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

Why is the Medicaid comparison limited to South 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. South 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.

Wesley Jones (NPI 1750300398)

Wesley Jones is a surgery physician provider located in Greenville, South Carolina. This profile covers 17 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	Wesley Jones
Address	890 W Faris Rd
City	Greenville
State	SC
ZIP	29605
Taxonomy	Surgery Physician
NPI Enumerated	July 18, 2006

Payer Source	Total Paid
Medicare	$80.9K
Medicaid	$0

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

17 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	60	$290	$16.9K
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…	300	$50	$14.2K
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	$330	$8.3K
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…	50	$130	$6.7K
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…	60	$100	$6K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	110	$60	$5.8K
47562	The provider removes the gallbladder through a laparoscope, a tubular instrument with a light source and camera inserted through the abdominal wall, to treat gallbladder disease.	10	$490	$5.4K
43275	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…	20	$220	$4.9K
36561	A central venous access catheter is a device that the physician inserts beneath the skin to draw blood or administer medication/nutrients to the patient. The catheter's tip must terminate in the…	20	$240	$3.6K
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…	40	$90	$3.3K

Showing 1–10 of 17

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99214	7,825	7,860	160	$80	$23.2K
43239	261	270	90	$120	$16.1K
99232	1,270	2,780	90	$60	$12K
43276	3	10	30	$340	$11.6K
43274	3	20	30	$310	$11.3K
99213	1,402	7,690	100	$60	$10.8K
99223	801	2,080	40	$130	$8.3K
47562	42	50	20	$450	$7.6K
36561	43	70	20	$310	$6.5K
99204	2,403	4,520	40	$110	$6.4K

Wesley Jones — Billing Profile & Reimbursement Data

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Wesley Jones — 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