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

Why is the Medicaid comparison limited to New Jersey 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. New Jersey (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.

Justin Lee (NPI 1588046684)

Justin Lee is a interventional cardiology physician provider located in Hackensack, New Jersey. This profile covers 16 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	Justin Lee
Address	211 Essex St
City	Hackensack
State	NJ
ZIP	07601
Taxonomy	Interventional Cardiology Physician
NPI Enumerated	June 24, 2015

Payer Source	Total Paid
Medicare	$91.7K
Medicaid	$0

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

16 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	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…	200	$100	$20.2K
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…	170	$100	$17.1K
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…	260	$70	$17K
99222	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	110	$110	$11.7K
92928	The provider inserts a catheter through the skin (percutaneous approach) and guides it into the heart's arteries. They deploy one or more stents (small tubes) to keep the artery open and may expand a…	10	$490	$6.9K
93458	In this procedure, the provider performs imaging supervision and interpretation for a coronary angiography with left heart catheterization and intraprocedural injections for left ventriculography. He…	30	$200	$5.3K
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…	30	$130	$3.3K
93456	In this procedure, the provider performs imaging supervision and interpretation for a coronary angiography with right heart catheterization. He also performs injections to assess any coronary artery…	10	$260	$3.1K
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	30	$90	$2.3K
92978	In this add–on procedure, the provider advances a catheter into a coronary vessel or previously placed graft using ultrasound or optical coherence tomography to view the extent of the blockage,…	10	$80	$1.1K

Showing 1–10 of 16

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
93306	420	990	220	$100	$25.8K
99214	5,243	13,640	130	$90	$23.6K
99233	1,668	4,270	110	$100	$22.5K
78452	604	650	60	$240	$19.9K
92928	141	180	20	$450	$12.1K
93458	158	240	40	$200	$9K
99284	1,298	1,560	60	$100	$7.7K
99222	657	4,370	40	$110	$6.7K
99204	4,496	7,160	40	$130	$6.5K
99203	5,094	5,660	40	$80	$4.8K

Justin Lee — Billing Profile & Reimbursement Data

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Justin Lee — 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