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

Why is the Medicaid comparison limited to South Carolina 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. South Carolina (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.

Elizabeth Price (NPI 1033561048)

Elizabeth Price is a colon & rectal surgery physician provider located in West Columbia, South Carolina. This profile covers 10 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	Elizabeth Price
Address	146 E Hospital Dr Ste 400
City	West Columbia
State	SC
ZIP	29169
Taxonomy	Colon & Rectal Surgery Physician
NPI Enumerated	July 1, 2016

Payer Source	Total Paid
Medicare	$36.6K
Medicaid	$0

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

10 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	80	$120	$9.8K
46600	The provider performs an anoscopy, or an examination of the anus using a small, rigid, tubular instrument called an anoscope. He collects samples for analysis by brushing or washing the anal canal.…	80	$80	$6.4K
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…	60	$90	$5.7K
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…	70	$70	$5K
46500	The provider injects a sclerosing solution into the submucosa of the lower part of the anus under a hemorrhoid. This procedure helps in reducing blood flow to the area and causes the hemorrhoid to…	10	$230	$3.2K
46221	In this procedure, the provider ligates, or ties off, the base of a hemorrhoid inside the rectum with a rubber band. The provider performs this procedure to let the hemorrhoid dry out due to a lack…	10	$210	$2.9K
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…	20	$80	$1.6K
45380	The provider examines the rectum and colon using a flexible colonoscope, a tubular instrument with a light source and camera, to look for the cause of a patient's symptoms, which may include…	10	$120	$1.3K
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,…	20	$40	$670
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	10	$10	$70

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99214	5,692	7,860	160	$80	$23.2K
45380	252	260	60	$170	$18.9K
99213	4,380	7,690	100	$60	$10.8K
46221	16	20	30	$190	$7K
99204	1,052	4,520	40	$110	$6.4K
99203	2,184	2,970	30	$70	$3.9K
46600	4	30	40	$80	$3.7K
46500	1	10	10	$230	$3.3K
36415	2,054	2,090	140	$10	$2.7K
99212	1,426	1,820	30	$30	$2.5K

Elizabeth Price — Billing Profile & Reimbursement Data

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Elizabeth Price — 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