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

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

Siva Raja (NPI 1548317522)

Siva Raja is a thoracic surgery (cardiothoracic vascular surgery) physician provider located in Cleveland, Ohio. This profile covers 10 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	Siva Raja
Address	9500 Euclid Ave
City	Cleveland
State	OH
ZIP	44195
Taxonomy	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
NPI Enumerated	January 4, 2007

Payer Source	Total Paid
Medicare	$71.9K
Medicaid	$0

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

10 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
43117	The provider performs removal from the two thirds of the esophagus closest to the stomach. He may also remove part of the upper stomach. In the chest, he connects the esophagus to the remaining…	10	$2,510	$35.2K
43281	The provider performs repair of a paraesophageal hernia, where the stomach slides up next to the esophagus, using laparoscopy. He may also perform fundoplasty, wrapping part of the stomach around the…	10	$1,200	$14.4K
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…	60	$100	$5.8K
99205	The provider sees a new 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 provider…	30	$140	$3.9K
43249	The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum and dilates (widens) the esophagus with a balloon less than 30 mm in diameter.	40	$110	$3.7K
43235	The provider inserts an endoscope through the mouth and down into the esophagus, stomach, and duodenum for diagnostic purposes; the provider may collect specimens by brushing or washing.	40	$80	$3.4K
43239	The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis.	30	$90	$2.6K
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…	20	$80	$1.3K
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…	20	$50	$1K
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,…	30	$20	$620

Siva Raja — Billing Profile & Reimbursement Data

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Siva Raja — 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
43117	1	10	10	$2,510	$35.2K
43281	2	10	10	$1,130	$19.3K
99214	18,567	20,010	100	$70	$11.7K
43239	477	670	50	$110	$8.8K
43249	31	160	20	$240	$7.3K
99213	17,394	20,000	70	$50	$6.6K
99204	1,685	8,330	30	$100	$4.4K
99205	798	2,130	20	$140	$4.2K
43235	55	370	20	$110	$3K
99212	2,119	4,100	30	$30	$1.7K