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

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

Steven Nelson (NPI 1245443522)

Steven Nelson is a dermatology physician provider located in Scottsdale, Arizona. This profile covers 17 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.

Provider details (source: NPPES NPI Registry)

Medicare: Complete Services Breakdown

Field	Value
Entity Type	Individual
Organization	Steven Nelson
Address	13400 E Shea Blvd
City	Scottsdale
State	AZ
ZIP	85259
Taxonomy	Dermatology Physician
NPI Enumerated	May 7, 2007

Payer Source	Total Paid
Medicare	$143.7K
Medicaid	$0

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

17 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…	1,740	$50	$90.2K
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…	150	$90	$13.1K
88321	A qualified provider, typically a pathologist, provides consultation and a report on slides prepared elsewhere. A unit of service is the surgical case regardless of the number of slides received.	100	$70	$7.3K
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…	80	$60	$4.9K
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.	110	$30	$3.7K
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…	30	$110	$3.5K
11102	The provider biopsies a single skin lesion using a tangential (side–ways) approach; he shaves off the lesion or scoops it out with a knife or curette.	50	$60	$3.1K
17110	The provider destroys benign lesions using techniques such as chemosurgery, cryosurgery, electrosurgery, or others. This code reports the destruction of one to 14 lesions other than skin tags or…	40	$80	$2.8K
17261	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 0.6 cm to 1.0 cm in…	30	$80	$2.6K
11104	The provider biopsies a skin lesion using a punch technique with a sharp hollow instrument; punch biopsies are commonly performed for deeper circular skin lesions.	30	$90	$2.2K

Showing 1–10 of 17

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
88305	58	270	700	$40	$71.1K
99214	4,591	10,410	120	$80	$20.6K
11102	411	500	170	$60	$13.8K
17110	415	510	120	$70	$13.1K
17000	381	580	210	$30	$11.8K
99213	4,611	9,600	80	$60	$9.6K
99204	3,261	5,790	40	$110	$6.7K
17003	368	530	810	$1	$5.7K
11103	319	410	80	$40	$4.3K
17261	44	100	30	$90	$4.2K

Steven Nelson — 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