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NPI 1205840469 · Hilo, HI · Dermatology Physician
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Charles Mauro is a dermatology physician provider located in Hilo, Hawaii. This profile covers 28 Medicare and 1 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)
| Field | Value |
|---|---|
| Entity Type | Individual |
| Organization | Charles Mauro |
| Address | 868 Ululani St |
| City | Hilo |
| State | HI |
| ZIP | 96720 |
| Taxonomy | Dermatology Physician |
| NPI Enumerated | July 27, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $352.7K |
| Medicaid | $220 |
This provider’s Medicare revenue totals $352.7K while Medicaid revenue is $224, so Medicare is the clear dominant payer for this clinician and Medicaid represents a de minimis share of their billed revenue. The presence of any Medicaid billing is limited to a single code (see below), so operational and revenue analysis should be weighted toward Medicare activity rather than a dual-payer practice model.
Revenue concentration on Medicare is moderate: the precomputed top three Medicare codes account for 34.3% of total Medicare revenue, driven by 88305 ($45.9K, 13.2%), 99213 ($43.6K, 12.5%), and 17004 ($30.1K, 8.6%). This mix indicates that a plurality of Medicare dollars flow from a combination of pathology reading (88305), routine established office visits (99213), and lesion destruction procedures (17004).
The code mix signals a procedure-forward dermatology practice: high-revenue procedural CPTs appear throughout the Medicare top codes set (for example, 17004, 17282, 17262, and excision/repair codes such as 11602 and 13121), which suggests regular treatment of premalignant and malignant skin lesions alongside surgical excisions and complex repairs. The concurrent presence of 88305 as a top Medicare revenue code also indicates frequent submission of specimens for pathology, consistent with procedural dermatology that generates biopsy material.
For procedural dermatology, this provider ranks well above peers on several malignant-lesion destruction codes: 17262 is reported as an “extreme outlier, far above typical national volume” (rank #62 of 6198, 99th percentile), 17282 is “notably above typical national volume” (rank #17 of 1147, 99th percentile), and 17272 is “notably above typical national volume” (rank #33 of 1540, 98th percentile). Those high national percentiles tell a consistent story that the clinician is a substantially higher-volume provider for certain destructive treatments of malignant lesions compared with most dermatology peers.
On evaluation/management volume, 99213 contributes $43.6K (12.5% of Medicare revenue) and ranks #12302 of 457151 providers nationally (97th percentile), indicating an unusually large volume of established outpatient visits for a single clinician. High E/M volume paired with the procedural mix suggests this provider maintains a busy clinic workflow that combines office visits with frequent same-day or follow-up procedures.
Pathology services are a meaningful component of Medicare revenue (88305: $45.9K, 13.2%) but are not a major presence in Medicaid billing: on Medicaid the entire reported revenue ($221, 100.0% of Medicaid revenue) comes from 88305 across 13 claims ($17 avg paid/claim), and that Medicaid 88305 activity ranks #25 of 25 providers in-state (0th percentile). Together these metrics imply the provider submits pathology specimens to Medicare at a routine rate but has negligible Medicaid pathology market share within the state.
Competitive standing is mixed by payer and code: for some surgical and lesion-destruction codes the provider is a national high-volume outlier or notably above typical peers (e.g., 17262, 17282, 17272), while for pathology reading under Medicare the provider’s 88305 activity is more typical (ranking in the 64th percentile nationally). This means the clinician is a regional/nationally significant procedural dermatology operator for certain lesion treatments, even though some components of their billing (like pathology under Medicare) are not unusually large versus peers.
The provider has a long tenure on file — NPI enumerated (registered) 2006-07-27 (~20 years ago) — which supports interpreting the observed procedural and visit volumes as the output of an established practice rather than a recent entrant. Historical tenure combined with concentrated procedure-driven Medicare revenue suggests a sustained surgical dermatology practice rather than a transient billing pattern.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
28 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 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… | 750 | $60 | $45.9K |
| 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… | 750 | $60 | $43.6K |
| 17004 | The provider destroys 15 or more premalignant lesions using techniques such as chemosurgery, cryosurgery, electrosurgery, or others. | 210 | $140 | $30.1K |
| 17282 | The provider destroys a malignant lesion on the face, ears, eyelids, nose, lips, or mucous membrane using techniques such as chemosurgery, cryosurgery, electrosurgery, or others. The malignant lesion… | 200 | $150 | $28.9K |
| 17262 | The provider destroys a malignant lesion on the trunk, arms, or legs using techniques such as chemosurgery, cryosurgery, electrosurgery, or others. The malignant lesion is 1.1 cm to 2.0 cm in… | 240 | $110 | $26.8K |
| 13121 | This is for a complex repair of a wound to the scalp, arms, and/or legs. This wound should be 2.6 to 7.5 cm in size. | 70 | $360 | $26.8K |
| 13132 | The provider repairs a wound measuring 2.6 cm to 7.5 cm in size of the cheeks, chin, mouth, neck, axillae, genitalia, hands, and/or feet, which may require scar revision, debridement extensive… | 60 | $390 | $24.2K |
| 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. | 430 | $40 | $16.6K |
| 17272 | The provider destroys a malignant lesion on the scalp, neck, hands, feet, or genitalia using techniques such as chemosurgery, cryosurgery, electrosurgery, or others. The malignant lesion is 1.1 cm to… | 120 | $130 | $14.8K |
| 13101 | This is for a complex repair of a wound to the trunk. This wound should be 2.6 to 7.5 cm in size. | 40 | $330 | $14.1K |
Showing 1–10 of 28
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 28 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
28 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| 88305 | 19 | 50 | 460 | $40 | $35.1K |
| 17004 | 8 | 40 | 80 | $130 | $18.3K |
| 17282 | 1 | 10 | 120 | $150 | $18K |
| 99214 | 728 | 1,440 | 100 | $80 | $15.2K |
| 13132 | 3 | 10 | 60 | $230 | $13.1K |
| 13121 | 1 | 10 | 50 | $260 | $12.4K |
| 17110 | 67 | 70 | 110 | $80 | $11.4K |
| 13101 | 1 | 10 | 30 | $300 | $9.4K |
| 12032 | 19 | 20 | 30 | $230 | $8.7K |
| 99213 | 30 | 1,460 | 70 | $60 | $8.4K |
Showing 1–10 of 28
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
View: By Year1 / 3
Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
1 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 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… | 10 | $20 | $220 |
How this provider's Medicaid billing volume and revenue compare to other Hawaii providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Hawaii median
1 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 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… | 25 | 30 | 1,750 | $70 | $378K |
Other providers in the same ZIP code as Charles Mauro, ranked by combined Medicare and Medicaid revenue.
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