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 District of Columbia for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to District of Columbia 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. District of Columbia (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.

Medstar Heart Institute LLC (NPI 1528345378)

Medstar Heart Institute LLC is a surgery physician provider located in Washington, District of Columbia. This profile covers 0 Medicare and 46 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Medicaid: Complete Services Breakdown

Field	Value
Entity Type	Organization
Organization	Medstar Heart Institute LLC
Address	110 Irving St Nw
City	Washington
State	DC
ZIP	20010
Taxonomy	Surgery Physician
NPI Enumerated	November 8, 2011

Payer Source	Total Paid
Medicaid	$4.8M
Medicare	$0

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

46 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
93306	The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent…	34,800	$40	$1.5M
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…	25,510	$40	$1M
93010	The provider interprets and reports on the results of a routine 12–lead (or more) electrocardiogram.	142,550	$10	$712.7K
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…	6,120	$70	$440.3K
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…	7,260	$50	$362.9K
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…	2,880	$70	$195.6K
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…	1,050	$100	$102.6K
93970	The provider performs an ultrasound scanning procedure called a duplex scan to characterize the pattern and direction of blood flow in extremity veins (arms or legs). This is a complete, bilateral…	4,080	$30	$102.1K
93750	In this procedure, the provider tests the settings of a ventricular assist device, a mechanical pump connected to the heart and aorta that ensures adequate blood flow in the presence of heart…	4,510	$20	$72.1K
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…	2,490	$30	$67.1K

Showing 1–10 of 46

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other District of Columbia providers billing the same CPT/HCPCS codes.

Claims Volume vs. District of Columbia Distribution

Medstar Heart Institute LLC — 5 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — District of Columbia

Full comparison — all codes billed, vs. District of Columbia median

46 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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…	14	30	1,050	$120	$581.4K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	84	130	290	$140	$579.2K
36902	The provider introduces a needle and/or catheter under fluoroscopic guidance (live X–rays that can be viewed on a monitor) and injects contrast material into the dialysis access point to visualize…	3	10	110	$1,480	$511.2K
93306	The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent…	1	30	450	$130	$439.5K
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…	6	50	580	$60	$424.9K
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	310	750	$70	$321.6K
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…	86	320	620	$50	$313.6K
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…	8	120	300	$120	$287.3K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	32	70	320	$40	$259.9K
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…	7	40	300	$100	$193.8K

Showing 1–10 of 46

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Omid Fatemi	CA	Interventional Cardiology Physician	$1M	$0
Amir Najafi	MD	Interventional Cardiology Physician	$773.4K	$0
Christopher Huffman	SC	Interventional Cardiology Physician	$630.8K	$0
Kusay Barakat	MD	Cardiovascular Disease Physician	$605.2K	$0
Alex Ryzhikov	MD	Cardiovascular Disease Physician	$591.3K	$0
Shawn Buki	MD	Cardiovascular Disease Physician	$475.3K	$0
Michael Lee	DC	Specialist	$438.8K	$0
Estelle Jean	MD	Internal Medicine Physician	$398.3K	$0
William Maxted	MD	Cardiovascular Disease Physician	$397.1K	$0
Stuart Gould	NJ	Internal Medicine Physician	$393.5K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Children's Hospital	DC	Children's Hospital	$0	$243.1M
Medstar Washington Hospital Center	DC	General Acute Care Hospital	$0	$239M
Children's Hospital	DC	Pediatrics Physician	$0	$115.3M
Whc Physician Group LLC	DC	General Practice Physician	$0	$93.8M
Medstar Medical Group Radiology, LLC	DC	Diagnostic Radiology Physician	$0	$17.5M
National Rehabilitation Hospital Inc	DC	Rehabilitation Hospital	$0	$16.9M
Hero Dental Of Washington Dc PC	DC	General Practice Dentistry	$0	$11.7M
Bio-medical Applications Of Columbia Heights, Inc.	DC	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$4.6M
Washington Hospital Center Corp	DC	General Practice Physician	$0	$3.7M
Capital Area Renal Associates, PC	DC	Internal Medicine Physician	$0	$3.6M

Medstar Heart Institute LLC — Billing Profile & Reimbursement Data

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Medstar Heart Institute LLC — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

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