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

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

Georgia Urology PA (NPI 1245250646)

Georgia Urology PA is a urology physician provider located in Riverdale, Georgia. This profile covers 0 Medicare and 15 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Medicaid: Complete Services Breakdown

Field	Value
Entity Type	Organization
Organization	Georgia Urology PA
Address	33 Upper Riverdale Rd Sw
City	Riverdale
State	GA
ZIP	30274
Taxonomy	Urology Physician
NPI Enumerated	July 20, 2006

Payer Source	Total Paid
Medicaid	$1M
Medicare	$0

Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.

15 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99244	The provider sees a patient for an office or other outpatient consultation involving evaluation and management (E/M). The E/M involves a moderate level of medical decision making or the provider…	3,660	$170	$619.2K
99243	The provider sees a patient for an office or other outpatient consultation involving evaluation and management (E/M). The E/M involves a low level of medical decision making or the provider spends at…	1,100	$120	$136.8K
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…	1,420	$80	$117.7K
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…	1,330	$50	$59.9K
52000	In this procedure, the provider performs an examination of the interior of the bladder, the urethra, and the ureteric openings by means of a cystourethroscope, a thin flexible or rigid tube with a…	460	$80	$37K
54161	The provider excises the foreskin of a patient older than 28 days; the provider uses a technique other than a clamp, other devices, or dorsal slit.	160	$210	$33.2K
54640	The provider performs an orchiopexy using an inguinal and/or scrotal approach to move a patient's undescended testicle(s) into the scrotum.	20	$400	$8.4K
76770	A retroperitoneal ultrasound is a noninvasive procedure used to assess the body parts within the abdomen (i.e.Kidneys, urinary bladder, and aorta). This particular code is used when the ultrasound is…	30	$140	$3.7K
81003	The lab analyst inserts a dip stick into a freshly collected urine specimen, removes the dipstick, and shakes off the excess urine. She places the stick onto a mechanical dip stick reader that will…	1,700	$1	$3.4K
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…	30	$110	$3.3K

Showing 1–10 of 15

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other Georgia providers billing the same CPT/HCPCS codes.

Claims Volume vs. Georgia Distribution

Georgia Urology PA — 1 of 12 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Georgia

Full comparison — all codes billed, vs. Georgia median

15 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
54161	The provider excises the foreskin of a patient older than 28 days; the provider uses a technique other than a clamp, other devices, or dorsal slit.	3	10	280	$990	$577.6K
54640	The provider performs an orchiopexy using an inguinal and/or scrotal approach to move a patient's undescended testicle(s) into the scrotum.	3	10	120	$1,330	$487.9K
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…	309	920	370	$60	$360.6K
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…	253	820	390	$70	$245K
99244	The provider sees a patient for an office or other outpatient consultation involving evaluation and management (E/M). The E/M involves a moderate level of medical decision making or the provider…	4	30	90	$160	$236.3K
76770	A retroperitoneal ultrasound is a noninvasive procedure used to assess the body parts within the abdomen (i.e.Kidneys, urinary bladder, and aorta). This particular code is used when the ultrasound is…	28	40	60	$200	$182.2K
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…	166	230	100	$110	$97.1K
99243	The provider sees a patient for an office or other outpatient consultation involving evaluation and management (E/M). The E/M involves a low level of medical decision making or the provider spends at…	5	30	160	$110	$77.4K
52000	In this procedure, the provider performs an examination of the interior of the bladder, the urethra, and the ureteric openings by means of a cystourethroscope, a thin flexible or rigid tube with a…	1	10	90	$110	$20.1K
81003	The lab analyst inserts a dip stick into a freshly collected urine specimen, removes the dipstick, and shakes off the excess urine. She places the stick onto a mechanical dip stick reader that will…	41	150	330	$1	$9.6K

Showing 1–10 of 15

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Prime Healthcare Foundation - Southern Regional, LLC	GA	General Acute Care Hospital	$0	$25.9M
John Miller	GA	Ophthalmology Physician	$1.9M	$0
Premier Womens Obgyn, LLC	GA	Obstetrics & Gynecology Physician	$0	$1.4M
Clayton County Dialysis, LLC	GA	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$965.3K
South Atlanta Radiology Associates, P.C.	GA	Diagnostic Radiology Physician	$0	$642.6K
Education System Management, Inc	GA	Clinical Medical Laboratory	$0	$577.6K
F & M Family Eyecare, LLC	GA	Optometrist	$0	$373.8K
La'cuana Sherman	GA	Professional Counselor	$0	$312.9K
Rajinikanth Seshan	GA	Nephrology Physician	$289.2K	$0
Alpesh Patel	GA	Hospitalist Physician	$272.6K	$0

Georgia Urology PA — Billing Profile & Reimbursement Data

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Georgia Urology PA — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Georgia Urology, PA	GA	Ambulatory Surgical Clinic/Center	$918.7K	$0
Julia Branch	GA	Family Nurse Practitioner	$488.4K	$0
Georgia Urology Asc Cumming	GA	Ambulatory Surgical Clinic/Center	$446.2K	$0
Lewis Kriteman	GA	Urology Physician	$363.8K	$0
Georgia Urology, PA	GA	Ambulatory Surgical Clinic/Center	$322.5K	$0
Georgia Urology, PA	GA	Ambulatory Surgical Clinic/Center	$315.4K	$0
John Abbott	GA	Urology Physician	$301.7K	$0
Daniel Belew	GA	Urology Physician	$280.5K	$0
Wesley Ludwig	GA	Urology Physician	$278.9K	$0
Carl Capelouto	GA	Urology Physician	$251.2K	$0