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

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

Patrick Kelly (NPI 1134189160)

Field	Value
Entity Type	Individual
Organization	Patrick Kelly
Address	3801 S Elmwood Ave
City	Sioux Falls
State	SD
ZIP	57105
Taxonomy	Vascular Surgery Physician
NPI Enumerated	March 24, 2006

Payer Source	Total Paid
Medicare	$888.2K
Medicaid	$0

Key Findings

This provider is effectively single‑payer on file: total Medicare revenue is $888.2K and there is no Medicaid billing on file. The absence of any Medicaid claims suggests the practice’s revenue and payer risk are concentrated in Medicare only, with no in‑state Medicaid footprint to diversify revenue sources.

Revenue concentration is high: the precomputed top‑3 Medicare codes account for 67.5% of the provider’s Medicare revenue. The three top codes are 37227 ($324.9K, 37.0%), 37225 ($146.5K, 16.7%), and 36482 ($121.8K, 13.9%), indicating that a small set of procedural codes dominate receipts.

The code mix indicates a procedural vascular surgery practice with both endovascular intervention and venous ablation activity. The presence of high‑revenue procedural codes 37227 and 37225 alongside 36482 (chemical adhesive ablation of a vein) and multiple imaging/diagnostic vascular codes suggests integrated interventional and diagnostic vascular services.

Per‑procedure payment levels show procedure economics favoring endovascular work: 37227 has an avg paid/claim of $9024 and 37225 has an avg paid/claim of $6657, which are substantially higher than typical office E/M avg payments. These higher per‑claim pays drive a large share of the provider’s Medicare revenue despite fewer claims for those codes.

The practice performs a notably high volume of noninvasive vascular diagnostics in addition to interventions. Examples include 93926 (167 claims, $12.9K revenue, 1.5%; ranks in the 98th percentile, described as notably above typical national volume) and 93922 (256 claims, $10.8K revenue, 1.2%; ranks in the 96th percentile, described as notably above typical national volume), indicating substantial in‑house duplex and physiologic testing.

Competitive standing on key codes is mixed: 37227 ranks #82 of 363 providers nationally (77th percentile; typical, unremarkable volume for this code), 37225 ranks #381 of 715 providers nationally (44th percentile; typical, unremarkable volume for this code), while 36482 ranks #122 of 710 providers nationally (83th percentile; typical, unremarkable volume for this code). These rankings point to above‑median activity for vein ablation but otherwise generally typical national volumes for peripheral endovascular codes.

The practice receives significant ambulatory visit volume supporting longitudinal care: 99213 appears 596 times with $40.5K revenue (4.6% of Medicare revenue) and ranks #19643 of 457151 providers nationally (96th percentile; notably above typical national volume for this code). This suggests robust office follow‑up and management activity that complements procedural work.

The provider has a long NPI tenure, enumerated 2006-03-24 (~20 years ago), indicating an established practice profile in Sioux Falls, SD. Combined with the revenue concentration (67.5% from the top three codes) and no Medicaid billing on file, the practice is stable but exposed to Medicare policy or reimbursement changes that affect its highest‑revenue procedures.

Medicare: Complete Services Breakdown

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

33 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
37227	N/A	40	$9,020	$324.9K
37225	N/A	20	$6,660	$146.5K
36482	In this procedure, the provider inserts a chemical adhesive through a catheter into an incompetent vein in an extremity to ablate the vein. The provider reports this code for treatment of the first…	90	$1,370	$121.8K
37228	N/A	20	$1,820	$43.7K
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…	600	$70	$40.5K
37221	N/A	10	$2,220	$31.1K
37252	In this add–on procedure, the provider inserts a specially designed catheter with an ultrasound transducer, a device that sends high–frequency sound waves through the tissues and detects their…	20	$780	$14.7K
93925	The provider performs a duplex ultrasound scan of the lower extremity arteries or bypass grafts on both sides. Providers perform noninvasive arterial diagnostic procedures to examine the rate of…	100	$150	$14K
29581	The provider applies a layered bandage to the lower leg, ankle, and foot, to treat venous stasis ulcers and venous insufficiency, the failure of the blood veins immediately below the skin. A…	160	$80	$13K
93926	The provider performs a duplex ultrasound scan of the lower extremity arteries or bypass grafts. Providers perform noninvasive arterial diagnostic procedures to examine the rate of blood flow and to…	170	$80	$12.9K

Showing 1–10 of 33

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 33 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. South Dakota Distribution

Patrick Kelly — 4 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — South Dakota

Full comparison — all codes billed, vs. state median

33 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
37227	2	10	20	$7,300	$270K
37225	3	10	20	$4,190	$142.4K
36482	2	10	40	$1,210	$64.3K
37252	8	10	30	$570	$27.9K
37228	3	10	20	$1,220	$25.6K
37221	5	10	20	$900	$24.3K
35301	6	10	10	$810	$12.1K
99214	670	1,660	90	$70	$11.4K
29581	2	10	130	$50	$9.5K
93925	8	30	50	$90	$7.7K

Showing 1–10 of 33

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Iowa Physicians Clinic Medical Foundation	IA	General Practice Physician	$0	$102.7M
Sanford Medical Center Fargo	ND	Family Medicine Physician	$0	$75.9M
Sanford Medical Center	SD	Family Medicine Physician	$0	$68.8M
Sanford Medical Center Fargo	ND	General Acute Care Hospital	$0	$50.2M
Columbus Radiology Corp	OH	Diagnostic Radiology Physician	$0	$49.9M
Sanford Health Of Northern Minnesota	MN	Internal Medicine Physician	$0	$27.2M
Somc Medical Care Foundation, Inc.	OH	Family Medicine Physician	$0	$25.3M
Sanford Medical Center	SD	General Acute Care Hospital	$0	$24.4M
Sanford Medical Center	SD	Clinical Medical Laboratory	$1.8M	$18M
The Robert Young Center For Community Mental Health	IL	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$12.8M

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
South Dakota Achieve	SD	Developmental Disabilities Clinic/Center	$0	$166.9M
Dakotabilities	SD	Voluntary or Charitable Agency	$0	$77.8M
Volunteers Of America, Dakotas	SD	Intellectual and/or Developmental Disabilities Residential Treatment Facility	$0	$60.9M
Southeastern Behavioral Healthcare	SD	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$59.1M
Resouces For Human Development, Inc.	SD	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$31.1M
Childrens Dental Center	SD	Pediatric Dentistry	$0	$24M
Sanford Medical Center	SD	Air Ambulance	$0	$11.9M
Avera Mckennan	SD	Family Medicine Physician	$0	$10.6M
Sanford Clinic	SD	Pediatrics Physician	$0	$5.5M
Avera Mckennan	SD	Air Ambulance	$0	$5.3M

Patrick Kelly — Billing Profile & Reimbursement Data

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Patrick Kelly — Billing Profile & Reimbursement Data

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Key Findings

Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References