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.

Marcelo Fernandes (NPI 1396130951)

Marcelo Fernandes is a cardiovascular disease physician provider located in Greenville, South Carolina. This profile covers 13 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	Marcelo Fernandes
Address	1005 Grove Rd
City	Greenville
State	SC
ZIP	29605
Taxonomy	Cardiovascular Disease Physician
NPI Enumerated	March 31, 2015

Payer Source	Total Paid
Medicare	$80.9K
Medicaid	$0

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

13 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…	370	$90	$31.8K
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…	160	$110	$17.9K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	80	$130	$9.8K
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	50	$130	$7K
93306	The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent…	100	$50	$5K
99205	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the provider…	30	$150	$4.3K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	40	$60	$2.6K
93312	In this procedure, the provider performs transesophageal echocardiography, or TEE, with multiple transducers, or probes, or a rotating transducer to obtain a two–dimensional (2D) image of the heart.…	20	$80	$1.7K
93225	The physician or other healthcare professional applies an electrocardiographic, or ECG recorder, to a patient for up to 48 hours to help detect abnormal heart rates and rhythms. This service reports…	30	$10	$350
93320	The provider performs a complete Doppler echocardiography, which uses high–frequency sound waves to create a two–dimensional image of the heart, while the use of Doppler technology allows…	20	$10	$290

Showing 1–10 of 13

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
93306	298	450	230	$80	$23.9K
99214	2,083	7,860	160	$80	$23.2K
99232	2,004	2,780	90	$60	$12K
99215	695	2,360	40	$120	$9.3K
99223	788	2,080	40	$130	$8.3K
99204	293	4,520	40	$110	$6.4K
99205	453	1,000	30	$150	$5.8K
93312	111	190	30	$80	$2.9K
93000	1,220	1,470	30	$10	$1.5K
93320	67	120	20	$20	$520

Marcelo Fernandes — Billing Profile & Reimbursement Data

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Marcelo Fernandes — 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