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

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

Rachel Shapiro (NPI 1720488836)

Rachel Shapiro is a surgical physician assistant provider located in San Diego, California. This profile covers 11 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	Rachel Shapiro
Address	200 W Arbor Dr
City	San Diego
State	CA
ZIP	92103
Taxonomy	Surgical Physician Assistant
NPI Enumerated	August 26, 2014

Payer Source	Total Paid
Medicare	$25.9K
Medicaid	$0

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

11 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	230	$60	$14.6K
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…	90	$40	$3.9K
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…	20	$80	$1.7K
52000	In this procedure, the provider performs an examination of the interior of the bladder, the urethra, and the ureteric openings by means of a cystourethroscope, a thin flexible or rigid tube with a…	30	$50	$1.6K
52310	The provider performs a simple cystourethroscopy, the inspection of the interior of the bladder, the urethra, prostatic urethra, and ureteric openings using a cystoscope passed through the urethra…	20	$100	$1.6K
51729	In this procedure, the provider performs a complex cystometrogram along with voiding pressure studies and urethral pressure profile studies to diagnose certain urinary disorders like an overactive…	20	$80	$1.3K
51797	Voiding pressure (sometimes referred to as leak point pressure) measures contractions of the detrusor muscle and can detect a pressure obstruction if the patient is able to void, or express, urine.	20	$30	$460
51784	This test measures the electrical activity in the anal or urethral sphincter muscles.	20	$10	$220
51600	Voiding cystourethrogram (VCUG) is also known as micturating cystourethrogram (MCUG). This is a technique which is performed to detect reflux by watching a person's urethra and urinary bladder during…	20	$10	$200
74455	In this procedure, the provider performs imaging supervision and interpretation of a voiding urethrocystography. Providers order the procedure to identify and diagnose abnormalities in the voiding…	20	$10	$170

Showing 1–10 of 11

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99214	12,025	37,970	120	$90	$23.2K
52000	569	720	70	$180	$16K
99213	15,989	34,660	80	$70	$13.2K
51729	81	110	30	$300	$12.1K
99204	14,056	19,360	40	$120	$7.2K
51797	122	180	20	$150	$5.9K
52310	89	150	20	$240	$5.3K
51600	21	30	20	$70	$2.6K
51784	167	240	30	$30	$1.2K
51741	223	380	40	$10	$1K

Rachel Shapiro — Billing Profile & Reimbursement Data

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Rachel Shapiro — 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