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

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

Shannon Setzer (NPI 1639355928)

Field	Value
Entity Type	Individual
Organization	Shannon Setzer
Address	4515 Valley Commons Dr Ste 202
City	Bozeman
State	MT
ZIP	59718
Taxonomy	Dermatology Physician
NPI Enumerated	January 16, 2008

Payer Source	Total Paid
Medicare	$487K
Medicaid	$0

Key Findings

This provider is effectively a Medicare-only practice: lifetime Medicare revenue is $487K and Medicaid revenue is none on file. The top 3 Medicare codes (17311, 77280, 77290) account for 40.6% of total Medicare revenue, indicating material dependence on a small set of services for a large share of billed dollars.

The code mix is consistent with a surgical dermatology practice that also bills for reconstructive closures and skin cancer procedures. High-revenue Mohs entries (17311 $109.7K, 17312 $31.2K, 17313 $14.8K) together with intermediate and complex repair codes (13132 $25.6K, 12032 $23.9K, 14041 $12.1K) point to substantial procedural volume focused on excision and reconstruction.

There is notable activity in photodynamic and topical-chemical therapies: J7308 ($20.5K) and 96567 ($5.4K) appear in the top-25, signaling routine use of aminolevulinic acid and photosensitizing treatments in the practice’s service mix. Coupled with frequent biopsy and destruction codes (11102 $15.2K, 17000 $15K, 17003 $7.3K), the billing profile reflects a breadth of therapeutic and procedural dermatology services.

Radiation-simulation codes contribute unexpectedly large shares of Medicare revenue: 77280 ($42.2K, 9.1%) and 77290 ($36.7K, 7.9%) are among the top revenue drivers and rank #330 of 3348 (90th percentile; "typical, unremarkable volume for this code") and #155 of 3650 (96th percentile; "typical, unremarkable volume for this code"), respectively. Their presence and elevated national percentiles suggest either integrated/co‑located radiation services or frequent coordination with radiation therapy pathways in the practice’s patient mix.

Competitive standing is mixed across procedure types: the largest single-code revenue driver 17311 ranks #1440 of 2969 (51th percentile; "typical, unremarkable volume for this code"), indicating modest national participation in Mohs relative to peers, while general office visits 99213 rank #32513 of 457151 (93th percentile; "typical, unremarkable volume for this code"), showing strong E/M throughput. Several reconstructive and excision codes sit at middle-to-high national percentiles (for example, 13132 at 79th percentile and 12032 at 92th percentile), illustrating localized strength in surgical repair.

No top codes are flagged with exceptional outlier labels in the supplied descriptions; most are annotated as "typical, unremarkable volume for this code" despite wide variation in percentiles. This pattern indicates the practice’s volumes are generally within expected national ranges, with specific relative strengths (e.g., 77290 at 96th percentile) rather than any single anomalous billing signal.

The provider has an established billing history with an NPI enumerated on 2008-01-16 (~18 years ago), which supports the interpretation of these patterns as mature practice behavior rather than a short-term data artifact. Given the long tenure, the absence of Medicaid billing is more likely a sustained operational choice or participation decision rather than a temporary gap, and it has implications for Medicaid network coverage and access in Bozeman, MT.

Medicare: Complete Services Breakdown

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

36 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…	240	$460	$109.7K
77280	The provider uses a simulator or other imaging modality to determine the size and location of ports to be used for radiation therapy. This code describes a simple level service.	200	$210	$42.2K
77290	Before starting radiation therapy, a physician needs to know the location and size of the cancerous tumor, the radiation doses required to treat the tumor, and the positioning of the radiation beams…	100	$360	$36.7K
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.	100	$330	$31.2K
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…	450	$60	$26.9K
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…	130	$200	$25.6K
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.	110	$230	$23.9K
J7308	Aminolevulinic acid HCl for topical administration, 20%, single unit dosage form (354 mg)	70	$300	$20.5K
11102	The provider biopsies a single skin lesion using a tangential (side–ways) approach; he shaves off the lesion or scoops it out with a knife or curette.	210	$70	$15.2K
17000	The provider destroys a premalignant lesion using techniques such as chemosurgery, cryosurgery, electrosurgery, or others. This code reports the destruction of the first or only lesion.	380	$40	$15K

Showing 1–10 of 36

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 36 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Montana Distribution

Shannon Setzer — 4 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Montana

Full comparison — all codes billed, vs. state median

36 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
17311	11	10	400	$390	$144.4K
G6001	5	10	380	$140	$61.5K
17312	9	10	150	$300	$52.6K
14040	3	10	20	$580	$44.9K
77280	4	20	40	$180	$28.9K
14060	8	10	30	$570	$20.1K
17313	6	10	40	$380	$16.2K
77401	4	10	360	$30	$14.6K
13132	3	10	40	$190	$14K
14041	2	10	20	$720	$12.9K

Showing 1–10 of 36

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Cary Chisholm	TX	Anatomic Pathology & Clinical Pathology Physician	$2.5M	$24.7K
Aaron Bruce	MT	Dermatology Physician	$682.7K	$0
Molly Buckland	MT	MOHS-Micrographic Surgery Physician	$420.2K	$0
Alyson Thede	MT	Dermatology Physician	$404.7K	$0
Cory Maughan	UT	MOHS-Micrographic Surgery Physician	$303.1K	$0
Dixon Robison	MT	Dermatology Physician	$253.9K	$49K
Logan Skelley	IA	MOHS-Micrographic Surgery Physician	$298.5K	$0
Latha Vellanki	AZ	Dermatology Physician	$289.4K	$0
Jonathan Bingham	MT	MOHS-Micrographic Surgery Physician	$243.6K	$0
Cassidy Juda	MT	Physician Assistant	$158.4K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Wojj Pediatric Dentistry	MT	Dental Clinic/Center	$0	$3.3M
Smiles Across Montana	MT	Dental Hygienist	$0	$1.9M
West Bozeman Surgery Center, LLC	MT	Ambulatory Surgical Clinic/Center	$1.9M	$55K
Psychiatry Associates PC	MT	Psychiatry Physician	$0	$1.4M
Marc Comaratta	MT	Retina Specialist (Ophthalmology) Physician	$1.2M	$124.7K
Foundation Therapy Services Inc	MT	Speech-Language Pathologist	$0	$1.1M
Lincare Inc.	MT	Durable Medical Equipment & Medical Supplies	$0	$1M
Montana Psychiatry, PLLC	MT	Psychiatry Physician	$0	$1M
Kenneth Olson	MT	Addiction Psychiatry Physician	$29.3K	$809.9K
Russell Swan	MT	Ophthalmology Physician	$560K	$0

Shannon Setzer — Billing Profile & Reimbursement Data

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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