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

Why is the Medicaid comparison limited to Puerto Rico 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. Puerto Rico (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.

Apcg Urology C S P (NPI 1285777326)

Apcg Urology C S P is a exclusive provider organization provider located in Guayama, Puerto Rico. This profile covers 0 Medicare and 25 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	Apcg Urology C S P
Address	Hospital Episcopal Cristo Redentor
City	Guayama
State	PR
ZIP	00784
Taxonomy	Exclusive Provider Organization
NPI Enumerated	February 15, 2007

Payer Source	Total Paid
Medicaid	$2M
Medicare	$0

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

25 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	18,280	$40	$657.9K
76872	The provider inserts an ultrasound probe into the rectum and performs a transrectal ultrasound to assess disorders of the prostate, rectum, and surrounding tissues.	3,610	$90	$328.1K
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…	4,070	$70	$296.8K
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…	4,880	$50	$238.9K
76856	A pelvic ultrasound is a noninvasive procedure used to assess body parts such as the bladder, ovaries, uterus, cervix, and fallopian tubes in females and the bladder, prostate gland, and seminal…	2,340	$60	$130.9K
76870	The provider performs an ultrasound of the scrotal pouch that contains the male testicles to assess disorders of testes, the organs that produce sperm in males.	1,260	$70	$81.9K
51741	Uroflowmetry (UFR) is the process of measuring how much liquid the patient excretes from the bladder. It is measured in cubic centimeters per second. The rate is the ratio of volume over time.	2,950	$30	$79.7K
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…	710	$110	$76.2K
76857	A pelvic ultrasound is a noninvasive procedure used to assess one or more pelvic structures, such as bladder, ovaries, uterus, cervix, and fallopian tubes in females and the bladder, prostate gland,…	560	$50	$29K
96402	In this procedure, the provider administers chemotherapy either subcutaneously, meaning under the skin, or intramuscularly, meaning in muscle. He administers a hormonal anti–neoplastic drug.	760	$30	$25.8K

Showing 1–10 of 25

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Puerto Rico Distribution

Apcg Urology C S P — 7 of 15 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Puerto Rico

Full comparison — all codes billed, vs. Puerto Rico median

25 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	182	390	290	$80	$96.8K
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	290	500	220	$40	$79.5K
76872	The provider inserts an ultrasound probe into the rectum and performs a transrectal ultrasound to assess disorders of the prostate, rectum, and surrounding tissues.	1	10	70	$90	$53K
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	311	500	130	$90	$43.1K
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…	126	3,230	330	$10	$42.4K
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…	21	1,400	160	$50	$29.6K
76856	A pelvic ultrasound is a noninvasive procedure used to assess body parts such as the bladder, ovaries, uterus, cervix, and fallopian tubes in females and the bladder, prostate gland, and seminal…	6	160	150	$60	$26.5K
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…	1	160	180	$60	$24.4K
99238	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends 30 minutes or less on the service on the…	147	250	180	$30	$23.1K
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	20	60	$130	$20K

Showing 1–10 of 25

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Alberto Corica Guinle	PR	Urology Physician	$0	$2M
James Ojago	PR	General Practice Physician	$0	$1.6M
Jorge Robles	PR	Anesthesiology Physician	$0	$1.5M
Heriberto Martinez Lebron	PR	Ophthalmology Physician	$2.7K	$1.4M
Gastroenterology Centre C.s.p.	PR	Gastroenterology Physician	$0	$1.4M
Marimar Caban	PR	Speech-Language Pathologist	$0	$1.4M
Hospital Menonita Guayama Inc	PR	Critical Access Hospital	$0	$1.3M
Jdo Servicios Pediatricos De Sur	PR	Pediatrics Physician	$0	$1.3M
Laboratorio Beiro Inc	PR	Clinical Medical Laboratory	$1.8K	$967.6K
Caribbean Health Alliance Psc	PR	Oncology Clinic/Center	$0	$919.2K

Apcg Urology C S P — Billing Profile & Reimbursement Data

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Apcg Urology C S P — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References