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

Why is the Medicaid comparison limited to Alabama 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. Alabama (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.

Upperline Healthcare, PC (NPI 1538686498)

Upperline Healthcare, PC is a foot & ankle surgery podiatrist provider located in Hoover, Alabama. This profile covers 0 Medicare and 40 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	Upperline Healthcare, PC
Address	2116 Chapel Hill Rd
City	Hoover
State	AL
ZIP	35216
Taxonomy	Foot & Ankle Surgery Podiatrist
NPI Enumerated	August 23, 2017

Payer Source	Total Paid
Medicaid	$1.4M
Medicare	$0

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

40 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	22,620	$20	$452.4K
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…	3,670	$60	$201.6K
11721	The provider surgically debrides (debulks or removes) 6 or more abnormal, diseased, or infected nails.	22,500	$10	$180K
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…	1,700	$80	$142.7K
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…	2,970	$40	$106.9K
11056	The provider removes 2 to 4 benign hyperkeratotic lesions by using surgical instruments like a scalpel or curette.	7,380	$10	$66.4K
73630	In this diagnostic procedure, the provider takes a minimum of three views of the foot to assess injury, fracture, arthritis, tumor, or congenital abnormality.	3,030	$10	$42.4K
L3000	Foot, insert, removable, molded to patient model, 'ucb' type, berkeley shell, each	320	$120	$36.7K
11042	The provider uses surgical instruments to remove the dead tissue in skin down to the subcutaneous layer and including the epidermis and dermis, up to the first 20 cm2.	1,310	$30	$36.6K
17110	The 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…	1,670	$20	$28.3K

Showing 1–10 of 40

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Alabama Distribution

Upperline Healthcare, PC — 7 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Alabama

Full comparison — all codes billed, vs. Alabama median

40 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
88305	The physician, typically a pathologist, performs a level IV examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally…	56	70	550	$50	$210.5K
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…	471	1,990	680	$60	$201.7K
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…	97	1,990	560	$40	$185.6K
A6212	Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing	2	10	740	$160	$120.5K
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…	180	400	470	$30	$97.1K
A5500	For diabetics only, fitting (including follow-up), custom preparation and supply of off-the-shelf depth-inlay shoe manufactured to accommodate multi-density insert(s), per shoe	2	10	220	$50	$74.4K
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…	114	240	130	$80	$46.1K
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…	21	630	60	$80	$45.8K
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,…	96	500	120	$60	$42.2K
17110	The 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…	3	20	200	$60	$39.3K

Showing 1–10 of 40

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Beth Pearce	FL	Primary Podiatric Medicine Podiatrist	$395.2K	$0
Kyle Herron	FL	Surgery Physician	$338.2K	$0
Scott Hannum	FL	Vascular Surgery Physician	$241.7K	$0
Glenn Osterweil	FL	Podiatrist	$232.7K	$130
Andrew Tompkins	KY	Foot & Ankle Surgery Podiatrist	$228.5K	$0
Curtis Wagner	FL	Podiatrist	$205.9K	$0
Su Xu	FL	Dermatopathology (Pathology) Physician	$203.1K	$0
Jeffrey Schnell	KY	Foot & Ankle Surgery Podiatrist	$174.6K	$0
Francesca Zappasodi	NC	Foot & Ankle Surgery Podiatrist	$148.5K	$0
Barry Schulman	TN	Podiatrist	$147.6K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
American Family Care, LLC	AL	Primary Care Clinic/Center	$0	$12.9M
The Children's Hospital Of Alabama	AL	Pediatrics Physician	$0	$2.7M
Surgical Clinic Solutions, LLC	AL	Ambulatory Surgical Clinic/Center	$2.2M	$0
Alacare Home Health Services, Inc.	AL	Community Based Hospice Care Agency	$0	$1.6M
Drs. Koslin & Kahn, P.C.	AL	Oral and Maxillofacial Surgery (Dentist)	$0	$1.3M
Child's Play Therapy LLC	AL	Rehabilitation Hospital Unit	$0	$1.2M
Nephrology Vascular Lab Of Central Alabama Asc LLC	AL	Ambulatory Surgical Clinic/Center	$706.8K	$0
Scott Rooney	AL	Interventional Pain Medicine Physician	$333.4K	$0
Donald Walters	AL	Dermatology Physician	$289.8K	$0
Daniel Bergman	AL	MOHS-Micrographic Surgery Physician	$274.6K	$0

Upperline Healthcare, PC — Billing Profile & Reimbursement Data

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Upperline Healthcare, PC — 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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