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

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

Claire Raphael (NPI 1275081812)

Claire Raphael is a cardiovascular disease physician provider located in Rochester, Minnesota. This profile covers 13 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	Claire Raphael
Address	200 1st St Sw
City	Rochester
State	MN
ZIP	55905
Taxonomy	Cardiovascular Disease Physician
NPI Enumerated	September 12, 2016

Payer Source	Total Paid
Medicare	$52.8K
Medicaid	$0

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

13 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
92928	The provider inserts a catheter through the skin (percutaneous approach) and guides it into the heart's arteries. They deploy one or more stents (small tubes) to keep the artery open and may expand a…	40	$410	$16.1K
93454	In this procedure, the provider performs imaging supervision and interpretation for a coronary angiography in which injections are performed to assess any coronary artery disease or any stenosis…	80	$150	$12.8K
93458	In this procedure, the provider performs imaging supervision and interpretation for a coronary angiography with left heart catheterization and intraprocedural injections for left ventriculography. He…	20	$170	$4K
92978	In this add–on procedure, the provider advances a catheter into a coronary vessel or previously placed graft using ultrasound or optical coherence tomography to view the extent of the blockage,…	50	$70	$3.7K
99231	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a straightforward or low level of medical…	90	$40	$3.2K
93455	In this procedure, the provider performs imaging supervision and interpretation for a catheter placement in the bypass graft. He also performs injections to assess any coronary artery disease or any…	20	$170	$3.2K
93456	In this procedure, the provider performs imaging supervision and interpretation for a coronary angiography with right heart catheterization. He also performs injections to assess any coronary artery…	10	$190	$2.1K
93571	The provider measures blood flow and pressure in a coronary artery or bypass graft during coronary angiography using a Doppler or pressure wire. The service may include stress testing with medication…	40	$50	$1.9K
99152	The provider performing a diagnostic or therapeutic procedure administers medication to reduce consciousness, but not render the patient unconscious or asleep, in a patient five years of age or…	170	$10	$1.5K
93505	The provider takes a sample of tissue from within the innermost layer of the heart muscle, primarily to check for signs of any damage due to rejection of a heart transplant.	10	$110	$1.3K

Showing 1–10 of 13

Claire Raphael — 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

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
92928	15	80	30	$380	$10.6K
93458	48	80	30	$180	$5.7K
93454	3	80	40	$140	$5.4K
99232	3,570	3,640	60	$60	$5.2K
93456	10	10	10	$200	$3.3K
93505	8	10	20	$140	$2.9K
93455	1	10	10	$150	$2.1K
92978	4	40	20	$70	$1.8K
99231	115	1,080	30	$40	$1.6K
99221	190	330	20	$60	$1.3K