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

Why is the Medicaid comparison limited to Michigan 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. Michigan (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 Larson (NPI 1174542724)

James Larson is a diagnostic radiology physician provider located in Grand Rapids, Michigan. This profile covers 25 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 Larson
Address	3264 N Evergreen Dr Ne
City	Grand Rapids
State	MI
ZIP	49525
Taxonomy	Diagnostic Radiology Physician
NPI Enumerated	July 18, 2006

Payer Source	Total Paid
Medicare	$42K
Medicaid	$0

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

25 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
76770	A retroperitoneal ultrasound is a noninvasive procedure used to assess the body parts within the abdomen (i.e.Kidneys, urinary bladder, and aorta). This particular code is used when the ultrasound is…	220	$30	$5.6K
77067	The provider takes two X–ray views of each breast for routine screening and may use specially designed computer software to help identify any potential abnormalities within the images; the software…	150	$40	$5.4K
76705	An abdominal ultrasound is a noninvasive procedure used to assess the body parts within the abdomen (i.e. liver, gallbladder, pancreas, bile ducts, spleen, and abdominal aorta). This particular code…	260	$20	$5.3K
77063	The provider captures three dimensional images of the breast using X–rays at various angles for routine checkup. He checks for the presence of any abnormality within the breasts. Tomosynthesis…	150	$30	$4.3K
93970	The provider performs an ultrasound scanning procedure called a duplex scan to characterize the pattern and direction of blood flow in extremity veins (arms or legs). This is a complete, bilateral…	110	$30	$2.8K
71045	In this diagnostic procedure, the provider performs a single radiological view of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and nearby…	390	$10	$2.7K
93975	The provider performs a complete study of the abdominal, pelvic, scrotal, and or retroperitoneal organs using duplex ultrasound. He performs the procedure to examine the vascular supply to the organs…	70	$40	$2.6K
93971	The provider performs an ultrasound scanning procedure called a duplex scan to characterize the pattern and direction of blood flow in extremity veins (arm or leg). This is a unilateral or limited…	120	$20	$1.9K
76536	The provider performs real–time ultrasound examination of the soft tissues of the head and neck and records and saves the images for later review.	100	$20	$1.9K
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	$1.5K

Showing 1–10 of 25

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
77067	263	390	290	$50	$19.6K
77063	253	380	260	$30	$11.8K
93880	236	620	40	$80	$5.1K
93970	93	550	40	$60	$4K
93923	121	180	30	$60	$3.1K
71045	337	800	320	$10	$2.9K
93975	11	140	20	$80	$2.4K
76770	33	590	40	$30	$2.4K
93971	82	550	40	$30	$2.2K
G0279	240	260	70	$20	$1.8K

James Larson — 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