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

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

Eric Edell (NPI 1356320980)

Eric Edell is a pulmonary disease physician provider located in Rochester, Minnesota. This profile covers 11 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	Eric Edell
Address	200 1st St Sw
City	Rochester
State	MN
ZIP	55905
Taxonomy	Pulmonary Disease Physician
NPI Enumerated	January 12, 2006

Payer Source	Total Paid
Medicare	$26.8K
Medicaid	$0

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

11 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	70	$90	$5.7K
32555	In this procedure, the provider removes the fluid, blood, or air from the space between the lungs and chest wall using a needle or catheter. He performs the procedure using imaging guidance.	40	$80	$3.5K
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…	30	$110	$2.9K
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…	40	$80	$2.8K
31652	The provider inserts a rigid or flexible lighted tubular instrument (endoscope) into the patient's lungs, with or without the aid of fluoroscopy, live X–ray images on a video display. The provider…	20	$160	$2.8K
31628	The provider uses a rigid or flexible bronchoscope to obtain one or more transbronchial biopsies from a single lobe of the lung. The provider may use fluoroscopic guidance.	20	$130	$2.4K
99442	N/A	30	$70	$2K
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…	30	$60	$1.8K
31622	In this procedure, the provider performs diagnostic rigid or flexible bronchoscopy, a test to view airways and diagnose lung disease. He may or may not use fluoroscopic guidance to perform this test.…	20	$90	$1.3K
31624	In this procedure, the provider uses a rigid or flexible bronchoscope for bronchial alveolar lavage, a procedure using saline solution to wash the cells from alveoli, the air sacs at the end of the…	30	$50	$1.3K

Showing 1–10 of 11

Eric Edell — 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
99214	5,167	10,100	70	$80	$8.1K
99213	5,886	9,120	50	$50	$4K
99204	1,482	3,340	20	$110	$3.6K
31652	8	20	20	$150	$2.8K
32555	18	80	20	$80	$2.6K
99203	805	2,690	20	$70	$2.3K
31628	7	20	20	$70	$1.6K
99442	91	420	20	$60	$1.4K
31622	3	10	20	$70	$1.3K
31624	11	30	20	$50	$1.2K