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

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

Thomas Fitzsimmons (NPI 1275581365)

Thomas Fitzsimmons is a ophthalmology physician provider located in Bend, Oregon. 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	Thomas Fitzsimmons
Address	1501 Ne Medical Center Dr
City	Bend
State	OR
ZIP	97701
Taxonomy	Ophthalmology Physician
NPI Enumerated	May 4, 2006

Payer Source	Total Paid
Medicare	$111.2K
Medicaid	$0

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

17 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	130	$120	$14.5K
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…	150	$90	$14.1K
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…	210	$60	$13K
15823	In this procedure, the provider surgically trims excessive skin that weighs down the upper eyelid, typically to improve the cosmetic appearance of the face and due to the interference of the tissue…	20	$630	$11.4K
99203	The provider sees a new 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 provider…	140	$70	$10.1K
67840	In this procedure, the provider excises a diseased or damaged area from the eyelid, excluding a chalazion, an inflamed oil gland. If necessary, he closes the wound with sutures.	40	$220	$8.1K
67904	The provider repairs a drooping eyelid by tightening the levator muscle that controls eyelid movement to improve cosmetic appearance or remove the obstruction to a patient’s vision. He accesses the…	10	$580	$7.6K
67961	The provider excises damaged or diseased tissue of the eyelid that may include the edges of the lid, the lid’s inner plate, the membrane lining of the lid, or the corner where the lids come together.…	20	$430	$6.9K
92285	Code 92285 describes photography of abnormalities using any of the methods described for documentation purposes and later comparison.	380	$20	$6K
67917	During this procedure, the provider performs an extensive repair of an ectropion, which is an outward turning of the lower eyelid and eyelashes, which can lead to excessive tearing and irritation of…	20	$380	$5.6K

Showing 1–10 of 17

Thomas Fitzsimmons — 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
67904	15	20	40	$610	$25.6K
15823	21	30	30	$590	$20.8K
67917	13	10	30	$470	$12.8K
99214	1,758	6,070	80	$70	$10.3K
99213	648	5,480	60	$50	$5.7K
67961	2	10	10	$410	$5.7K
67840	2	10	20	$210	$5.5K
99204	111	2,750	30	$110	$4.4K
68815	2	10	20	$270	$4K
68840	3	10	30	$130	$3.7K