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

Why is the Medicaid comparison limited to New York 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. New York (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.

Abhinav Agrawal (NPI 1487094082)

Abhinav Agrawal is a pulmonary disease physician provider located in New Hyde Park, New York. This profile covers 26 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	Abhinav Agrawal
Address	410 Lakeville Rd Ste 107
City	New Hyde Park
State	NY
ZIP	11042
Taxonomy	Pulmonary Disease Physician
NPI Enumerated	June 27, 2013

Payer Source	Total Paid
Medicare	$134.9K
Medicaid	$0

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

26 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99291	Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is…	120	$200	$24K
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…	90	$160	$14.3K
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…	110	$120	$13K
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…	70	$160	$11K
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…	50	$200	$9.9K
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	$160	$8K
31641	In this procedure, the provider performs rigid or flexible bronchoscopy to view airways during a procedure. She may or may not use fluoroscopic guidance. She uses a nonexcision method, such as by…	30	$230	$7.7K
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	70	$110	$7.2K
31645	The provider uses a rigid or flexible bronchoscope to view the airways and aspirates (sucks out) fluid from the tracheobronchial tree, the branched distribution of airways of the lung that includes…	150	$40	$6.2K
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.	40	$140	$5.7K

Showing 1–10 of 26

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99214	13,703	30,450	90	$100	$19K
99233	4,882	8,640	80	$100	$15.8K
99291	884	4,680	50	$190	$15.2K
99213	31,192	31,440	80	$70	$12.1K
99215	1,838	8,280	40	$140	$10.1K
99223	3,231	8,650	40	$150	$9.3K
99205	899	4,260	30	$180	$6.4K
94729	606	680	70	$40	$4.8K
31641	1	10	20	$230	$4.7K
94726	347	400	60	$40	$3.9K

Abhinav Agrawal — Billing Profile & Reimbursement Data

Sign up for Abhinav Agrawal — Billing Profile & Reimbursement Data policy alerts

Abhinav Agrawal — Billing Profile & Reimbursement Data

Sign up for Abhinav Agrawal — 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