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

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

Justin Caplan (NPI 1124277272)

Justin Caplan is a neurological surgery physician provider located in Baltimore, Maryland. This profile covers 12 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	Justin Caplan
Address	1800 Orleans St
City	Baltimore
State	MD
ZIP	21287
Taxonomy	Neurological Surgery Physician
NPI Enumerated	September 13, 2008

Payer Source	Total Paid
Medicare	$44.3K
Medicaid	$0

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

12 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
36223	In this procedure, the provider performs imaging supervision and interpretation for angiography performed by inserting a catheter through a distal artery into the thoracic aorta and farther into the…	40	$320	$13.4K
61645	Using fluoroscopy, live X–rays displayed on a video monitor, the provider inserts a catheter percutaneously (through a small incision in the skin) into an intracranial artery, a branch of the carotid…	10	$680	$7.4K
36226	In this procedure, the provider performs imaging supervision and interpretation for angiography performed by inserting a catheter through a distal artery into the thoracic aorta and aortic arch. He…	30	$260	$6.5K
36225	In this procedure, the provider performs imaging supervision and interpretation for angiography performed by inserting a catheter through a distal artery into the thoracic aorta, internal carotid…	30	$180	$4.7K
36224	In this procedure, the provider performs imaging supervision and interpretation for angiography performed by inserting a catheter through a distal artery into the thoracic aorta and farther into the…	10	$360	$4K
99223	The provider sees a patient for an initial 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	$150	$2.2K
76377	In this procedure, the provider performs interpretation and reporting for computed tomograph, magnetic resonance imaging, ultrasound, or other tomographic modality under concurrent supervision with…	50	$30	$1.6K
99231	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a straightforward or low level of medical…	30	$40	$1.3K
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…	10	$70	$990
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…	20	$60	$900

Showing 1–10 of 12

Justin Caplan — 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
99213	8,704	9,280	100	$60	$12.5K
61645	12	10	20	$690	$11K
36223	3	10	20	$340	$10.9K
99223	2,535	2,930	40	$140	$10.3K
36224	15	20	20	$340	$10.2K
36226	7	10	30	$210	$6.4K
36225	2	10	20	$170	$5.2K
99203	3,172	3,630	40	$80	$5K
76377	29	80	30	$60	$3.2K
99231	540	940	40	$40	$3K