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    OpenPayerNPI Medicare & MedicaidTodd Holmes
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    Todd Holmes — Billing Profile & Reimbursement Data

    NPI 1467578005 · Burlington, VT · MOHS-Micrographic Surgery Physician

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    Todd Holmes is a mohs-micrographic surgery physician provider located in Burlington, Vermont. This profile covers 19 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.

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    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeIndividual
    OrganizationTodd Holmes
    Address111 Colchester Ave
    CityBurlington
    StateVT
    ZIP05401
    TaxonomyMOHS-Micrographic Surgery Physician
    NPI EnumeratedMarch 22, 2007

    Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)

    Payer SourceTotal Paid
    Medicare$153.6K
    Medicaid$0

    Key Findings

    Specialty and service line: The provider is taxonomized as a MOHS-Micrographic Surgery Physician and the billing mix matches that specialty — Mohs excision codes 17311 and 17312 are the largest single-code contributors, and reconstructive closures and graft codes such as 14060 and 15260 appear prominently. This pattern indicates an operation that performs staged tumor extirpation with subsequent local reconstruction, rather than a primarily clinic-based medical dermatology practice.

    Revenue concentration: Medicare revenue is highly concentrated in a small set of Mohs and reconstruction codes — the precomputed top 3 Medicare codes by revenue account for 75.7% of this provider's total Medicare revenue. Specifically, 17311 generated $79.9K (52.0% of Medicare revenue), 17312 generated $20.9K (13.6%), and 14060 generated $15.4K (10.1%), confirming that a handful of procedural codes drive the majority of public-payer revenue.

    Scale of Medicare activity: Lifetime Medicare revenue for this provider is $153.6K, a relatively modest absolute scale for a procedural specialist. The claim-level averages on the largest codes ($222/claim for 17311, $144/claim for 17312, $498/claim for 14060) further indicate that revenue is concentrated in medium-dollar procedural encounters rather than high-volume low-dollar E/M visits.

    Payer mix: This provider is effectively single-payer within public programs — there is no Medicaid billing on file. The absence of any Medicaid claims suggests the provider’s public-payor mix is dominated by Medicare, with Medicaid contributing $0 in the dataset provided.

    Competitive standing on Mohs: Nationally the provider’s volumes for core Mohs codes are described as typical rather than dominant — 17311 ranks #959 of 2969 providers (68th percentile; typical, unremarkable volume) and 17312 ranks #1248 of 2770 providers (55th percentile; typical, unremarkable volume). These percentiles imply the provider is a modestly active Mohs practitioner at the national level but not a regional or national outlier.

    Variation across reconstructive and repair codes: Reconstructive and repair codes show mixed competitive signals: 14060 ranks #703 of 2135 (66th percentile; typical, unremarkable volume) while intermediate repair 12052 ranks #221 of 1767 (87th percentile; typical, unremarkable volume). This suggests relatively stronger-than-average activity in intermediate facial repairs compared with peers, alongside routine but not exceptional graft/reconstruction volumes.

    Limited revenue from ancillary pathology and E/M: Ancillary pathology codes and office E/M contribute only small amounts to Medicare revenue (for example, 88342 $729 (0.5%), 88331 $624 (0.4%), 99213 $4.1K (2.7%)). These figures indicate the practice’s revenue is dominated by operative procedures rather than in-office evaluation or pathology billing.

    Tenure and practice stability: The provider’s NPI was enumerated 2007-03-22 (~19 years ago), indicating long-established participation in Medicare. Combined with the concentrated procedural book of business, this tenure is consistent with an established Mohs-focused surgical practice that serves Medicare beneficiaries as its primary public-payer population.

    Medicare: Total Revenue Breakdown by CPT/HCPCS Code

    Medicare revenue breakdown by CPT/HCPCS procedure code.

    View: Bar Chart1 / 2

    Medicare: Complete Services Breakdown

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

    19 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    17311Mohs surgery is a multi–staged procedure that is performed to excise a malignant lesion layer by layer, along with histo–pathological assessment. The assessment is performed to ensure that the…360$220$79.9K
    17312Mohs surgery is a multi–staged method of excising a malignant lesion layer by layer, along with histo–pathological assessment, to ensure negative malignancy of the margins.150$140$20.9K
    14060The provider replaces the lesions in the eyelids, nose, ears, or lips, with the healthy tissues from an adjacent site. This code represents a defect of 10 cm2 or less.30$500$15.4K
    15260This code is for a free full–thickness skin graft of the nose, ears, eyelids, and/or lips that is 20 cm2 or less in size.10$630$8.8K
    12052This CPT® code is used for the intermediate repair of wounds to the face, ears, eyelids, nose, lips and/or mucous membranes that are 2.6 to 5.0 cm in size.90$80$7K
    99213The 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…90$40$4.1K
    17313Mohs surgery is a multi–staged method of excising a malignant lesion layer by layer, along with histo–pathological assessment, to ensure negative malignancy of the margins.10$210$2.7K
    17000The provider destroys a premalignant lesion using techniques such as chemosurgery, cryosurgery, electrosurgery, or others. This code reports the destruction of the first or only lesion.70$30$2.3K
    12053This CPT® code is used for the intermediate repair of wounds to the face, ears, eyelids, nose, lips, and/or mucous membranes that are 5.1 to 7.5 cm in size.20$80$2K
    12042This CPT® code is used for the intermediate repair of superficial wounds to the neck, hands, feet, and/or external genitalia that are 2.6 to 7.5 cm in size.20$80$1.7K

    Showing 1–10 of 19

    Medicare: Competitive Analysis & Benchmarks

    How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 19 CPT/HCPCS codes.

    View: State1 / 2

    Full comparison — all codes billed, vs. state median

    19 rows

    CPT/HCPCS CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    17311310370$310$115.2K
    17312210130$200$24.7K
    1406021030$520$12.9K
    1526021010$720$12.9K
    170003040170$30$7.7K
    111022740140$50$7.4K
    9921340191080$50$6.7K
    1203292020$170$5.8K
    1205221040$130$5.7K
    1731341020$260$4.6K

    Showing 1–10 of 19

    Related Providers

    Other providers that share a Tax Identification Number (TIN) with Todd Holmes, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Somc Medical Care Foundation, Inc.OHFamily Medicine Physician$0$25.3M
    University Of Vermont Medical Center IncVTInternal Medicine Physician$0$17.6M
    Northeastern Vermont Regional Hospital, IncVTPrimary Care Clinic/Center$0$2.8M
    James StaffordTXRadiation Oncology Physician$1.5M$0
    University Of Vermont Medical Center IncVTGeneral Acute Care Hospital$0$780.5K
    Paul UngerVTHematology & Oncology Physician$744.6K$0
    University Of Vermont Health Network Specialty Care Transport, LLCVTLand Ambulance$144K$510.7K
    Carlos TorresTXAnatomic Pathology & Clinical Pathology Physician$580.7K$0
    Brian KimVTOphthalmology Physician$488.3K$0
    Glenn GoldmanVTMOHS-Micrographic Surgery Physician$454.5K$0

    Nearby Providers

    Other providers in the same ZIP code as Todd Holmes, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Howard Center IncVTDevelopmentally Disabled Services Day Training Agency$0$332.2M
    Howard Center IncVTAdolescent and Children Mental Health Clinic/Center$0$130.1M
    Vermont Department Of Mental HealthVTAdult Mental Health Clinic/Center$0$105.1M
    Community Health Centers Of Burlington IncVTFederally Qualified Health Center (FQHC)$0$39.8M
    Howard Center IncVTMethadone Clinic$517.9K$35M
    Howard Center IncVTState or Local Public Health Clinic/Center$0$23.4M
    Transition IiVTCase Manager/Care Coordinator$0$17.3M
    The Dental Center At Community Health Center Of BurlingtonVTDental Clinic/Center$0$6.7M
    City Of Burlington VermontVTLand Ambulance$677.2K$4.3M
    Spectrum, Inc.VTAddiction (Substance Use Disorder) Counselor$0$2.4M

    Frequently Asked Questions

    References

    1. 1.Medicare Physician & Other Practitioner by Provider and Service. CMS.gov.Provider-level Medicare Part B utilization and payment data.
    2. 2.NPPES NPI Registry. CMS.gov.National Provider Identifier registry used for provider enumeration and taxonomy metadata.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

    Medicare Revenue by CPT/HCPCS Code
    Claims Volume vs. Vermont Distribution
    Todd Holmes — 1 of 19 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Vermont