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

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

Raj Patel (NPI 1720379712)

Field	Value
Entity Type	Individual
Organization	Raj Patel
Address	615 1st St N
City	Alabaster
State	AL
ZIP	35007
Taxonomy	MOHS-Micrographic Surgery Physician
NPI Enumerated	April 25, 2011

Payer Source	Total Paid
Medicare	$2.7M
Medicaid	$0

Key Findings

This provider is effectively a single-payer Medicare operator: lifetime Medicare revenue is $2.7M and there is no Medicaid billing on file, indicating the practice’s payer mix is concentrated entirely in Medicare rather than dual Medicaid/Medicare volume. Analysts should treat this profile as Medicare-centric when evaluating demand, contracting, or network impact in AL.

Revenue concentration is high and focused: the precomputed top 3 Medicare codes account for 73.4% of the provider’s total Medicare revenue, indicating that a small group of procedure/add-on codes drives most of the $2.7M lifetime Medicare receipts. This concentration suggests the practice’s financial performance is sensitive to utilization or reimbursement changes for those few codes.

The single largest Medicare revenue contributor is Q4194, which generated $1.4M and represents 49.8% of total Medicare revenue; the provider ranks #3 of 69 nationally for this code and is in the 97th percentile. This indicates the practice is a national-level high-volume user of Q4194 (Novachor per cm2 add-on), implying a business model heavily centered on Mohs-related or reconstructive product add-on billing.

Primary Mohs surgery CPTs are core to the practice: 17311 ($387.6K, 14.2% of Medicare revenue), 17313 ($153K, 5.6%), and 17312 ($138.7K, 5.1%) together reflect extensive Mohs procedural volume and staging. Several Mohs CPTs rank at or near extreme outlier percentiles (17313 at 99th percentile; 17311 at 96th), confirming the provider operates at a volume well above typical national peers for Mohs surgery.

In addition to Mohs codes and add-on products, the provider shows unusually high volume in complex repair and closure codes: 13132 ($96.1K, 3.5%), 13121 ($86K, 3.2%), and related complex repair codes all rank at or near the 100th percentile nationally. This pattern indicates a full-service Mohs and reconstruction practice that performs a high rate of secondary repairs and complex closures following tumor extirpation.

The competitive standing is a mix of national prominence on specific lines and otherwise routine activity: the provider is a dominant national outlier for several codes (e.g., Q4194 rank #3/69, 17313 99th percentile, 13132 100th percentile), while common office/outpatient E/M and some excision codes show unremarkable volumes (e.g., 99213 at the 37th percentile). This suggests market-leading specialization in Mohs and reconstruction rather than broad general dermatology throughput.

Tenure is substantial: the NPI was enumerated on 2011-04-25 (~15 years ago), indicating an established practice presence in AL. This length of service supports the high accumulated volume in specialized procedures and the buildup of the concentrated revenue base seen in the Medicare data.

Several product-addition and skin substitute codes show notable utilization: Q4197 ($256.3K, 9.4%) ranks in the 74th percentile and 15275 ($26.5K, 1.0%) ranks in the 97th percentile, indicating routine use of specialized grafts and topical/biologic add-ons in the practice’s cases. These code patterns are consistent with a Mohs-centered surgical workflow that frequently requires adjunctive materials and reconstruction aids.

Medicare: Complete Services Breakdown

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

33 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
Q4194	Novachor, per square centimeter (add-on, list separately in addition to primary procedure)	1,680	$810	$1.4M
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…	880	$440	$387.6K
Q4197	Puraply xt, per square centimeter (add-on, list separately in addition to primary procedure)	2,050	$130	$256.3K
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.	350	$440	$153K
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.	470	$300	$138.7K
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…	540	$180	$96.1K
13121	This is for a complex repair of a wound to the scalp, arms, and/or legs. This wound should be 2.6 to 7.5 cm in size.	440	$200	$86K
13101	This is for a complex repair of a wound to the trunk. This wound should be 2.6 to 7.5 cm in size.	180	$230	$40.8K
17314	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.	130	$290	$36.8K
14060	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 cm2 or less.	50	$550	$27.6K

Showing 1–10 of 33

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 33 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Alabama Distribution

Raj Patel — 11 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Alabama

Full comparison — all codes billed, vs. state median

33 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
Q4194	2	10	400	$810	$767.7K
Q4197	2	10	1,160	$130	$156.6K
17311	4	40	290	$400	$152.5K
17313	2	40	80	$390	$47.1K
17312	2	40	130	$290	$46.3K
14061	7	20	20	$660	$21.7K
13132	1	50	70	$190	$20.7K
14041	5	20	20	$610	$18.9K
99214	7,099	7,330	120	$80	$16.8K
14060	3	30	30	$520	$15.6K

Showing 1–10 of 33

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Scott Freeman	AL	MOHS-Micrographic Surgery Physician	$2.9M	$0
John Chapman	LA	MOHS-Micrographic Surgery Physician	$1.5M	$0
Vernon Forrester	AL	MOHS-Micrographic Surgery Physician	$1.3M	$0
Christopher Harmon	AL	MOHS-Micrographic Surgery Physician	$1.1M	$0
Brian King	AL	MOHS-Micrographic Surgery Physician	$998.5K	$0
Tarek Fakhouri	TX	Dermatology Physician	$806.6K	$0
Evans Bailey	AL	MOHS-Micrographic Surgery Physician	$780.1K	$0
Jonathan Cappel	AL	Procedural Dermatology Physician	$764.8K	$0
Joshua Eickstaedt	NC	MOHS-Micrographic Surgery Physician	$532K	$0
Lynn Cooper	GA	Anatomic Pathology & Clinical Pathology Physician	$466.9K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Shelby Oral Facial Surgery PC	AL	Oral & Maxillofacial Surgery (D.M.D.)	$0	$4M
Bbh Sbmc, LLC	AL	General Acute Care Hospital	$0	$3.5M
Lauri M. Williams, Dmd, PC	AL	Pediatric Dentistry	$0	$2.4M
Cytopath PC	AL	Anatomic Pathology & Clinical Pathology Physician	$77.9K	$1.4M
Warrior Wellness Group	AL	Professional Counselor	$0	$1M
Alabaster Pediatrics LLC	AL	Pediatrics Physician	$0	$1M
Nopporn Unnoppet	AL	Rheumatology Physician	$559.5K	$0
David Fieno	AL	Cardiovascular Disease Physician	$559.2K	$0
Clifton Vance	AL	Cardiovascular Disease Physician	$497.1K	$0
Shelby Baptist Ambulatory Surgery Center, LLC	AL	Ambulatory Surgical Clinic/Center	$470.2K	$0

Raj Patel — 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