denture Crafters LLC.	ME	Denturist	$0	$354.4K
Jeffrey Colnes	ME	Cardiovascular Disease Physician	$226K	$0
Ashley Mace	ME	Nurse Practitioner	$133.9K	$0
David Cunningham	ME	Clinical Cardiac Electrophysiology Physician	$132.9K	$0
Judith Fisher	ME	Dermatology Physician	$116.1K	$0
Jennifer Cutts	ME	Diagnostic Radiology Physician	$115.2K	$0
Stephen Morley	ME	Psychiatric/Mental Health Nurse Practitioner	$16K	$97.9K
Kira Wendorf	ME	Diagnostic Radiology Physician	$113.1K	$0

Joan Sisto — Billing Profile & Reimbursement Data

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Key Findings

Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References