Loading...

    Explore
    • Policy Monitoring
    • Live Policy Feed
    • Billing Codes
    • NPI Medicare & Medicaid
    • Healthcare Providers
    • Health Insurance Payers
    • States
    • Service Lines
    • Taxonomy Codes
    Lookup tools
    • Billing Code Lookup
    • CPT Modifier Lookup
    • Provider Taxonomy Code Lookup
    • Healthcare Provider & Facility Lookup
    • Health Insurance Payer Lookup
    • Payer Contact Directory

    Policy & Benchmark Tools

    • Prior Authorization Lookup
    • Coverage Criteria Lookup
    • Timely Filing Lookup
    • Billing Code Reimbursement Rates
    • Payer Comparison Dashboard
    • Facility Comparison Dashboard
    • All tools

    Company

    • About OpenPayer
    • Data Sources
    • Trek Health
    OpenPayerby Trek Health
    LinkedInYouTube

    © 2026 Trek Health. All rights reserved.

    OpenPayer is built and maintained by Trek Health.

    v1.0.28
    OpenPayerNPI Medicare & MedicaidCarlton Phillips
    Ask Trek AI about this page

    Carlton Phillips — Billing Profile & Reimbursement Data

    NPI 1083974539 · Birmingham, AL · MOHS-Micrographic Surgery Physician

    Customize your policy alerts

    Sign up for Carlton Phillips — Billing Profile & Reimbursement Data policy alerts

    Get alerted when relevant policies change without checking for updates manually.

    Monitor payer policy activity

    Receive email alerts as soon as relevant payer policies are published or updated.

    Carlton Phillips is a mohs-micrographic surgery physician provider located in Birmingham, Alabama. This profile covers 42 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.

    Table of contents

    Progress1 / 8

    Explore openpayer tools

    • Billing CodesCPT, HCPCS, DRG & more
    • Reimbursement RatesCommercial vs. Medicare rate reports
    • ProvidersHospitals & facilities
    • PayersPlans & market footprint
    • Taxonomy CodesNUCC specialty codes
    • ModifiersCPT modifiers & usage
    • Prior AuthorizationPA policies by payer & drug
    • Timely FilingFiling deadlines by payer
    • Coverage CriteriaMedical necessity by payer
    • Payer ContactsClaims, PA & appeals contacts
    View all tools

    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeIndividual
    OrganizationCarlton Phillips
    Address2100 16th Ave S
    CityBirmingham
    StateAL
    ZIP35205
    TaxonomyMOHS-Micrographic Surgery Physician
    NPI EnumeratedMay 17, 2012

    Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)

    Payer SourceTotal Paid
    Medicare$903.2K
    Medicaid$0

    Medicare: Total Revenue Breakdown by CPT/HCPCS Code

    Medicare revenue breakdown by CPT/HCPCS procedure code.

    View: Bar Chart1 / 2

    Medicare: Complete Services Breakdown

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

    42 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    17311Mohs surgery is a multi–staged procedure that is performed to excise a malignant lesion layer by layer, along with histo–pathological assessment. The assessment is performed to ensure that the…800$370$293.2K
    17312Mohs surgery is a multi–staged method of excising a malignant lesion layer by layer, along with histo–pathological assessment, to ensure negative malignancy of the margins.440$300$132K
    15260This code is for a free full–thickness skin graft of the nose, ears, eyelids, and/or lips that is 20 cm2 or less in size.90$720$61.5K
    17313Mohs surgery is a multi–staged method of excising a malignant lesion layer by layer, along with histo–pathological assessment, to ensure negative malignancy of the margins.150$370$54.5K
    Q4229Cogenex amniotic membrane, per square centimeter (add-on, list separately in addition to primary procedure)310$160$51.2K
    Q4180Revita, per square centimeter (add-on, list separately in addition to primary procedure)270$170$46.6K
    14060The provider replaces the lesions in the eyelids, nose, ears, or lips, with the healthy tissues from an adjacent site. This code represents a defect of 10 cm2 or less.70$530$36.7K
    13132The provider repairs a wound measuring 2.6 cm to 7.5 cm in size of the cheeks, chin, mouth, neck, axillae, genitalia, hands, and/or feet, which may require scar revision, debridement extensive…130$180$24.1K
    14041The provider replaces the lesions in the forehead, cheeks, chin, mouth, neck, axillae or armpits, genitalia, hands, or feet with the healthy tissues from an adjacent site. This code represents a…30$680$21.8K
    12032This CPT® code is used for the intermediate repair of wounds to the scalp, axillae, trunk and/or extremities (excluding hands and feet) that are 2.6 to 7.5 cm in size.140$130$18K

    Showing 1–10 of 42

    Medicare: Competitive Analysis & Benchmarks

    How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 42 CPT/HCPCS codes.

    View: State1 / 2

    Full comparison — all codes billed, vs. state median

    42 rows

    CPT/HCPCS CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    17311840290$400$152.5K
    Q4180210390$350$136.9K
    Q4229310340$160$61.2K
    17313134080$390$47.1K
    17312340130$290$46.3K
    1526043020$660$25K
    14061112020$660$21.7K
    13132155070$190$20.7K
    1404152020$610$18.9K
    992145,6367,330120$80$16.8K

    Showing 1–10 of 42

    Related Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    James KrellALDermatology Physician$273.6K$0
    Melanie AppellALDermatology Physician$117.1K$0
    Heidi EssigALMedical Physician Assistant$99.1K$0

    Nearby Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Paragon Contracting Services LLCALEmergency Medicine Physician$0$54.5M
    Oral & Facial Surgery Of Al, PCALSpecialist$0$6.4M
    Pediatric Dental Associates Of Birmingham, LLCALPediatric Dentistry$0$6.1M
    University Of Alabama At BirminghamALDevelopmental Disabilities Clinic/Center$0$4.8M
    Magnolia Pediatrics South IncALPediatric Adolescent Medicine Physician$0$2.9M
    Birmingham Pediatric AssocALPediatrics Physician$0$2.5M
    Alabama Ophthalmology Associates, P.C.ALOphthalmology Physician$0$2.1M
    St. Vincent's P.e.t. Center, LLCALDiagnostic Radiology Physician$1.6M$0
    St. Vincent's BirminghamALGeneral Acute Care Hospital$0$1.3M
    Cara BondlyALHematology & Oncology Physician$986.3K$0

    Frequently Asked Questions

    References

    1. 1.Medicare Physician & Other Practitioner by Provider and Service. CMS.gov.Provider-level Medicare Part B utilization and payment data.
    2. 2.NPPES NPI Registry. CMS.gov.National Provider Identifier registry used for provider enumeration and taxonomy metadata.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

    Medicare Revenue by CPT/HCPCS Code
    Claims Volume vs. Alabama Distribution
    Carlton Phillips — 3 of 25 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Alabama