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

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

James Chen (NPI 1093132250)

Field	Value
Entity Type	Individual
Organization	James Chen
Address	200 1st St Sw
City	Rochester
State	MN
ZIP	55905
Taxonomy	Anesthesiology Physician
NPI Enumerated	March 26, 2014

Payer Source	Total Paid
Medicare	$16.2K
Medicaid	$0

Medicare: Complete Services Breakdown

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

5 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99291	Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is…	50	$160	$7.8K
00790	The provider performs anesthesia services for a patient undergoing intraperitoneal procedures in the upper abdomen, including laparoscopy, which are not specified by any other anesthesia code.	10	$190	$2.7K
00840	The provider performs anesthesia services for a patient undergoing intraperitoneal procedures in the lower abdomen, including laparoscopy, which are not specified by any other anesthesia code.	10	$180	$2.1K
00860	The provider performs anesthesia services for an extraperitoneal procedure in lower abdomen, including the urinary tract.	10	$190	$2.1K
00914	The provider performs anesthesia services for a patient undergoing removal of the prostate gland through the urethra, which is the opening for the outflow of urine.	10	$140	$1.5K

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 5 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Minnesota Distribution

James Chen — 0 of 5 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Minnesota

Full comparison — all codes billed, vs. state median

5 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99291	328	1,150	30	$160	$7.5K
00790	49	110	10	$160	$2.4K
00860	4	10	10	$150	$2K
00840	24	50	10	$140	$1.9K
00914	3	10	10	$140	$1.9K

James Chen — Billing Profile & Reimbursement Data

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James Chen — 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