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NPI 1558330217 · Saco, ME · Podiatrist
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Eric Muca is a podiatrist provider located in Saco, Maine. This profile covers 18 Medicare and 6 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)
| Field | Value |
|---|---|
| Entity Type | Individual |
| Organization | Eric Muca |
| Address | 333 Lincoln St |
| City | Saco |
| State | ME |
| ZIP | 04072 |
| Taxonomy | Podiatrist |
| NPI Enumerated | March 15, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $255.2K |
| Medicaid | $48.7K |
Medicare dominates this provider’s billing volume: lifetime Medicare revenue is $255.2K compared with $48.7K in Medicaid, making Medicare the primary payer for this practice based on the reporting on file. Medicaid is active but represents a materially smaller share of lifetime revenue.
Revenue is highly concentrated in a narrow set of procedural codes across both payers: the top three Medicare codes account for 76.2% of the provider’s total Medicare revenue, and the top three Medicaid codes account for 99.1% of the provider’s total Medicaid revenue. This concentration indicates the practice derives nearly all payor revenue from a few procedure types rather than a broad mix of services.
The practice appears to be a procedure-focused podiatry operation: the top revenue drivers are 11721, 11056, and 11055, which are nail debridement and benign hyperkeratotic lesion removal procedures. On Medicare those codes generate $99.2K (11721, 39.1%), $53.4K (11056, 21.0%), and $40.9K (11055, 16.1%); on Medicaid they show 5.3K claims and $31.9K for 11721, 1.5K claims and $13.8K for 11056, and 914 claims and $5.5K for 11055, reinforcing a high-volume procedural practice focused on nail and lesion care.
On national Medicare metrics this provider is an outlier for core procedural codes: 11721 ranks #44 of 12535 (100th percentile; extreme outlier) and 11055 ranks #72 of 6800 (99th percentile; extreme outlier), while 11056 ranks #166 of 8266 (98th percentile; notably above typical national volume). These placements signal unusually high national activity in those specific procedures compared with peers.
Within Maine Medicaid the competitive picture is more modest: 11721 ranks #9 of 67 (88th percentile; typical, unremarkable volume), 11056 ranks #5 of 17 (75th percentile; typical), and 11055 ranks #2 of 20 (95th percentile; typical). In-state ranking shows meaningful market share for these procedures but the provided labels characterize the volumes as typical for the state peer group rather than extreme.
Evaluation-and-management services are present but secondary to procedures: Medicare E/M codes 99214 and 99203 account for $19.3K (7.6%) and $11K (4.3%) of Medicare revenue respectively, indicating office visits are a smaller portion of overall Medicare income. Medicaid E/M reporting shows lower paid amounts and unusual zero-dollar entries (for example, 99214: 65 claims, $0 avg paid/claim, $0 revenue), suggesting differential reimbursement and/or claims-reporting patterns between payers that depress E/M revenue on Medicaid.
Payer-level unit economics differ markedly: for code 11721 Medicaid shows higher claim volume (5.3K claims) but a much lower avg paid/claim ($6) compared with Medicare for the same code (3.3K claims, $30 avg paid/claim). This pattern underscores that the provider achieves most revenue from Medicare payments while Medicaid supplies high volume at lower per-claim dollars.
The provider has a long tenure in the NPI file (enumerated 2006-03-15, ~20 years ago), which combined with a concentrated, procedure-heavy code mix suggests an established local podiatry practice with stable, repeatable procedural billing patterns rather than a newly-entered or generalist practice profile.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
18 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 11721 | The provider surgically debrides (debulks or removes) 6 or more abnormal, diseased, or infected nails. | 3,310 | $30 | $99.2K |
| 11056 | The provider removes 2 to 4 benign hyperkeratotic lesions by using surgical instruments like a scalpel or curette. | 1,050 | $50 | $53.4K |
| 11055 | The provider removes a single benign hyperkeratotic lesion by using surgical instruments like a scalpel or curette. | 830 | $50 | $40.9K |
| 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… | 210 | $90 | $19.3K |
| 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… | 150 | $70 | $11K |
| 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… | 80 | $70 | $5.2K |
| 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… | 60 | $80 | $4.6K |
| 11750 | The provider removes part or all of a fingernail or toenail, including the nail plate and matrix and including the lunula if the excision is complete. | 30 | $110 | $3.5K |
| 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. | 40 | $100 | $3.5K |
| 10061 | The provider incises the area of abscess and drains the collection of pus, such as those related to a carbuncle, hidradenitis, cyst, furuncle, or paronychia, with the help of surgical instruments. A… | 20 | $160 | $3.1K |
Showing 1–10 of 18
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 18 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
View: By Year1 / 3
Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
6 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 11721 | The provider surgically debrides (debulks or removes) 6 or more abnormal, diseased, or infected nails. | 5,320 | $10 | $31.9K |
| 11056 | The provider removes 2 to 4 benign hyperkeratotic lesions by using surgical instruments like a scalpel or curette. | 1,540 | $10 | $13.8K |
| 11055 | The provider removes a single benign hyperkeratotic lesion by using surgical instruments like a scalpel or curette. | 910 | $10 | $5.5K |
| 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… | 80 | $10 | $470 |
| 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… | 70 | $0 | $0 |
| 99324 | N/A | 50 | $0 | $0 |
How this provider's Medicaid billing volume and revenue compare to other Maine providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Maine median
6 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 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… | 408 | 460 | 1,240 | $30 | $190K |
| 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… | 122 | 170 | 220 | $30 | $24.4K |
| 11056 | The provider removes 2 to 4 benign hyperkeratotic lesions by using surgical instruments like a scalpel or curette. | 5 | 20 | 420 | $20 | $21.9K |
| 11721 | The provider surgically debrides (debulks or removes) 6 or more abnormal, diseased, or infected nails. | 9 | 70 | 890 | $10 | $21.5K |
| 11055 | The provider removes a single benign hyperkeratotic lesion by using surgical instruments like a scalpel or curette. | 2 | 20 | 60 | $10 | $4.5K |
| 99324 | N/A | 3 | 10 | 30 | $10 | $670 |
Other providers in the same ZIP code as Eric Muca, ranked by combined Medicare and Medicaid revenue.
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