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

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

Stephen Small (NPI 1518956002)

Stephen Small is a plastic surgery physician provider located in Toms River, New Jersey. This profile covers 16 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	Stephen Small
Address	413 Lakehurst Rd Ste 301
City	Toms River
State	NJ
ZIP	08755
Taxonomy	Plastic Surgery Physician
NPI Enumerated	October 18, 2005

Payer Source	Total Paid
Medicare	$90.3K
Medicaid	$0

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

16 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99203	The provider sees a new 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 provider…	190	$90	$17.5K
15120	This procedure is a split–thickness autograft of the face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits. This excision and placement is for the first 100…	20	$530	$12.6K
13132	The provider repairs a wound measuring 2.6 cm to 7.5 cm in size of the cheeks, chin, mouth, neck, axillae, genitalia, hands, and/or feet, which may require scar revision, debridement extensive…	40	$250	$10.3K
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…	130	$70	$9.5K
15100	This procedure is a split–thickness autograft from the trunk, arms, or legs. This excision and placement is for the first 100 cm2 or less or one percent of the body area of an infant or child.	20	$610	$9.2K
13121	This is for a complex repair of a wound to the scalp, arms, and/or legs. This wound should be 2.6 to 7.5 cm in size.	40	$200	$7.1K
13101	This is for a complex repair of a wound to the trunk. This wound should be 2.6 to 7.5 cm in size.	30	$200	$6.7K
15004	The provider prepares the skin of a body part with an open wound, burn eschar, or scar contracture to receive a skin graft. This procedure helps in repairing areas of the face, scalp, eyelids, mouth,…	20	$220	$4.8K
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…	30	$100	$2.5K
11642	The provider excises a cancerous (malignant) lesion, including margins, of 1.1 to 2.0 cm in diameter, from the skin of the face, ears, eyelids, nose, lips.	20	$80	$1.9K

Showing 1–10 of 16

Stephen Small — Billing Profile & Reimbursement Data

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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
99214	12,013	13,640	130	$90	$23.6K
13132	33	80	30	$250	$14.4K
11102	555	590	120	$70	$14.2K
99213	5,974	14,090	100	$70	$13.1K
13121	40	90	30	$260	$13K
15120	1	10	20	$530	$11.1K
13101	25	80	30	$280	$9.5K
15004	10	20	20	$250	$8.1K
15100	1	10	20	$500	$7.5K
99204	6,394	7,160	40	$130	$6.5K