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.

Charles Daly (NPI 1396001590)

Charles Daly is a orthopaedic hand surgery physician provider located in Charleston, South Carolina. This profile covers 14 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	Charles Daly
Address	171 Ashley Ave
City	Charleston
State	SC
ZIP	29425
Taxonomy	Orthopaedic Hand Surgery Physician
NPI Enumerated	April 2, 2012

Payer Source	Total Paid
Medicare	$72.7K
Medicaid	$0

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

14 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	270	$110	$30K
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…	240	$90	$22.6K
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…	60	$60	$3.4K
20550	Aponeurosis is an abnormal sheet like extension of the tendon. Injection of a tendon or ligament is the medical therapeutic procedure to reduce the aponeurosis formation.	80	$40	$2.8K
26055	Trigger finger, or stenosing tenosynovitis, is when a finger remains in a bent position. It is painful to open or close the finger. A swollen tendon or formation of knots or nodules in the tendon may…	20	$170	$2.7K
20605	In this procedure, the provider inserts a needle through the skin of a patient and into an intermediate joint or bursa and then uses the syringe attachment to the needle to remove fluid or he may…	60	$40	$2.5K
29125	The provider applies a static, or rigid, splint to the lower arm extending from the elbow to the palm to immobilize an injury to the forearm or wrist during healing or for stabilization of a fracture…	30	$50	$1.5K
20610	In this procedure, the provider inserts a needle through the skin of a patient and into a major joint or bursa and then uses the syringe attachment to the needle to remove fluid or he may inject a…	30	$50	$1.4K
77002	The provider uses fluoroscopic guidance to place a needle for biopsy, aspiration, injection, or localization of a device to detect any lesions in any area of the body, except for the spine, or to…	20	$80	$1.2K
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…	20	$70	$1.1K

Showing 1–10 of 14

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99214	2,988	7,860	160	$80	$23.2K
26055	62	70	40	$260	$12.4K
99213	4,917	7,690	100	$60	$10.8K
20610	587	810	70	$50	$7.3K
77002	124	150	40	$70	$6.8K
99204	53	4,520	40	$110	$6.4K
99203	2,390	2,970	30	$70	$3.9K
20526	26	40	20	$60	$2.3K
20550	50	230	40	$40	$2.2K
20600	113	140	40	$30	$1.9K

Charles Daly — Billing Profile & Reimbursement Data

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Charles Daly — 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