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

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

Marie Gerhard-herman (NPI 1720045180)

Marie Gerhard-herman is a cardiovascular disease physician provider located in Boston, Massachusetts. This profile covers 13 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	Marie Gerhard-herman
Address	Brigham And Womens Hospital
City	Boston
State	MA
ZIP	02115
Taxonomy	Cardiovascular Disease Physician
NPI Enumerated	April 28, 2006

Payer Source	Total Paid
Medicare	$63.8K
Medicaid	$0

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

13 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	100	$120	$11.8K
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	80	$140	$10.5K
99205	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the provider…	60	$140	$9.1K
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…	90	$100	$9K
93010	The provider interprets and reports on the results of a routine 12–lead (or more) electrocardiogram.	1,180	$10	$8.2K
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…	60	$80	$4.8K
93970	The provider performs an ultrasound scanning procedure called a duplex scan to characterize the pattern and direction of blood flow in extremity veins (arms or legs). This is a complete, bilateral…	120	$30	$3.2K
93790	The provider prescribes ambulatory blood pressure monitoring in which a patient wears a device continuously that automatically measures blood pressure at intervals over 24 hours and records the…	160	$10	$2.2K
93971	The provider performs an ultrasound scanning procedure called a duplex scan to characterize the pattern and direction of blood flow in extremity veins (arm or leg). This is a unilateral or limited…	110	$20	$1.8K
93880	Duplex scanning of arteries for the evaluation of blood flow is a type of non–invasive vascular diagnostic process. A physician can visualize and selectively assess the flow patterns of peripheral…	60	$30	$1.7K

Showing 1–10 of 13

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99214	10,114	15,410	110	$80	$15.6K
99233	1,675	4,170	70	$100	$12.6K
99215	1,303	6,360	40	$120	$8.9K
99223	876	4,430	30	$140	$7.6K
93880	162	360	50	$70	$6.1K
99205	303	2,430	30	$160	$5.5K
93010	168	1,110	230	$10	$3.6K
93923	73	140	30	$50	$2.5K
93926	71	100	30	$60	$2.4K
93970	36	490	30	$50	$2.1K

Marie Gerhard-herman — Billing Profile & Reimbursement Data

Sign up for Marie Gerhard-herman — Billing Profile & Reimbursement Data policy alerts

Marie Gerhard-herman — Billing Profile & Reimbursement Data

Sign up for Marie Gerhard-herman — Billing Profile & Reimbursement Data policy alerts

Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Frequently Asked Questions

References