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

Why is the Medicaid comparison limited to Massachusetts 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. Massachusetts (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.

Kyle Alpaugh (NPI 1174919054)

Kyle Alpaugh is a orthopaedic surgery physician provider located in Boston, Massachusetts. This profile covers 10 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	Kyle Alpaugh
Address	55 Fruit St
City	Boston
State	MA
ZIP	02114
Taxonomy	Orthopaedic Surgery Physician
NPI Enumerated	April 8, 2015

Payer Source	Total Paid
Medicare	$155.7K
Medicaid	$0

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

10 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
27130	In this procedure, the provider surgically replaces the hip joint by prosthesis, or artificial hip joint. He replaces both the femoral and acetabular components with or without using an autograft or…	60	$1,120	$70.4K
27447	In this procedure, the provider replaces the damaged weight bearing surfaces of both the medial and lateral compartments in the knee joint using implants of metal or other strong materials. The…	40	$1,130	$43.9K
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…	190	$80	$14.7K
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…	70	$140	$9.4K
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…	60	$110	$6K
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	$100	$5.1K
0055T	The provider uses a computer equipped with surgical navigation technology to help guide and validate the type and position of an orthopedic implant using computed tomography, or CT, or magnetic…	30	$140	$3.4K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	40	$40	$1.3K
20610	In this procedure, the provider inserts a needle through the skin of a patient and into a major joint or bursa and then uses the syringe attachment to the needle to remove fluid or he may inject a…	20	$70	$1.1K
97607	The provider applies controlled subatmospheric pressure around a wound through a sealed dressing to remove fluids and infectious materials and to aid in healing of wounds that have a total surface…	20	$20	$460

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
27447	112	280	30	$810	$35.7K
27130	34	190	30	$880	$33.3K
99214	10,549	15,410	110	$80	$15.6K
99213	3,012	13,700	70	$60	$8.8K
0055T	10	10	60	$130	$7.8K
20610	860	980	60	$50	$5.8K
99204	1,225	5,870	30	$120	$5.6K
99203	1,339	4,290	30	$80	$4.1K
99212	1,189	2,660	30	$40	$2.4K
97607	2	10	30	$20	$580

Kyle Alpaugh — 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