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

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

Roger Riley (NPI 1184642456)

Roger Riley is a anatomic pathology & clinical pathology physician provider located in Richmond, Virginia. This profile covers 11 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	Roger Riley
Address	1250 E Marshall Street
City	Richmond
State	VA
ZIP	23298
Taxonomy	Anatomic Pathology & Clinical Pathology Physician
NPI Enumerated	July 17, 2006

Payer Source	Total Paid
Medicare	$22.4K
Medicaid	$0

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

11 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
88360	The lab analyst applies a single antibody stain on a slide or slides prepared from a single patient specimen, such as tumor tissue. Then a qualified provider, typically a pathologist, evaluates the…	150	$30	$4.7K
85097	The clinician, typically a pathologist, interprets a smear prepared from a sample of bone marrow.	90	$40	$3.2K
88341	The lab analyst applies an additional single antibody stain on a slide or slides prepared from the same patient specimen as the initial antibody stain, such as tumor tissue. Then a qualified…	140	$20	$3.2K
88305	The physician, typically a pathologist, performs a level IV examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally…	100	$30	$2.9K
85060	The physician, typically a clinical pathologist, performs a peripheral blood smear review and provides an interpretation and written report of the examination.	120	$20	$2.2K
88321	A qualified provider, typically a pathologist, provides consultation and a report on slides prepared elsewhere. A unit of service is the surgical case regardless of the number of slides received.	30	$70	$1.9K
88342	The lab analyst applies an initial single antibody stain on a slide or slides prepared from a single patient specimen, such as tumor tissue. Then a qualified provider, typically a pathologist,…	50	$30	$1.4K
88313	The lab analyst performs the technical lab steps to stain a specimen for Group II identification, for example an iron stain or trichrome stain. A qualified provider, typically a pathologist,…	110	$10	$990
88189	The clinician, typically a pathologist, interprets flow cytometry results of 16 or more markers.	10	$70	$720
88311	The lab analyst performs a decalcification procedure on a specimen. Dissolving the calcium makes it easier to perform certain examinations.	70	$10	$670

Showing 1–10 of 11

Roger Riley — 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
88305	223	250	760	$40	$55.8K
88341	147	200	290	$30	$17.1K
88342	176	210	160	$50	$13K
88189	40	40	110	$70	$11.7K
88313	51	140	60	$20	$5.2K
88360	24	120	90	$40	$3.8K
88321	26	50	30	$70	$3K
85097	11	50	50	$40	$2.2K
85060	14	90	50	$20	$1.7K
88311	38	140	50	$10	$630