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.

Sonny Tucker (NPI 1144487562)

Sonny Tucker is a vascular surgery physician provider located in Durham, North Carolina. This profile covers 14 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	Sonny Tucker
Address	2100 Erwin Rd
City	Durham
State	NC
ZIP	27710
Taxonomy	Vascular Surgery Physician
NPI Enumerated	May 22, 2008

Payer Source	Total Paid
Medicare	$30.8K
Medicaid	$0

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

14 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
36821	The provider creates an arteriovenous (AV) anastomosis by connecting a vein to an artery in any site to provide better vascular access in a patient with kidney failure who will receive hemodialysis…	20	$440	$8.4K
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…	150	$50	$6.7K
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…	60	$60	$3.7K
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…	50	$60	$3K
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…	70	$40	$2.7K
93880	Duplex scanning of arteries for the evaluation of blood flow is a type of non–invasive vascular diagnostic process. A physician can visualize and selectively assess the flow patterns of peripheral…	50	$30	$1.4K
93978	The provider performs a complete study of the aorta, the inferior vena cava or IVC, the iliac vasculature, or bypass grafts using duplex Doppler ultrasound scanning. He performs the study to assess…	40	$30	$990
93922	Noninvasive physiologic studies of upper or lower extremity arteries, single level, bilateral	120	$10	$960
99221	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a straightforward or low level of medical…	10	$60	$820
93990	The provider assesses the flow of blood through a hemodialysis graft using duplex ultrasound scanning. He performs this procedure to evaluate the condition of the graft.	40	$20	$610

Showing 1–10 of 14

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
36821	7	20	10	$450	$8.6K
99232	3,020	5,690	70	$60	$8.1K
99213	4,184	16,320	70	$50	$7.1K
93978	51	130	30	$100	$5.1K
93880	262	700	40	$80	$5.1K
99203	1,426	5,450	30	$70	$3.1K
93922	58	320	40	$40	$2.9K
93970	484	700	30	$60	$2.9K
93975	91	140	20	$100	$2.8K
93926	102	150	30	$60	$2.3K

Sonny Tucker — Billing Profile & Reimbursement Data

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Sonny Tucker — 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