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

Why is the Medicaid comparison limited to North Carolina 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. North Carolina (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.

Malcolm Branch (NPI 1639252877)

Malcolm Branch is a gastroenterology physician provider located in Durham, North Carolina. This profile covers 9 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	Malcolm Branch
Address	Duke University Medical Ctr
City	Durham
State	NC
ZIP	27710
Taxonomy	Gastroenterology Physician
NPI Enumerated	October 23, 2006

Payer Source	Total Paid
Medicare	$24.7K
Medicaid	$0

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

9 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
43276	Endoscopic retrograde cholangiopancreatography (ERCP) is endoscopic inspection of the duodenum, the papilla of vater, followed by radiologic assessment of the pancreatic duct and the biliary…	30	$300	$8.1K
43274	The physician performs an ERCP (a diagnostic procedure that combines upper endoscopy and retrograde (reverse or backward) injection of contrast material, a type of dye, into the biliary ducts to…	30	$270	$7.6K
43264	The provider performs a diagnostic procedure that combines upper endoscopy and retrograde (reverse) injection of contrast material, a type of dye, into the biliary ducts to obtain fluoroscopic images…	30	$110	$3K
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…	10	$100	$1.4K
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…	10	$100	$1.2K
74328	In this procedure, the provider performs imaging supervision and interpretation, S&I, for a separately reportable endoscopic biliary duct catheterization. The provider X–rays the biliary ducts during…	70	$20	$1.1K
43262	The provider performs an endoscopic retrograde cholangiopancreatography (ERCP), a diagnostic procedure that combines upper endoscopy and retrograde (reverse) injection of contrast material, a type of…	10	$80	$1.1K
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…	10	$70	$880
74360	The provider performs imaging supervision and interpretation, or S&I, for a separately reportable procedure where a provider inserts a balloon dilator into a patient's esophagus to ease an esophageal…	20	$20	$320

Malcolm Branch — Billing Profile & Reimbursement Data

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Malcolm Branch — 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
99214	17,773	18,060	110	$80	$15.1K
43274	11	40	20	$310	$8.3K
43276	3	10	20	$320	$7.9K
99204	7,714	8,430	30	$110	$4.8K
99222	2,670	3,340	20	$90	$3.3K
43264	17	50	20	$100	$3K
43262	12	20	20	$40	$790
74328	4	40	20	$20	$580
74360	5	10	20	$20	$380