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

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

Sonia Cohen (NPI 1033557756)

Sonia Cohen is a surgical oncology physician provider located in Boston, Massachusetts. This profile covers 11 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	Sonia Cohen
Address	Massachusetts General Hospital
City	Boston
State	MA
ZIP	02114
Taxonomy	Surgical Oncology Physician
NPI Enumerated	June 5, 2013

Payer Source	Total Paid
Medicare	$43K
Medicaid	$0

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

11 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
38525	The provider surgically removes the lymph nodes in the deep axilla through an open incision. He may send them to the laboratory for analysis. The provider performs the procedure as an investigation…	20	$370	$8.2K
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…	90	$80	$6.6K
11606	The provider excises a cancerous (malignant) lesion, including margins, over 4.0 cm in diameter, from the skin of the trunk, arms, or legs.	30	$220	$5.5K
11604	The provider excises a cancerous (malignant) lesion, including margins, of 3.1 to 4.0 cm in diameter, from the skin of the trunk, arms, or legs.	40	$130	$4.8K
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…	30	$140	$4.1K
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…	60	$50	$3.5K
38900	The provider injects a nonradioactive dye into the tissues surrounding the lymph nodes. The provider examines the lymph nodes during the procedure to detect the presence of disease and identify the…	30	$120	$3.4K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	20	$120	$2.6K
12044	This CPT® code is used for the intermediate repair of superficial wounds to the neck, hands, feet, and/or external genitalia that are 7.6 to 12.5 cm in size.	10	$140	$1.8K
13121	This is for a complex repair of a wound to the scalp, arms, and/or legs. This wound should be 2.6 to 7.5 cm in size.	10	$150	$1.6K

Showing 1–10 of 11

Sonia Cohen — 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

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99214	8,744	15,410	110	$80	$15.6K
13121	64	70	40	$240	$14.1K
99215	4,736	6,360	40	$120	$8.9K
99213	7,402	13,700	70	$60	$8.8K
99204	3,093	5,870	30	$120	$5.6K
38525	11	40	20	$200	$4.2K
11606	1	10	20	$250	$4K
12034	21	20	20	$200	$3.9K
11604	1	20	20	$170	$3.4K
38900	5	40	20	$110	$2.2K