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

Why is the Medicaid comparison limited to New York 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 York (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.

Marc Sher (NPI 1376682443)

Marc Sher is a surgery physician provider located in New Hyde Park, New York. 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	Marc Sher
Address	3003 New Hyde Park Rd
City	New Hyde Park
State	NY
ZIP	11042
Taxonomy	Surgery Physician
NPI Enumerated	February 5, 2007

Payer Source	Total Paid
Medicare	$121.4K
Medicaid	$0

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

15 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	200	$100	$18.8K
49507	In this procedure, the provider surgically repairs an inguinal hernia that is incarcerated, meaning trapped, or strangulated, meaning the blood supply is cut off. Use this code for initial hernia…	30	$550	$13.8K
45378	The provider examines the colon and rectum using a colonoscope, a flexible tube with a camera at its inserted end. If he sees any areas of abnormal mucosa or tissue, he takes samples using a brush…	70	$170	$11.5K
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…	140	$80	$10.9K
47562	The provider removes the gallbladder through a laparoscope, a tubular instrument with a light source and camera inserted through the abdominal wall, to treat gallbladder disease.	20	$540	$9.8K
49594	The provider uses any approach to perform initial repair of one or more anterior abdominal hernias with a total length of 3 cm to 10 cm. The hernias are incarcerated (trapped) or strangulated…	20	$610	$9.1K
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…	60	$150	$9K
46221	In this procedure, the provider ligates, or ties off, the base of a hemorrhoid inside the rectum with a rubber band. The provider performs this procedure to let the hemorrhoid dry out due to a lack…	30	$270	$9K
45380	The provider examines the rectum and colon using a flexible colonoscope, a tubular instrument with a light source and camera, to look for the cause of a patient's symptoms, which may include…	50	$150	$7.6K
50715	In this procedure, the provider surgically frees the ureter from fibrous bands of inflamed tissues of the retroperitoneum, or the space between the peritoneum and the abdominal wall.	10	$540	$5.9K

Showing 1–10 of 15

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
45385	797	1,100	40	$320	$19.4K
99214	20,448	30,450	90	$100	$19K
99233	8,065	8,640	80	$100	$15.8K
45380	468	1,220	40	$230	$15K
46221	30	50	40	$250	$14.2K
99232	8,093	11,850	80	$70	$13.8K
99213	10,862	31,440	80	$70	$12.1K
49594	2	10	10	$720	$11.5K
49507	3	10	10	$570	$11.3K
47562	20	80	10	$530	$8.5K

Marc Sher — 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