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

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

John Cooke (NPI 1366563306)

John Cooke is a anesthesiology physician provider located in West Columbia, South Carolina. This profile covers 24 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	John Cooke
Address	2720 Sunset Blvd
City	West Columbia
State	SC
ZIP	29169
Taxonomy	Anesthesiology Physician
NPI Enumerated	April 3, 2007

Payer Source	Total Paid
Medicare	$33.2K
Medicaid	$0

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

24 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
01922	The provider performs anesthesia services for a patient undergoing non–invasive imaging or radiation therapy.	60	$70	$4K
00731	The anesthesia provider performs anesthesia services for an unspecified type of upper gastrointestinal endoscopic procedure during which another provider introduces the endoscope to but not beyond…	60	$60	$3.1K
00840	The provider performs anesthesia services for a patient undergoing intraperitoneal procedures in the lower abdomen, including laparoscopy, which are not specified by any other anesthesia code.	20	$130	$2.5K
01402	The provider performs anesthesia services for a patient undergoing an open or arthroscopic total knee arthroplasty.	20	$130	$2.4K
01480	The provider performs anesthesia services for a patient undergoing an open procedure on the bones of the lower leg, ankle, and foot.	30	$80	$2.1K
00910	The provider performs anesthesia services for a patient undergoing transurethral procedures including urethrocystoscopy. The surgical provider may examine the organs of the urinary system from within…	40	$50	$1.8K
00537	The provider performs anesthesia services for a patient undergoing cardiac electrophysiologic procedures, such as mapping, pacing, recording, arrhythmia induction, lead testing, and similar services,…	10	$140	$1.7K
00790	The provider performs anesthesia services for a patient undergoing intraperitoneal procedures in the upper abdomen, including laparoscopy, which are not specified by any other anesthesia code.	20	$110	$1.7K
00400	The provider performs anesthesia services for a patient undergoing any procedure on the integumentary system on the extremities, anterior trunk and perineum, not otherwise specified.	20	$70	$1.4K
64415	The provider injects one or more anesthetic agents and/or a steroid into the brachial plexus area, a group of nerves in the arm that originates in the neck. Report this code for one or more…	20	$50	$1.3K

Showing 1–10 of 24

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
00537	121	150	20	$180	$4.1K
01402	202	380	20	$140	$3.3K
00811	301	740	20	$70	$3.2K
00813	234	370	20	$90	$2.6K
00812	303	410	20	$70	$2.6K
00731	131	850	20	$70	$2.6K
00840	48	150	20	$130	$2.3K
00790	100	240	10	$140	$2.2K
00530	72	80	20	$80	$2.1K
01922	17	210	20	$80	$2.1K

John Cooke — Billing Profile & Reimbursement Data

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John Cooke — 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