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

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

Donald Wilson (NPI 1275513376)

Field	Value
Entity Type	Individual
Organization	Donald Wilson
Address	715 Linda Falls Ter
City	Angwin
State	CA
ZIP	94508
Taxonomy	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
NPI Enumerated	January 17, 2006

Payer Source	Total Paid
Medicare	$4.5K
Medicaid	$0

Medicare: Complete Services Breakdown

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

3 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
33533	Coronary artery bypass, using arterial graft(s); single arterial graft	10	$190	$2.6K
33257	In this add–on procedure, at the same time as another cardiac procedure, the provider destroys abnormal tissue of the atria of the heart causing an abnormal heart rhythm, and then she reconstructs…	20	$80	$1.2K
33518	The provider diverts blood flow from damaged vessels in the heart by grafting two vein segments taken from another location, such as the leg, while the patient is undergoing a coronary artery bypass…	10	$50	$610

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 3 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. California Distribution

Donald Wilson — 0 of 3 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — California

Full comparison — all codes billed, vs. state median

3 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
33533	151	200	20	$880	$21.2K
33257	5	10	10	$320	$5.1K
33518	67	90	20	$210	$3.6K

Donald Wilson — Billing Profile & Reimbursement Data

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Donald Wilson — 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