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

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

Fabien Maldonado (NPI 1437161221)

Fabien Maldonado is a pulmonary disease physician provider located in Nashville, Tennessee. This profile covers 11 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	Fabien Maldonado
Address	3601 Tvc
City	Nashville
State	TN
ZIP	37232
Taxonomy	Pulmonary Disease Physician
NPI Enumerated	August 12, 2006

Payer Source	Total Paid
Medicare	$34K
Medicaid	$0

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

11 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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	$100	$8.1K
31629	The provider uses a diagnostic rigid or flexible bronchoscope to obtain one or more biopsies from the trachea, main stem, and/or lobar bronchus using a transbronchial needle aspiration technique.	50	$120	$6.2K
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…	40	$120	$4.5K
31652	The provider inserts a rigid or flexible lighted tubular instrument (endoscope) into the patient's lungs, with or without the aid of fluoroscopy, live X–ray images on a video display. The provider…	30	$120	$3.8K
31627	In this add–on procedure, the provider uses previously taken CT or MRI images integrated with specialized software to facilitate bronchoscopy.	50	$70	$3.5K
31654	In this add–on procedure, the provider uses ultrasound guidance in the throat (trachea) and/or the major air passages to the lungs (bronchi) in addition to passing a rigid or flexible scope into the…	50	$50	$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	$2K
31628	The provider uses a rigid or flexible bronchoscope to obtain one or more transbronchial biopsies from a single lobe of the lung. The provider may use fluoroscopic guidance.	30	$50	$1.5K
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…	20	$60	$1.4K
31624	In this procedure, the provider uses a rigid or flexible bronchoscope for bronchial alveolar lavage, a procedure using saline solution to wash the cells from alveoli, the air sacs at the end of the…	20	$40	$570

Showing 1–10 of 11

Fabien Maldonado — Billing Profile & Reimbursement Data

Sign up for Fabien Maldonado — Billing Profile & Reimbursement Data policy alerts

Fabien Maldonado — Billing Profile & Reimbursement Data

Sign up for Fabien Maldonado — Billing Profile & Reimbursement Data policy alerts

Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Frequently Asked Questions

References

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99232	3,575	3,990	100	$60	$11.4K
99215	659	2,710	40	$110	$8.3K
99205	379	1,300	20	$140	$4.9K
71250	566	570	70	$40	$4.5K
31629	7	20	30	$90	$4.2K
99222	1,683	2,630	30	$90	$3.9K
31652	6	20	30	$130	$3.6K
31627	7	30	30	$70	$2.8K
31654	8	20	30	$50	$2.2K
31628	12	30	30	$60	$2K