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    v1.0.28
    OpenPayerNPI Medicare & MedicaidMichael Heffernan
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    Michael Heffernan — Billing Profile & Reimbursement Data

    NPI 1518923432 · San Luis Obispo, CA · Dermatology Physician

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    Michael Heffernan is a dermatology physician provider located in San Luis Obispo, California. This profile covers 52 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
    OrganizationMichael Heffernan
    Address15 Santa Rosa St
    CitySan Luis Obispo
    StateCA
    ZIP93405
    TaxonomyDermatology Physician
    NPI EnumeratedApril 21, 2006

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

    Payer SourceTotal Paid
    Medicare$2.1M
    Medicaid$0

    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.

    52 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    J3245Injection, tildrakizumab, 1 mg4,200$110$462K
    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…440$540$236.9K
    99214The 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…2,180$100$206.6K
    17110The provider destroys benign lesions using techniques such as chemosurgery, cryosurgery, electrosurgery, or others. This code reports the destruction of one to 14 lesions other than skin tags or…1,660$90$144.6K
    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.360$360$127.8K
    17003In this add–on procedure, the provider destroys a premalignant lesion using techniques such as chemosurgery, cryosurgery, electrosurgery, or others. This code is appropriate for the second through…16,500$10$99K
    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.2,600$40$99K
    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.170$490$86K
    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…1,260$70$81.9K
    Q4159Affinity, per square centimeter (add-on, list separately in addition to primary procedure)180$310$56.8K

    Showing 1–10 of 52

    Medicare: Competitive Analysis & Benchmarks

    How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 52 CPT/HCPCS codes.

    View: State1 / 2

    Full comparison — all codes billed, vs. state median

    52 rows

    CPT/HCPCS CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    J32459204,100$110$520.4K
    Q4159810730$320$257.7K
    Q41962230870$80$109.3K
    1731156440130$490$101.6K
    1731243390110$360$58.9K
    883053031,580450$40$51.3K
    173132831050$490$35.2K
    9921420137,970120$90$23.2K
    14061516020$790$22K
    173143520040$340$19.9K

    Showing 1–10 of 52

    Related Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    University Dermatology, Inc.INDermatology Physician$0$6.2M
    Cheryl KetelsenCAMedical Physician Assistant$1.2M$0
    Alexander ZemtsovINDermatology Physician$831.4K$0
    Joseph LillisCODermatology Physician$642.7K$0
    Sean MarzolfKYDermatology Physician$450.1K$0
    Ruchik DesaiINDermatology Physician$386.4K$0
    Andrew DuboisINDermatology Physician$330.2K$0
    Minati SwoffordINDermatology Physician$248.4K$0
    Alison KlenkINDermatology Physician$75.4K$0

    Nearby Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Community Health Centers Of The Central Coast, IncCACommunity Health Clinic/Center$0$31.2M
    Barry EibschutzCARheumatology Physician$6.6M$583.6K
    Galileo Surgery Center, LPCAAmbulatory Surgical Clinic/Center$1.4M$1.1M
    Joseph DiehlCAMOHS-Micrographic Surgery Physician$1.6M$0
    Jeffrey WuCARadiation Oncology Physician$1.4M$0
    Christopher JohnsonCAUrology Physician$896.5K$0
    Craig CanfieldCAUrology Physician$785.9K$0
    Magnetic Resonance Imaging Of San Luis Obispo, Inc.CADiagnostic Radiology Physician$652.7K$6.2K
    Nicholas CaggianoCASurgery of the Hand (Surgery) Physician$558.5K$0
    Russ LevitanCASpecialist$394.9K$0

    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. California Distribution
    Michael Heffernan — 12 of 25 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — California