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

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

Stephen Malone (NPI 1356377204)

Field	Value
Entity Type	Individual
Organization	Stephen Malone
Address	260 Beiser Blvd
City	Dover
State	DE
ZIP	19904
Taxonomy	Orthopaedic Surgery of the Spine Physician
NPI Enumerated	June 23, 2006

Payer Source	Total Paid
Medicare	$82.3K
Medicaid	$0

Medicare: Complete Services Breakdown

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

8 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…	340	$70	$22.6K
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…	120	$120	$14.8K
22612	The provider performs arthrodesis, also known as spinal fusion, in the lumbar spine (lower back), to permanently join two vertebrae, the interlocking bones of the spine. The provider applies bone…	10	$1,260	$13.8K
63030	This procedure is laminotomy of one lumbar interspace with decompression of the nerve root(s), and includes a partial facetectomy, foraminotomy, and/or the excision of a herniated intervertebral…	20	$710	$13.5K
27245	In this procedure, the provider performs an open treatment of a femoral fracture between, around, or below the trochanters. He fixes the fracture using an intramedullary implant, or an implant the…	10	$980	$11.7K
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…	30	$80	$2.2K
99222	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	20	$100	$2.1K
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.	30	$60	$1.6K

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 8 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Delaware Distribution

Stephen Malone — 0 of 8 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Delaware

Full comparison — all codes billed, vs. state median

8 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
22612	20	20	30	$740	$29.6K
27245	14	20	20	$700	$14.1K
99213	347	1,810	120	$60	$13.6K
63030	1	10	20	$490	$7.4K
99204	104	950	30	$110	$6.5K
99222	441	600	40	$100	$5.6K
99203	429	670	40	$70	$5.3K
99283	18	90	20	$50	$1.3K

Stephen Malone — Billing Profile & Reimbursement Data

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Stephen Malone — 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