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 Nelson (NPI 1154676294)

James Nelson is a anesthesiology physician provider located in Rochester, Minnesota. This profile covers 19 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	James Nelson
Address	200 1st St Sw
City	Rochester
State	MN
ZIP	55905
Taxonomy	Anesthesiology Physician
NPI Enumerated	July 16, 2012

Payer Source	Total Paid
Medicare	$35.9K
Medicaid	$0

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

19 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
93306	The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent…	160	$50	$8.1K
00560	The provider performs anesthesia services for a patient undergoing a procedure involving the heart, the sac around the heart, and the great vessels of the chest, such as the aorta, its major…	20	$250	$5K
00537	The provider performs anesthesia services for a patient undergoing cardiac electrophysiologic procedures, such as mapping, pacing, recording, arrhythmia induction, lead testing, and similar services,…	20	$230	$3.5K
00541	The provider performs anesthesia services for a patient undergoing a procedure involving opening the chest wall and using one lung ventilation.	10	$270	$3.5K
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.	20	$170	$2.6K
36556	The provider inserts a central venous access catheter in the neck, chest, or groin to draw blood or administer medication or nutrients to a patient 5 years of age or older.	30	$70	$2K
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	$170	$1.8K
01922	The provider performs anesthesia services for a patient undergoing non–invasive imaging or radiation therapy.	20	$100	$1.8K
36620	In this procedure, the provider inserts a catheter percutaneously (through the skin) into an artery and uses this catheter for the purpose of sampling, transfusion, or continuous real–time blood…	50	$40	$1.7K
93314	In this procedure, the provider performs transesophageal echocardiography, TEE, with interpretation of the overall function of the heart’s valves and chambers and determines the presence of many…	20	$70	$1.5K

Showing 1–10 of 19

James Nelson — 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
93306	222	330	220	$60	$14.2K
00537	26	40	20	$240	$5.4K
00560	4	10	20	$220	$3.9K
00541	1	10	10	$260	$3.2K
00790	39	110	10	$160	$2.4K
01922	11	50	20	$130	$2.3K
93314	13	20	20	$70	$1.9K
00840	30	50	10	$140	$1.9K
00731	333	650	20	$70	$1.8K
00400	24	30	10	$90	$1.2K