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

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

John Roussalis (NPI 1235252669)

Field	Value
Entity Type	Individual
Organization	John Roussalis
Address	537 Stanton Christiana Rd
City	Newark
State	DE
ZIP	19713
Taxonomy	Plastic and Reconstructive Surgery Physician
NPI Enumerated	April 9, 2007

Payer Source	Total Paid
Medicare	$1.2M
Medicaid	$0

Key Findings

This provider reports $1.2M in lifetime Medicare revenue and has no Medicaid billing on file, so the practice is effectively single‑payer (Medicare) in the available data. The NPI has been enumerated since 2007-04-09 (~19 years ago), indicating an established presence in the market.

Revenue is highly concentrated: the precomputed top 3 Medicare codes by revenue account for 73.2% of this provider's total Medicare revenue. Those top three codes are A2001 ($685.3K revenue, 844 claims, $812 avg paid/claim), Q4158 ($109.8K revenue, 752 claims, $146 avg paid/claim), and 14301 ($72.2K revenue, 104 claims, $694 avg paid/claim), showing dependence on a small set of high‑value procedural and product codes.

The code mix signals a procedure‑focused plastic/reconstructive surgery practice that relies heavily on skin‑substitute/add‑on products and reconstructive excision/repair work. High utilization of A2001 and Q4158 (per cm2 skin substitute add‑ons) alongside multiple skin graft and complex repair codes (for example 15002, 15271, 13121, 13101) points to wound care, grafting, and flap/adjacent tissue reconstruction as primary service lines.

A2001 is the dominant revenue driver but is a modest national participant for that code, ranking #16 of 37 (58th percentile) and described as a typical, unremarkable volume for A2001; Q4158 likewise ranks as typical volume (#12 of 36, 69th percentile). By contrast, several reconstructive procedure codes show substantially elevated activity: 13101 ranks #18 of 2174 (99th percentile) and is labeled an extreme outlier, and 15002 ranks #8 of 283 (98th percentile) and 13121 ranks #140 of 3302 (96th percentile), both described as notably above typical national volume.

Despite the heavy procedural profile, evaluation & management codes play a secondary role in Medicare revenue—99214 generated $26.2K (265 claims, $99 avg paid/claim) and 99213 generated $14.8K (214 claims, $69 avg paid/claim)—each characterized as typical, unremarkable volume. This distribution is consistent with a specialty surgical practice that bills E&M episodically around procedural care rather than relying primarily on office visits for revenue.

Several codes tied to excisions of malignant lesions and repair complexity are also above typical national volume (for example 11603 ranks #98 of 3144, 97th percentile; 11602 ranks #310 of 5197, 94th percentile), reinforcing a clinical focus on oncologic skin excision with reconstructive closure. The mix of higher‑percentile excision and complex repair codes indicates the provider performs a meaningful volume of multi‑stage or complex reconstructions relative to peers.

The concentration of revenue in a few high‑value codes (top 3 = 73.2%) implies financial sensitivity to changes in utilization patterns or reimbursement for those specific codes, particularly A2001 which contributes the single largest share ($685.3K). Payer policy updates or supply/product availability affecting per‑cm2 skin substitutes would likely have an outsized impact on this provider's Medicare revenue.

From a competitive/market positioning perspective, the provider appears to be a specialized, procedure‑heavy operator rather than a broad primary‑care or high‑volume E&M practice: modest national standing on skin‑substitute add‑ons (typical volumes for A2001 and Q4158) combined with extreme or notably above typical volumes on several reconstructive codes suggests a niche that is stronger in complex repairs and grafting relative to most peers. Given no Medicaid activity on file, any assessment of in‑state competitive position for Medicaid cannot be made from the available data.

Medicare: Complete Services Breakdown

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

30 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
A2001	Innovamatrix ac, per square centimeter (add-on, list separately in addition to primary procedure)	840	$810	$685.3K
Q4158	Kerecis omega3, per square centimeter (add-on, list separately in addition to primary procedure)	750	$150	$109.8K
14301	The provider replaces the lesions in any area with the healthy tissues from an adjacent site. This code represents a defect of 30.1 cm2 to 60.0 cm2.	100	$690	$72.2K
14021	The provider repairs lesions in the patient’s scalp, arms, or legs by using the healthy tissues from an adjacent site. This code represents a defect of 10.1 cm2 to 30.0 cm2.	70	$550	$38.7K
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.	180	$170	$31.5K
15002	The provider incises the skin of a body part with an open wound, burn eschar, or scar contracture to prepare the site to receive a skin graft. This procedure helps in repairing an area of the trunk,…	180	$180	$31.3K
14041	The provider replaces the lesions in the forehead, cheeks, chin, mouth, neck, axillae or armpits, genitalia, hands, or feet with the healthy tissues from an adjacent site. This code represents a…	50	$590	$29K
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.	170	$160	$27.5K
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…	270	$100	$26.2K
15271	The provider uses a skin substitute, such as an allograft or xenograft, to cover wounds on the patient’s trunk, arms, and/or legs up to an area of 100 cm2. This code covers up to the first 25 cm2.	160	$120	$19.7K

Showing 1–10 of 30

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 30 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Delaware Distribution

John Roussalis — 5 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Delaware

Full comparison — all codes billed, vs. state median

30 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
A2001	1	10	840	$810	$685K
Q4158	1	10	750	$150	$109.4K
14301	3	10	50	$900	$89.4K
14041	4	10	40	$630	$42.1K
15004	5	10	220	$170	$41.8K
15002	1	10	180	$320	$41.3K
14021	2	10	40	$540	$28.9K
99214	630	1,830	150	$80	$25.5K
13121	2	20	50	$240	$19.2K
11102	48	50	180	$60	$17.7K

Showing 1–10 of 30

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Panzer Dermatology Associates	DE	Specialist	$0	$1.6M
Christopher Conti	DE	MOHS-Micrographic Surgery Physician	$1.1M	$0
Matthew Hanson	DE	Dermatology Physician	$1M	$0
Paul Sabini	DE	Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician	$462.9K	$0
Lori Spencer	DE	Dermatology Physician	$432.2K	$0
Helen Mashek	DE	Dermatology Physician	$393.5K	$0
Gina Caputo	DE	Dermatology Physician	$259K	$0
Joseph Andrews	DE	Dermatology Physician	$249.7K	$0
John Mcintire	DE	Otolaryngology Physician	$214.5K	$0
Dawn Hirokawa	DE	Dermatology Physician	$197.5K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Associated Retinal Consultants LLC	DE	Ophthalmology Physician	$0	$25.2M
Columbus Medical Services, LLC	DE	Case Management Agency	$0	$18.7M
Christiana Care Health Services Inc	DE	Hospitalist Physician	$0	$13.6M
Caritas Home Health Services, Inc	DE	Home Health Agency	$0	$11.2M
Delaware Center For Maternal Fetal Medicine Of Christiana Care	DE	Maternal & Fetal Medicine Physician	$0	$9.8M
Christiana Care Health Services Inc	DE	Neonatal-Perinatal Medicine Physician	$0	$8.9M
Medical Oncology Hematology Consultants PA	DE	Hematology & Oncology Physician	$0	$7.7M
Christiana Care Quality Partners	DE	Urgent Care Clinic/Center	$0	$7M
Jamal Misleh	DE	Hematology & Oncology Physician	$6.8M	$0
Mid-atlantic Behavioral Health, LLC	DE	Intellectual & Developmental Disabilities Psychologist	$0	$6.5M

John Roussalis — 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