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

Why is the Medicaid comparison limited to North 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. North 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.

William Downey (NPI 1063475226)

William Downey is a cardiovascular disease physician provider located in Charlotte, North Carolina. This profile covers 16 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	William Downey
Address	1237 Harding Pl
City	Charlotte
State	NC
ZIP	28204
Taxonomy	Cardiovascular Disease Physician
NPI Enumerated	April 10, 2006

Payer Source	Total Paid
Medicare	$54.8K
Medicaid	$0

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

16 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	140	$80	$11.1K
92928	The provider inserts a catheter through the skin (percutaneous approach) and guides it into the heart's arteries. They deploy one or more stents (small tubes) to keep the artery open and may expand a…	20	$390	$9.1K
93454	In this procedure, the provider performs imaging supervision and interpretation for a coronary angiography in which injections are performed to assess any coronary artery disease or any stenosis…	50	$140	$6.9K
93456	In this procedure, the provider performs imaging supervision and interpretation for a coronary angiography with right heart catheterization. He also performs injections to assess any coronary artery…	30	$210	$5.4K
99457	The provider manages treatment using data from remote physiologic monitoring. The service requires at least one real–time interactive communication with the patient or caregiver during the month and…	120	$40	$4.6K
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…	40	$120	$4.5K
99454	The provider supplies one or more devices for remote physiologic monitoring that occurs for 16 to 30 days in a 30–day period.	100	$40	$3.8K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	40	$60	$2.2K
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	20	$90	$1.5K
92978	In this add–on procedure, the provider advances a catheter into a coronary vessel or previously placed graft using ultrasound or optical coherence tomography to view the extent of the blockage,…	20	$70	$1.3K

Showing 1–10 of 16

William Downey — 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	8,010	18,060	110	$80	$15.1K
92928	80	140	30	$390	$13.8K
99233	3,994	4,230	70	$90	$10.1K
99458	82	90	110	$30	$10K
99232	4,126	5,690	70	$60	$8.1K
99457	63	150	100	$40	$7.9K
99454	69	130	110	$40	$7.5K
99204	3,462	8,430	30	$110	$4.8K
93454	11	60	30	$150	$4.4K
93456	5	20	20	$220	$4.3K