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

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

Shannon Wallace (NPI 1205102092)

Shannon Wallace is a urogynecology and reconstructive pelvic surgery (obstetrics & gynecology) physician provider located in Cleveland, Ohio. 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.

Medicare: Complete Services Breakdown

Field	Value
Entity Type	Individual
Organization	Shannon Wallace
Address	Cleveland Clinic 9500 Euclid Avenue
City	Cleveland
State	OH
ZIP	44195
Taxonomy	Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
NPI Enumerated	March 27, 2012

Payer Source	Total Paid
Medicare	$21.4K
Medicaid	$0

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

11 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
57425	The provider uses a laparoscopic approach to suspend the top of the vagina to a strong structure to treat vaginal vault prolapse using sutures or mesh.	10	$580	$6.4K
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	$70	$4.3K
52287	The provider performs an examination of the interior of the bladder, the urethra, and the ureteric openings by means of a cystoscope. He then inserts a needle and injects a neurolytic drug into the…	20	$140	$2.2K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	20	$110	$2.1K
99205	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the provider…	10	$120	$1.7K
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…	20	$80	$1.5K
51728	In this procedure, the provider performs a complex cystometrogram along with voiding pressure studies to diagnose certain urinary disorders like an overactive bladder, stress incontinence, or urinary…	20	$80	$1.3K
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…	20	$50	$950
51797	Voiding pressure (sometimes referred to as leak point pressure) measures contractions of the detrusor muscle and can detect a pressure obstruction if the patient is able to void, or express, urine.	20	$30	$620
51784	This test measures the electrical activity in the anal or urethral sphincter muscles.	20	$10	$270

Showing 1–10 of 11

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99214	12,441	20,010	100	$70	$11.7K
57425	6	10	10	$650	$9.1K
52287	46	60	20	$250	$8.6K
99213	17,173	20,000	70	$50	$6.6K
99215	3,567	4,950	30	$110	$5.9K
99204	5,756	8,330	30	$100	$4.4K
99205	1,633	2,130	20	$140	$4.2K
51728	47	80	20	$140	$3.8K
51797	44	80	20	$90	$2.7K
51784	65	100	30	$20	$780

Shannon Wallace — 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