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

Why is the Medicaid comparison limited to South 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. South 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.

Tyler Ptacek (NPI 1225324791)

Field	Value
Entity Type	Individual
Organization	Tyler Ptacek
Address	101 E Minnesota St Ste 200
City	Rapid City
State	SD
ZIP	57701
Taxonomy	Interventional Pain Medicine Physician
NPI Enumerated	June 23, 2011

Payer Source	Total Paid
Medicare	$507.9K
Medicaid	$0

Key Findings

Practice profile and service mix are consistent with an interventional pain medicine operation: the portfolio is dominated by image‑guided spine procedures and implantable device management (notably 63650, 64483, 62323 and 62370) alongside routine E/M visits and intra‑articular injections (99214, 99213, J7329). The presence of substantial claims for device lead placement (63650 – electrode placement in the epidural space) and pump/catheter codes (62370, 62350) signals a procedure‑centric practice that combines implantable neuromodulation and image‑guided injections.

Revenue concentration is high: total Medicare revenue is $507.9K and the top 3 Medicare codes by revenue account for 42.8% of this provider's total Medicare revenue. Within that concentration, 63650 alone represents $122.3K (26.3% of Medicare revenue), with 99214 at $44.8K (9.6%) and 64483 at $31.8K (6.8%), indicating a small set of high‑value procedures drive a large share of income.

Payer mix is effectively single‑payer Medicare: this profile shows $507.9K in Medicare revenue and no Medicaid billing on file, so the provider’s public‑payer exposure is dominated by Medicare rather than a split Medicare/Medicaid mix. This concentrated payer exposure may shape negotiation leverage and patient access patterns within-state where Medicaid participation appears absent.

The provider shows above‑average national standing on several spine/interventional procedure codes: 63650 ranks #91 of 1371 providers nationally (93th percentile; notably above typical national volume for this code), and sacroiliac joint injections 27096 rank #270 of 5443 (95th percentile; notably above typical national volume). These percentiles indicate the clinician is a relatively high‑volume national performer for specific interventional spine interventions compared with peers.

There are clear statistical outliers in the E/M and procedural mix that merit attention: 99204 (new patient comprehensive visit) is reported as an extreme outlier (rank #2176 of 227068, 99th percentile), indicating unusually high national volume for that new‑patient visit level; by contrast, J0585 (onabotulinumtoxinA units) ranks #2809 of 3636 (22th percentile), reflecting comparatively lower national utilization of botulinum toxin relative to other providers filing that code. These divergent percentiles suggest focused expertise in spine procedures combined with selective use of adjunctive therapies.

Operationally, the blend of high counts for fluoroscopically guided procedures and imaging support codes (for example 77002 at 174 claims, $15.5K revenue, rank #388 of 7010, 94th percentile) points to a workflow built around image‑guided interventions and procedure suites. That infrastructure requirement—specialized imaging, device inventory and post‑implant follow‑up—aligns with the revenue profile driven by 63650 and related interventional codes and implies higher fixed procedural costs than a pure clinic‑based E/M practice.

Tenure and potential referral position: the provider’s NPI was enumerated 2011-06-23 (~15 years ago), indicating an established practice history that could support the higher procedural volumes observed. This longevity combined with above‑median procedural ranks on several spine codes is consistent with an experienced interventional pain clinician who has maintained procedural throughput over time.

From a payer monitoring and competitive perspective, the mix warrants routine utilization review focused on the high‑impact codes: 63650 (26.3% of Medicare revenue and high national percentile), 99204 (extreme outlier) and imaging‑dependent procedures such as 77002. Additionally, the absence of Medicaid billing suggests limited coverage of this provider in the state Medicaid network, which may affect access patterns for dual‑eligible or lower‑income patients and should be considered in network adequacy and contracting discussions.

Medicare: Complete Services Breakdown

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

60 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
63650	In this procedure, the provider places electrodes in the epidural space to relieve pain and reduce or eliminate spasms.	140	$910	$122.3K
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…	480	$90	$44.8K
64483	This procedure is the injection of an anesthetic agent and/or steroid in the form of a transforaminal epidural injection into a single level (either lumbar or sacral).	150	$220	$31.8K
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…	260	$120	$31.5K
62323	The provider injects a diagnostic or a therapeutic substance, such as pain medication or a steroid, into the space around the spinal nerves of the lumbar (lower back) or sacral (caudal, or tailbone)…	150	$200	$29.3K
27096	The provider performs an injection in the joint between the sacrum and ilium on one side of the body, with the aid of imaging equipment to locate the injection site. He injects an anesthetic to…	140	$150	$20.7K
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…	310	$70	$20.5K
J0585	Injection, onabotulinumtoxina, 1 unit	3,600	$10	$18K
64635	Under fluoroscopic or CT guidance, the provider applies an agent to a lower back joint to destroy nerve tissue.	50	$360	$16.9K
77002	The provider uses fluoroscopic guidance to place a needle for biopsy, aspiration, injection, or localization of a device to detect any lesions in any area of the body, except for the spine, or to…	170	$90	$15.5K

Showing 1–10 of 60

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 60 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. South Dakota Distribution

Tyler Ptacek — 4 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — South Dakota

Full comparison — all codes billed, vs. state median

60 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
63685	2	10	30	$4,180	$113K
J0585	10	10	7,900	$1	$86.8K
63650	1	10	30	$860	$56.6K
0275T	1	10	20	$1,690	$25.3K
64483	7	30	100	$120	$12.3K
J7329	1	10	1,600	$10	$11.5K
99214	125	1,660	90	$70	$11.4K
64635	4	20	30	$230	$8.5K
64628	2	10	20	$340	$7.8K
99215	438	450	40	$100	$7.5K

Showing 1–10 of 60

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Monument Health Rapid City Hospital, Inc	SD	Multi-Specialty Clinic/Center	$0	$18.7M
Monument Health Rapid City Hospital, Inc.	SD	General Acute Care Hospital	$0	$11.5M
Nathan Steinle	CA	Retina Specialist (Ophthalmology) Physician	$9.5M	$0
Prema Abraham	SD	Retina Specialist (Ophthalmology) Physician	$7.1M	$0
Monument Health Rapid City Hospital, Inc.	SD	Multi-Specialty Clinic/Center	$0	$5.2M
Rapid City Medical Center, LLP	SD	Multi-Specialty Clinic/Center	$0	$4.5M
Kyle Thompson	ID	Retina Specialist (Ophthalmology) Physician	$4.5M	$0
Douglas Holmes	WY	Retina Specialist (Ophthalmology) Physician	$4.1M	$0
Mitchell Goff	UT	Retina Specialist (Ophthalmology) Physician	$3.8M	$0
Brendan Girschek	AZ	Ophthalmology Physician	$3.2M	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Behavior Management Systems, Inc.	SD	Community/Behavioral Health Agency	$0	$19.8M
Community Health Center Of The Black Hills Inc	SD	Federally Qualified Health Center (FQHC)	$0	$10.2M
Jrk Services, Inc	SD	Home Health Agency	$0	$10.1M
Black Hills Pediatrics, LLP	SD	Pediatrics Physician	$0	$9.7M
Rapid City Emergency Services PA	SD	Emergency Medicine Physician	$0	$8.2M
Wellspring Inc.	SD	Psychiatry Physician	$0	$7.4M
Radiology Associates Prof, LLC	SD	Diagnostic Radiology Physician	$0	$5.3M
City Of Rapid City	SD	Ambulance	$1.4M	$3.7M
Black Hills Oral & Maxillofacial Surgery PC	SD	Oral and Maxillofacial Pathology Dentistry	$0	$3.2M
Black Hills Regional Eye Surgery Center, LLC	SD	Ambulatory Surgical Clinic/Center	$2.9M	$158.6K

Tyler Ptacek — 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