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 U.S. Virgin Islands for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to U.S. Virgin Islands 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. U.S. Virgin Islands (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.

Urban Foot Care Center PC (NPI 1457611170)

Field	Value
Entity Type	Organization
Organization	Urban Foot Care Center PC
Address	9a Lagrande Princesse Plaza
City	Christiansted
State	VI
ZIP	00820
Taxonomy	Foot & Ankle Surgery Podiatrist
NPI Enumerated	May 29, 2012

Payer Source	Total Paid
Medicaid	$35.3K
Medicare	$0

Key Findings

This provider effectively operates as a Medicaid-only biller: there is no Medicare billing on file while total Medicaid revenue is $35.3K, indicating the practice’s billed public-payer scale is concentrated in Medicaid rather than Medicare. The absence of any Medicare activity suggests the provider is functionally single-payer (Medicaid) in the available claims records.

Revenue is highly concentrated in a small set of visit codes: the precomputed top three Medicaid codes by revenue account for 94.0% of this provider’s total Medicaid revenue. Those top three are 99213 ($19.2K, 54.3% of Medicaid revenue), 99204 ($10.4K, 29.5%), and 99214 ($3.6K, 10.1%), which together dominate the practice’s Medicaid receipts.

The code mix (99213, 99204, 99214) points to an ambulatory podiatry practice focused on evaluation-and-management office visits for both new and established patients, with encounters ranging from low to moderate medical decision making and visit times of ~20–45+ minutes. A secondary procedural line appears in 11042 (debridement of tissue), which produced $2.1K (6.0% of Medicaid revenue) and indicates some wound-care or minor surgical services are provided alongside routine visits.

Volume and reimbursement patterns show this practice earns most of its Medicaid revenue from frequent, lower-paid office visits: 99213 tallied 456 claims at $42 avg paid/claim for $19.2K in revenue, while 99204 posted 84 claims at $124 avg paid/claim for $10.4K. The distribution — many lower-paid established-patient visits plus fewer higher-paid new-patient visits — is consistent with a clinic that maintains ongoing patient panels and also takes new consults.

Competitive standing within the state is modest for the highest-revenue codes: 99213 ranks #20 of 41 providers in-state (53th percentile) and is characterized in the source as 'typical, unremarkable volume for this code,' while 99204 ranks #12 of 25 (54th percentile) and likewise shows typical volume. 99214 is comparatively low statewide (ranks #35 of 43, 19th percentile), which suggests limited high-complexity visit volume relative to peers.

The procedural code 11042 (debridement) appears as an in-state outlier in reporting: 66 claims produced $2.1K and this code ranks #1 of 1 providers in-state with '0th percentile; no state peer volume comparison available.' That indicates this provider may be the only Medicaid reporter of that specific debridement code in-state, or reporting practices differ across peers, making direct competitiveness unclear for that procedure.

The provider has an established enrollment history, with the NPI enumerated on 2012-05-29 (~14 years ago), which supports an interpretation of a sustained local presence. Despite long tenure, the modest $35.3K Medicaid lifetime revenue and the concentration in a few E&M codes suggest a small-volume practice footprint rather than a major statewide Medicaid revenue generator.

Medicaid: Complete Services Breakdown

Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.

4 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	460	$40	$19.2K
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…	80	$120	$10.4K
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…	40	$90	$3.6K
11042	The provider uses surgical instruments to remove the dead tissue in skin down to the subcutaneous layer and including the epidermis and dermis, up to the first 20 cm2.	70	$30	$2.1K

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other U.S. Virgin Islands providers billing the same CPT/HCPCS codes.

Claims Volume vs. U.S. Virgin Islands Distribution

Urban Foot Care Center PC — 0 of 4 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — U.S. Virgin Islands

Full comparison — all codes billed, vs. U.S. Virgin Islands median

4 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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…	35	40	560	$140	$322K
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…	20	40	430	$110	$260.9K
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…	12	30	80	$150	$27K
11042	The provider uses surgical instruments to remove the dead tissue in skin down to the subcutaneous layer and including the epidermis and dermis, up to the first 20 cm2.	1	10	70	$30	$2.1K

Nearby Providers

Other providers in the same ZIP code as Urban Foot Care Center PC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
St Croix Vision Center Inc	VI	Optometrist	$0	$3.6M
One Dental Practice LLC	VI	Dentist	$0	$3.2M
Governor Juan F. Luis Hospital & Medical Center	VI	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$3M
Js Therapies, LLC	VI	Occupational Therapist	$0	$2.9M
Healthquest, LLC.	VI	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$2.4M
Department Of Health, Ems Stx	VI	Land Ambulance	$0	$2.2M
Lindsy Wagner LLC	VI	Clinical Social Worker	$0	$2.2M
Ophthalmology Consultants, PC	VI	Ophthalmology Physician	$0	$2.1M
Acute Alternative Medical Group	VI	Emergency Medical Services (Emergency Medicine) Physician	$0	$1.9M
Pediatric Care Center LLC	VI	Pediatrics Physician	$0	$1.7M

Urban Foot Care Center PC — Billing Profile & Reimbursement Data

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Urban Foot Care Center PC — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References