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

Why is the Medicaid comparison limited to North Dakota 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. North Dakota (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.

Rachel Ness (NPI 1205031713)

Field	Value
Entity Type	Individual
Organization	Rachel Ness
Address	3173 43rd Street S Ste A
City	Fargo
State	ND
ZIP	58104
Taxonomy	Dermatology Physician
NPI Enumerated	June 15, 2007

Payer Source	Total Paid
Medicare	$539.5K
Medicaid	$0

Key Findings

This provider’s billed activity is concentrated almost entirely in Medicare: total Medicare revenue is $539.5K while Medicaid shows none on file, so the practice functions effectively as a single‑payer (Medicare) operation in the available data. That payer mix will materially shape network contracting and case-mix reviews because there is no Medicaid volume to evaluate.

Revenue is highly concentrated in a few radiation-planning and guidance codes: the precomputed top 3 Medicare codes by revenue account for 72.2% of this provider's total Medicare revenue, led by 77280 ($210.6K revenue, 39.4%) and G6001 ($144.7K revenue, 27.1%), with 77401 contributing $30.8K (5.8%). Those three codes collectively drive the majority of billed Medicare dollars, indicating a narrow set of high-value procedures underpinning revenue.

The code mix points to a service line centered on radiation therapy planning and guidance combined with outpatient dermatologic procedures: high-revenue codes include 77280, G6001, 77427 and ancillary physics/planning codes such as 77336 and 77332, while dermatology procedures (e.g., 96920, 17110, 17000, 11602, and shave/excision codes like 11301/11302/11311) appear as lower-revenue complements. This pattern suggests the clinician’s billing profile reflects substantial involvement in radiation treatment planning and delivery for skin-related conditions alongside routine dermatology lesion management.

Competitive standing varies by code: for 77280 the provider ranks #103 of 3348 providers nationally (97th percentile) and is described as "notably above typical national volume," indicating a nationally prominent position for that specific service. By contrast, G6001 ranks #79 of 280 (72th percentile; typical, unremarkable volume) and 77401 ranks #109 of 426 (75th percentile; typical, unremarkable volume), so the provider is an outlier on 77280 but more typical on other high-revenue radiotherapy codes.

Office evaluation-and-management activity comprises a modest share of Medicare billing: 99213 accounts for $20.3K (3.8% of Medicare revenue) with 344 claims and 99214 accounts for $11.1K (2.1% of Medicare revenue) with 131 claims, indicating revenue and volume are driven more by procedural and radiation-planning services than by routine E&M visits. This has implications for encounter-level case-mix and utilization reviews, which should focus on procedure coding patterns rather than high ambulatory visit volumes.

There are clear statistical low-volume points within the top-25 list that may reflect specialized workflows: for example 77334 appears at #4448 of 4463 providers nationally (0th percentile; typical, unremarkable volume) and 77300 sits at the 15th percentile, showing that while some planning codes are heavily used, other specialized physics/device-design codes are rarely billed by this provider. These contrasts suggest a focused set of radiation services rather than broad-spectrum radiation-oncology procedures.

High claim counts for select radiotherapy guidance codes indicate throughput-driven operational execution: G6001 shows 1K claims and 77280 shows 984 claims, both with substantial average payments ($142 and $214 avg paid/claim respectively), which combined produce the majority of Medicare revenue. That volume profile is consistent with frequent, procedure-focused sessions rather than episodic or consultative engagement.

The NPI enumeration date of 2007-06-15 (~19 years ago) indicates long tenure in Medicare data; coupled with the concentrated, high-ranking activity on 77280 and substantial claims for G6001, this suggests an established practice pattern and an enduring specialization in radiation-guidance services for dermatologic indications. Analysts considering referral networks or competitive positioning should treat this provider as a long-standing, niche player in radiation-planning for skin disease rather than a general dermatology practice.

Medicare: Complete Services Breakdown

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

32 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
77280	The provider uses a simulator or other imaging modality to determine the size and location of ports to be used for radiation therapy. This code describes a simple level service.	980	$210	$210.6K
G6001	Ultrasonic guidance for placement of radiation therapy fields	1,020	$140	$144.7K
77401	Deleted effective Jan. 1, 2026.	960	$30	$30.8K
77427	Radiation therapy utilizes ionizing radiation beams that are directed at cancerous cells in order to destroy them. The radiation, damages the DNA (the genetic material) in the cell, thus preventing…	180	$150	$26.9K
96920	The provider uses an excimer (ultraviolet) laser to treat the skin disease psoriasis. Use this code for a total treatment area of less than 250 sq cm.	190	$120	$23.1K
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…	340	$60	$20.3K
17110	The provider destroys benign lesions using techniques such as chemosurgery, cryosurgery, electrosurgery, or others. This code reports the destruction of one to 14 lesions other than skin tags or…	180	$70	$12.8K
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…	130	$90	$11.1K
77336	This code is for reporting ongoing medical physics consultation. When a patient is undergoing radiation treatment for a particular span of time with a number of therapy sessions every week, the…	130	$70	$8.8K
17000	The provider destroys a premalignant lesion using techniques such as chemosurgery, cryosurgery, electrosurgery, or others. This code reports the destruction of the first or only lesion.	190	$30	$6K

Showing 1–10 of 32

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 32 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. North Dakota Distribution

Rachel Ness — 1 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — North Dakota

Full comparison — all codes billed, vs. state median

32 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
G6001	1	10	1,020	$140	$144.9K
77401	1	10	960	$30	$31.2K
77427	7	10	160	$150	$28.5K
77280	1	10	50	$180	$25.9K
96920	1	10	190	$120	$23.1K
77336	4	10	290	$70	$17.4K
99214	561	1,470	90	$60	$10.4K
77334	13	10	160	$60	$10.4K
17000	34	70	180	$30	$6.7K
77300	11	10	160	$40	$6K

Showing 1–10 of 32

Related Providers

Other providers that share a Tax Identification Number (TIN) with Rachel Ness, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Anil Potti	ND	Hematology & Oncology Physician	$4.9M	$0
Marina Gilca	ND	Retina Specialist (Ophthalmology) Physician	$4.3M	$0
William Noyes	ND	Radiation Oncology Physician	$1.2M	$0
Jonathan Marshall	NY	Diagnostic Radiology Physician	$761.9K	$4.4K
Myles Mitsunaga	CA	Diagnostic Radiology Physician	$510.8K	$113.9K
Aaron Fortney	ND	Ophthalmology Physician	$561.1K	$0
Monte Leidenix	ND	Ophthalmology Physician	$553.3K	$0
Mark Sczepanski	ND	Ophthalmology Physician	$545.7K	$0
Ikechukwu Onyeka	ND	Internal Medicine Physician	$486.7K	$0
Scott Marlowe	PA	Diagnostic Ultrasound Physician	$468.7K	$60

Nearby Providers

Other providers in the same ZIP code as Rachel Ness, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Pediatric Therapy Partners, Inc.	ND	Early Intervention Provider Agency	$0	$7M
Fargo Maple View LLC	ND	Alzheimer Center (Dementia Center)	$0	$4M
Beyond Boundaries Occupational Therapy, Inc.	ND	Multi-Specialty Clinic/Center	$0	$3.9M
Max Johnson	ND	Retina Specialist (Ophthalmology) Physician	$2.8M	$0
St. Sophie's, LLC	ND	Adolescent and Children Mental Health Clinic/Center	$0	$2.7M
Shangri-la Home Care	ND	Home Health Agency	$0	$2M
Beyond Boundaries Speech Language Therapy, Inc.	ND	Speech-Language Pathologist	$0	$2M
About Smiles Dental, LLC	ND	Dental Clinic/Center	$0	$1.7M
Center For Pain Medicine Surgery Center LLC	ND	Ambulatory Surgical Clinic/Center	$1.2M	$0
Davita Dakota Dialysis Center LLC	ND	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$1.2M

Rachel Ness — Billing Profile & Reimbursement Data

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Key Findings

Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References