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

Why is the Medicaid comparison limited to West Virginia 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. West Virginia (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.

David Carlisle (NPI 1639231087)

Field	Value
Entity Type	Individual
Organization	David Carlisle
Address	165 Scott Ave
City	Morgantown
State	WV
ZIP	26508
Taxonomy	MOHS-Micrographic Surgery Physician
NPI Enumerated	December 14, 2006

Payer Source	Total Paid
Medicare	$638.7K
Medicaid	$0

Key Findings

This provider is effectively single‑payer in the claims on file: Total Medicare revenue is $638.7K and there is no Medicaid billing on file. The absence of Medicaid activity indicates the provider’s Medicare business dominates revenue and patient mix.

Revenue is highly concentrated in Mohs and related reconstructive procedures: the top 3 Medicare codes by revenue are 17311 ($277K, 43.7%), 17312 ($117.3K, 18.5%), and 15260 ($44.8K, 7.1%), and the top 3 Medicare codes by revenue account for 69.3% of this provider's total Medicare revenue. This concentration signals that a small set of procedure lines account for the majority of billed Medicare dollars.

The code mix is characteristic of an active Mohs micrographic surgery practice that performs immediate reconstruction: high revenue shares on Mohs codes 17311/17312/17313 combined with notable use of full‑thickness graft codes such as 15260 and adjacent tissue transfer codes like 14041 indicate both excision and onsite reconstructive work. The presence of intraoperative pathology (88331) and surgical pathology (88305) billed alongside surgical codes supports an integrated workflow where specimen evaluation and closure are part of the same episode.

17311 is a national strength for this clinician: it generates $277K (43.7% of Medicare revenue) and ranks #211 of 2969 providers nationally (93th percentile), which the data labels as notably above typical national volume for this code. By contrast 17312 also contributes materially ($117.3K, 18.5%) and ranks #249 of 2770 (91th percentile) but is described in the file as typical, unremarkable volume; overall these rankings point to above‑average Mohs volume on at least one flagship Mohs code while other Mohs codes track more in line with peers.

Several reconstructive repair codes show different competitive signals: 15260 ($44.8K, 7.1%) ranks #121 of 1336 (90th percentile) and is characterized as typical, unremarkable, while 12052 ($24.8K, 3.9%) is an outlier with 203 claims and a rank of #27 of 1767 (99th percentile), labeled an extreme outlier far above typical national volume. This pattern suggests the provider does an unusually high volume of intermediate face/eyelid/ear/nose/lip repairs relative to peers, which may reflect referral patterns or a subspecialty focus on facial reconstruction.

Pathology and E/M activity are present but secondary: intraoperative consultation 88331 appears 75 times for $5.4K (0.9% of Medicare revenue) and ranks #782 of 4659 (83th percentile), showing above‑median usage of intraoperative pathology support, while surgical pathology 88305 has higher claim count (218) but modest revenue ($5.2K, 0.8%) and ranks #10510 of 14580 (28th percentile). Together these data indicate the provider relies on pathology services consistent with Mohs workflows but does not generate large separate pathology revenue.

The provider has long tenure on file, with NPI enumerated (registered) 2006-12-14 (~20 years ago), which supports interpreting current procedural volumes as coming from an established practice rather than a new entrant. Extended enrollment combined with concentrated Mohs revenue suggests an established referral base for skin cancer surgery and reconstruction.

Operational and payer‑mix implications: with $638.7K total Medicare revenue and no Medicaid billing on file, the practice is heavily dependent on Medicare population flows and reimbursement. Analysts should note the single‑payer concentration when modeling revenue sensitivity to Medicare policy or regional shifts in senior patient volumes, and should factor in the unusually high volume on specific repair codes (notably 12052) when benchmarking staffing, OR utilization, and reconstruction capacity against peers.

Medicare: Complete Services Breakdown

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

30 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
17311	Mohs surgery is a multi–staged procedure that is performed to excise a malignant lesion layer by layer, along with histo–pathological assessment. The assessment is performed to ensure that the…	710	$390	$277K
17312	Mohs surgery is a multi–staged method of excising a malignant lesion layer by layer, along with histo–pathological assessment, to ensure negative malignancy of the margins.	400	$290	$117.3K
15260	This code is for a free full–thickness skin graft of the nose, ears, eyelids, and/or lips that is 20 cm2 or less in size.	60	$720	$44.8K
14041	The provider replaces the lesions in the forehead, cheeks, chin, mouth, neck, axillae or armpits, genitalia, hands, or feet with the healthy tissues from an adjacent site. This code represents a…	50	$670	$30.8K
12052	This CPT® code is used for the intermediate repair of wounds to the face, ears, eyelids, nose, lips and/or mucous membranes that are 2.6 to 5.0 cm in size.	200	$120	$24.8K
17313	Mohs surgery is a multi–staged method of excising a malignant lesion layer by layer, along with histo–pathological assessment, to ensure negative malignancy of the margins.	70	$360	$24.4K
12032	This CPT® code is used for the intermediate repair of wounds to the scalp, axillae, trunk and/or extremities (excluding hands and feet) that are 2.6 to 7.5 cm in size.	120	$150	$18.1K
13132	The provider repairs a wound measuring 2.6 cm to 7.5 cm in size of the cheeks, chin, mouth, neck, axillae, genitalia, hands, and/or feet, which may require scar revision, debridement extensive…	80	$170	$14.2K
15240	This code is for a free full–thickness skin graft of the forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands, and/or feet that is 20 cm2 or less in size.	20	$680	$11.5K
14061	The provider replaces the lesions in the eyelids, nose, ears, or lips, with the healthy tissues from an adjacent site. This code represents a defect of 10.1 cm2 to 30.0 cm2 in size.	20	$690	$10.4K

Showing 1–10 of 30

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 30 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. West Virginia Distribution

David Carlisle — 2 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — West Virginia

Full comparison — all codes billed, vs. state median

30 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
17311	3	10	460	$400	$193.5K
17312	3	10	240	$290	$83.9K
17313	7	10	100	$400	$47.6K
14041	2	10	30	$660	$31K
15260	1	10	40	$710	$27.7K
88305	58	80	670	$30	$23.9K
14061	4	10	20	$690	$18.6K
13132	5	20	30	$220	$15.8K
13152	5	10	50	$210	$10.9K
13121	11	20	30	$210	$9.7K

Showing 1–10 of 30

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mountain State Medical Specialties, PLLC	WV	Dermatology Physician	$0	$3.6M
John Hancox	WV	MOHS-Micrographic Surgery Physician	$959.7K	$0
Amy Norton	WV	Dermatology Physician	$217.9K	$334.9K
Barrett Louden	WV	Dermatology Physician	$259.2K	$0
Jeffrey Jackson	WV	Dermatopathology Physician	$241.8K	$0
Jeffrey Dodson	WV	Dermatology Physician	$235.8K	$0
Charles Franz	WV	Dermatology Physician	$231.3K	$0
Michelle Endicott	WV	Dermatology Physician	$217.4K	$0
Susan Touma	WV	Dermatology Physician	$189.7K	$0
Janelle King	WV	Dermatology Physician	$167.3K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mulberry Street Management Services, Inc.	WV	In Home Supportive Care Agency	$0	$175.6M
West Virginia's Choice	WV	Home Health Agency	$0	$72.7M
Mulberry Street Management Services, Inc.	WV	Community/Behavioral Health Agency	$0	$28.9M
Valley Comprehensive Community Mental Health Center	WV	Respite Care	$0	$21.8M
Valley Comprehensive Community Mental Health Center	WV	Community/Behavioral Health Agency	$0	$19.4M
Valley Comprehensive Community Mental Health Center, Inc.	WV	Mental Health Counselor	$0	$16.7M
Mulberry Street Management Services, Inc.	WV	Case Management Agency	$0	$8.3M
Baymark Health Services Of West Virginia, Inc.	WV	Substance Use Disorder Rehabilitation Clinic/Center	$80.4K	$7.9M
Dr. Cynthia D. Parks Dds, PLLC	WV	Pediatric Dentistry	$0	$2.7M
West Virginia Choice	WV	Home Health Agency	$0	$2.2M

David Carlisle — Billing Profile & Reimbursement Data

Sign up for David Carlisle — Billing Profile & Reimbursement Data policy alerts

David Carlisle — Billing Profile & Reimbursement Data

Sign up for David Carlisle — Billing Profile & Reimbursement Data policy alerts

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