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

Why is the Medicaid comparison limited to New Jersey 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. New Jersey (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 Mccain (NPI 1295801157)

Donald Mccain is a surgical oncology physician provider located in Hackensack, New Jersey. This profile covers 15 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	Donald Mccain
Address	20 Prospect Ave
City	Hackensack
State	NJ
ZIP	07601
Taxonomy	Surgical Oncology Physician
NPI Enumerated	November 24, 2006

Payer Source	Total Paid
Medicare	$179.2K
Medicaid	$0

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

15 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
15734	The provider develops a muscle, myocutaneous, or fasciocutaneous flap obtained from the trunk (the area between the neck and the waist) and places it over a defect on the patient's body.	50	$1,120	$58K
15736	The provider creates a muscle, myocutaneous, or fasciocutaneous flap from an upper extremity of the patient to treat an injury or open wound on an affected area.	40	$880	$31.7K
15738	The provider creates a muscle, myocutaneous, or fasciocutaneous flap from a lower extremity of the patient to treat injury or open wounds on an affected area.	40	$860	$30.1K
15733	The provider develops a muscle, myocutaneous, or fasciocutaneous flap from one of the muscles in the forehead, around the jaws, or neck, preserving the vascular supply, and uses it to cover a nearby…	20	$740	$13.4K
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…	90	$150	$13.1K
11606	The provider excises a cancerous (malignant) lesion, including margins, over 4.0 cm in diameter, from the skin of the trunk, arms, or legs.	60	$140	$8.6K
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…	50	$110	$5.1K
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…	50	$90	$4.7K
11646	The provider excises a cancerous (malignant) lesion, including margins, over 4.0 cm in diameter, from the skin of the face, ears, eyelids, nose, lips.	10	$270	$3.3K
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…	20	$150	$3.2K

Showing 1–10 of 15

Donald Mccain — 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
15738	2	10	80	$830	$68.9K
15736	1	10	40	$880	$31.7K
15734	3	10	20	$850	$27.2K
99214	10,482	13,640	130	$90	$23.6K
15733	1	10	20	$740	$13.4K
99213	11,925	14,090	100	$70	$13.1K
99223	3,859	4,980	50	$140	$11.8K
11606	2	20	30	$300	$11.1K
99204	1,092	7,160	40	$130	$6.5K
38525	45	50	20	$290	$5.2K