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

Why is the Medicaid comparison limited to North Dakota 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. North Dakota (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.

Derrick Cote (NPI 1538397070)

Field	Value
Entity Type	Individual
Organization	Derrick Cote
Address	310 N 9th Street
City	Bismarck
State	ND
ZIP	58501
Taxonomy	Orthopaedic Surgery Physician
NPI Enumerated	June 23, 2009

Payer Source	Total Paid
Medicare	$251.1K
Medicaid	$0

Key Findings

Practice profile and service mix: This NPI is an Orthopaedic Surgery Physician whose three highest-revenue Medicare codes are 27447 ($83.5K, 33.2%), 27130 ($31.1K, 12.4%) and 99214 ($30.4K, 12.1%), and those top three codes together account for 57.7% of the provider's Medicare revenue. That mix (primary knee and hip arthroplasty codes plus a high-volume established-patient E/M code) points to a surgical practice centered on major joint replacement with routine postoperative and follow-up office visits as an integral part of revenue generation.

Revenue concentration and scale: Total Medicare revenue is $251.1K and the precomputed top-3 share is 57.7%, indicating a high concentration of Medicare dollars in a small set of high-value arthroplasty and E/M codes. This level of concentration means business performance will be sensitive to fluctuations in arthroplasty case volume or reimbursement for those specific codes.

Payer mix: The provider has no Medicaid billing on file, making Medicare effectively the sole public payer represented in the available claims data. With Medicaid absent, the provider’s public-payer exposure is concentrated in Medicare only, which has implications for network contracting and risk if commercial payer patterns differ.

Competitive standing on major arthroplasty codes: For the leading surgical code 27447 the provider ranks #1244 of 12089 (89th percentile) and is characterized as a typical, unremarkable volume for this code despite being above many peers; 27130 ranks #3027 of 8062 (61th percentile) and 99214 ranks #88263 of 479517 (82th percentile). Taken together, these ranks describe a locally established arthroplasty surgeon with above-average presence on knee replacement relative to the national pool but not a nationally dominant arthroplasty center.

Procedure-level outliers and operational implications: The injection code 20610 shows 408 claims and $19.6K revenue and ranks #1909 of 39752 (95th percentile), described in the data as notably above typical national volume. This suggests relatively heavy office-based procedural throughput (joint/bursa injections) compared with peers and reinforces a mixed surgical/office-procedure practice model rather than a purely operating-room–focused practice.

Supply/medication billing anomaly in volume: J3301 appears with 3.5K claims for $3.5K revenue and ranks #444 of 38702 (99th percentile), labeled an extreme outlier, far above typical national volume for this code. The unusually high claim count for a low per-claim payment points to frequent administration or billing of triamcinolone units in office encounters; this is a notable utilization pattern that warrants attention when benchmarking supply and medication use.

Imaging and supportive service utilization: Several imaging codes are high in percentile—77077 (172 claims) ranks #35 of 487 (93rd percentile) and 72190 (61 claims) ranks #54 of 852 (94th percentile)—consistent with frequent use of plain radiographs and joint surveys. Elevated imaging use aligns with active management of arthroplasty and musculoskeletal complaints, and suggests the provider relies on in-office or referral imaging to support surgical decision-making and follow-up.

Tenure and likely practice size: The NPI was enumerated on 2009-06-23 (~17 years ago), indicating a long-standing presence in the Bismarck, ND market. Combined with the modest absolute Medicare revenue ($251.1K) and the code-level volume profile, the pattern is consistent with an established solo or small-group orthopaedic surgeon who maintains a steady but not high-volume arthroplasty and office-procedure practice.

Medicare: Complete Services Breakdown

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

26 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
27447	In this procedure, the provider replaces the damaged weight bearing surfaces of both the medial and lateral compartments in the knee joint using implants of metal or other strong materials. The…	90	$960	$83.5K
27130	In this procedure, the provider surgically replaces the hip joint by prosthesis, or artificial hip joint. He replaces both the femoral and acetabular components with or without using an autograft or…	30	$970	$31.1K
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…	330	$90	$30.4K
23472	In this procedure, the provider performs a total shoulder arthroplasty in which the provider replaces the damaged head of the humerus and the glenoid cavity with prosthetic implants. The provider…	20	$1,100	$19.7K
20610	In this procedure, the provider inserts a needle through the skin of a patient and into a major joint or bursa and then uses the syringe attachment to the needle to remove fluid or he may inject a…	410	$50	$19.6K
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…	80	$120	$9.8K
99204	The provider sees a new 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 provider…	80	$120	$9.4K
77077	The provider performs a joint survey study of two or more joints in which he performs only a single view of each joint.	170	$40	$6.2K
64721	Neuroplasty or transposition of the median nerve at the carpal tunnel is done to treat a condition called carpal tunnel syndrome (CTS). The carpal tunnel is a narrow tunnel in the wrist through which…	20	$340	$5.8K
73564	In this procedure, the provider takes four or more X–ray views of the knee joint to check for any fracture, swelling, or reason for pain in the knee area.	170	$30	$5.5K

Showing 1–10 of 26

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 26 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. North Dakota Distribution

Derrick Cote — 3 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — North Dakota

Full comparison — all codes billed, vs. state median

26 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
27447	2	60	40	$1,110	$47.9K
27130	18	40	30	$970	$35K
23472	10	20	20	$720	$17.9K
64721	11	10	40	$390	$16.3K
99214	195	1,470	90	$60	$10.4K
26055	10	10	40	$230	$8.8K
99215	116	480	40	$100	$6.9K
99213	715	1,490	80	$50	$5.8K
99205	67	160	30	$140	$5.1K
99204	73	570	30	$100	$4.4K

Showing 1–10 of 26

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
St Josephs Hospital And Health Center	ND	Rural Acute Care Hospital	$0	$4.1M
Coal Country Community Health Center	ND	Federally Qualified Health Center (FQHC)	$0	$983.2K
Darrin Johnson	MN	Diagnostic Radiology Physician	$908.4K	$0
Shree Subedi	WA	Diagnostic Radiology Physician	$774.2K	$0
Matthew Manganaro	NY	Diagnostic Radiology Physician	$688K	$0
Steven Kraljic	ND	Neurological Surgery Physician	$426.1K	$0
Michael Lin	MN	Diagnostic Radiology Physician	$142.8K	$270.1K
St Joseph's Hospital And Health Center	ND	Clinic/Center	$0	$398.8K
Bradley Close	MN	Diagnostic Radiology Physician	$397.3K	$0
Coal Country Community Health Center	ND	Federally Qualified Health Center (FQHC)	$0	$384.7K

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Enable, Inc.	ND	Intellectual and/or Developmental Disabilities Residential Treatment Facility	$0	$40.8M
Heartview Foundation	ND	Substance Use Disorder Rehabilitation Clinic/Center	$0	$13.6M
Sanford Bismarck	ND	General Acute Care Hospital	$0	$12.5M
Bismarck Public Schools Early Intervention	ND	Early Intervention Provider Agency	$0	$12M
West Central Behavioral Health Clinic	ND	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$6.2M
D. Michael Goebel D.d.s., PC	ND	Pediatric Dentistry	$0	$5.8M
Poppy's Promise LLC	ND	Community/Behavioral Health Agency	$0	$5.6M
Sanford Bismarck	ND	Clinical Medical Laboratory	$726.9K	$4.3M
St. Alexius Medical Center	ND	Specialist	$0	$3.6M
Lasting Love Homecare	ND	In Home Supportive Care Agency	$0	$3.6M

Derrick Cote — Billing Profile & Reimbursement Data

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Key Findings

Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References