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

Why is the Medicaid comparison limited to South Dakota 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. South Dakota (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.

Marcus Frohm (NPI 1316141310)

Field	Value
Entity Type	Individual
Organization	Marcus Frohm
Address	1310 W 22nd St
City	Sioux Falls
State	SD
ZIP	57105
Taxonomy	MOHS-Micrographic Surgery Physician
NPI Enumerated	June 13, 2007

Payer Source	Total Paid
Medicare	$378.1K
Medicaid	$0

Key Findings

This profile is consistent with a Mohs-micrographic surgery practice: the top revenue-driving codes are surgical in nature (17311, 17312) with adjacent reconstruction and complex closure codes (14041, 14061, 13132) featuring prominently, indicating the provider performs excision of malignant skin lesions and same-encounter reconstructive procedures. The largest single-code revenue line is 17311 ($173.3K, 45.9% of Medicare revenue), which aligns with the MOHS-Micrographic Surgery Physician taxonomy and suggests a procedure-centered operative practice rather than a primarily medical-management or consult-only model.

Medicare revenue is modest in scale at $378.1K and highly concentrated: the precomputed top-3 Medicare codes account for 63.4% of total Medicare revenue, with 17311 ($173.3K, 45.9%), 14041 ($41.6K, 11.0%), and 17312 ($24.5K, 6.5%) together driving the majority of payments. This concentration means surgical Mohs and selected reconstructive procedures are the primary business lines generating revenue for this provider.

Payer mix is effectively single-payer Medicare: Total Medicaid revenue is none (no Medicaid billing on file), so the provider’s public-billing exposure is nearly entirely Medicare-based. Analysts should treat the Medicaid channel as absent for competitive and access modeling and focus on Medicare utilization patterns when projecting public-payer volumes.

Competitive standing varies by code: for Mohs excision 17311 this provider ranks #171 of 2969 providers nationally (94th percentile; notably above typical national volume for this code), indicating above-average national volume for that core procedure. The reconstructive code 14041 also ranks highly at #80 of 1009 providers nationally (92th percentile), while the companion Mohs code 17312 is more typical at #1072 of 2770 providers nationally (61th percentile); overall this points to concentrated leadership on specific high-value Mohs and reconstruction codes but otherwise moderate participation across related procedure codes.

The provider is an extreme outlier on new-patient E/M volume: 99203 appears with 347 claims and $21.9K revenue (5.8% of Medicare revenue) and is reported as ranked #714 of 161519 providers nationally (100th percentile; extreme outlier, far above typical national volume for this code). Coupled with substantial 99213 activity (240 claims, $11.8K, 3.1%), this pattern suggests unusually high new-patient evaluation throughput relative to national peers, which may reflect clinic intake practices or a high referral rate for surgical evaluation.

Ancillary and diagnostic pathology billing is present but represents a small share of revenue: 88305 accounts for $7.7K (2.0% of Medicare revenue) and ranks #9404 of 14580 providers nationally (35th percentile; typical, unremarkable volume). Biopsy codes such as 11102 and 11103 are billed but are minor revenue contributors, implying either specimens are partly routed to external pathology services or pathology yields lower per-case revenue compared with the surgical procedures.

The provider has a long-enumerated NPI (enumerated 2007-06-13, ~19 years ago), indicating an established practice tenure. Given the combination of long tenure, concentrated Mohs revenue, and high relative volume on specific procedural and new-patient E/M codes, this profile is consistent with an experienced, procedure-focused clinician drawing steady Medicare surgical volume over many years.

Medicare: Complete Services Breakdown

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

23 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
17311	Mohs surgery is a multi–staged procedure that is performed to excise a malignant lesion layer by layer, along with histo–pathological assessment. The assessment is performed to ensure that the…	770	$230	$173.3K
14041	The provider replaces the lesions in the forehead, cheeks, chin, mouth, neck, axillae or armpits, genitalia, hands, or feet with the healthy tissues from an adjacent site. This code represents a…	70	$580	$41.6K
17312	Mohs surgery is a multi–staged method of excising a malignant lesion layer by layer, along with histo–pathological assessment, to ensure negative malignancy of the margins.	170	$150	$24.5K
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…	350	$60	$21.9K
14061	The provider replaces the lesions in the eyelids, nose, ears, or lips, with the healthy tissues from an adjacent site. This code represents a defect of 10.1 cm2 to 30.0 cm2 in size.	40	$620	$21.6K
13132	The provider repairs a wound measuring 2.6 cm to 7.5 cm in size of the cheeks, chin, mouth, neck, axillae, genitalia, hands, and/or feet, which may require scar revision, debridement extensive…	170	$120	$21.1K
17313	Mohs surgery is a multi–staged method of excising a malignant lesion layer by layer, along with histo–pathological assessment, to ensure negative malignancy of the margins.	60	$200	$12.7K
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…	240	$50	$11.8K
14301	The provider replaces the lesions in any area with the healthy tissues from an adjacent site. This code represents a defect of 30.1 cm2 to 60.0 cm2.	10	$640	$8.4K
14060	The provider replaces the lesions in the eyelids, nose, ears, or lips, with the healthy tissues from an adjacent site. This code represents a defect of 10 cm2 or less.	20	$500	$7.9K

Showing 1–10 of 23

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 23 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. South Dakota Distribution

Marcus Frohm — 2 of 23 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — South Dakota

Full comparison — all codes billed, vs. state median

23 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
17311	1	10	410	$320	$120.5K
17312	5	10	130	$270	$43.5K
88305	43	60	1,030	$30	$39.1K
14060	11	10	40	$510	$25.7K
14061	2	10	20	$700	$25.1K
14041	2	10	30	$630	$22.2K
13132	5	20	80	$160	$17.1K
14301	3	10	10	$750	$15K
17313	3	10	40	$310	$14.9K
99214	935	1,660	90	$70	$11.4K

Showing 1–10 of 23

Related Providers

Other providers that share a Tax Identification Number (TIN) with Marcus Frohm, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Sanford Medical Center	SD	Family Medicine Physician	$0	$68.8M
Columbus Radiology Corp	OH	Diagnostic Radiology Physician	$0	$49.9M
Somc Medical Care Foundation, Inc.	OH	Family Medicine Physician	$0	$25.3M
Sanford Medical Center	SD	General Acute Care Hospital	$0	$24.4M
Sanford Medical Center	SD	Clinical Medical Laboratory	$1.8M	$18M
Sanford Medical Center	SD	Air Ambulance	$0	$11.9M
Sanford Clinic	SD	Diagnostic Radiology Physician	$0	$6M
Sanford Clinic	SD	Pediatrics Physician	$0	$5.5M
Chad Laurich	SD	Vascular Surgery Physician	$3.2M	$0
NPI 1588636484	—	—	$3.2M	$0

Nearby Providers

Other providers in the same ZIP code as Marcus Frohm, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
South Dakota Achieve	SD	Developmental Disabilities Clinic/Center	$0	$166.9M
Dakotabilities	SD	Voluntary or Charitable Agency	$0	$77.8M
Volunteers Of America, Dakotas	SD	Intellectual and/or Developmental Disabilities Residential Treatment Facility	$0	$60.9M
Southeastern Behavioral Healthcare	SD	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$59.1M
Resouces For Human Development, Inc.	SD	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$31.1M
Childrens Dental Center	SD	Pediatric Dentistry	$0	$24M
Avera Mckennan	SD	Family Medicine Physician	$0	$10.6M
Avera Mckennan	SD	Air Ambulance	$0	$5.3M
Avera Mckennan	SD	Emergency Medicine Physician	$0	$4.1M
Avera Mckennan	SD	General Acute Care Hospital	$0	$3.7M

Marcus Frohm — Billing Profile & Reimbursement Data

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Key Findings

Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References