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 District of Columbia for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to District of Columbia 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. District of Columbia (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.

Susan Stein (NPI 1164533584)

Susan Stein is a colon & rectal surgery physician provider located in Washington, District of Columbia. 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	Susan Stein
Address	2150 Pennsylvania Ave Nw Fl 9
City	Washington
State	DC
ZIP	20037
Taxonomy	Colon & Rectal Surgery Physician
NPI Enumerated	August 31, 2006

Payer Source	Total Paid
Medicare	$79.6K
Medicaid	$0

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

12 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
46221	In this procedure, the provider ligates, or ties off, the base of a hemorrhoid inside the rectum with a rubber band. The provider performs this procedure to let the hemorrhoid dry out due to a lack…	80	$250	$20.3K
46600	The provider performs an anoscopy, or an examination of the anus using a small, rigid, tubular instrument called an anoscope. He collects samples for analysis by brushing or washing the anal canal.…	160	$110	$16.4K
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…	120	$100	$11.3K
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…	90	$80	$6.9K
45385	The provider examines the colon and rectum using a colonoscope, a long, thin flexible tubular instrument with a light source and camera. He removes one or more tumors, polyps, or other lesions with a…	30	$230	$6.1K
99214	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…	50	$100	$5.3K
45300	In this procedure, the provider examines the inner part of the anus, rectum, and the sigmoid colon using a proctosigmoid scope, a short rigid instrument with a camera at its one end. He may also…	30	$110	$3.5K
45378	The provider examines the colon and rectum using a colonoscope, a flexible tube with a camera at its inserted end. If he sees any areas of abnormal mucosa or tissue, he takes samples using a brush…	20	$140	$2.9K
45380	The provider examines the rectum and colon using a flexible colonoscope, a tubular instrument with a light source and camera, to look for the cause of a patient's symptoms, which may include…	20	$100	$2.4K
99204	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the provider…	20	$140	$2.3K

Showing 1–10 of 12

Susan Stein — Billing Profile & Reimbursement Data

Sign up for Susan Stein — Billing Profile & Reimbursement Data policy alerts

Susan Stein — Billing Profile & Reimbursement Data

Sign up for Susan Stein — Billing Profile & Reimbursement Data policy alerts

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
46221	1	10	80	$230	$17.7K
99214	939	1,400	90	$100	$15.3K
45385	31	50	40	$250	$12.7K
99213	429	1,200	50	$70	$8.5K
45380	40	50	40	$150	$7.5K
99204	513	670	30	$130	$6.4K
46600	1	10	60	$90	$5.8K
99203	35	430	30	$80	$3.8K
45300	1	10	30	$110	$3.5K
45378	7	30	20	$160	$3.1K