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

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

Payton Schmidt (NPI 1760895973)

Field	Value
Entity Type	Individual
Organization	Payton Schmidt
Address	1500 E Medical Center Dr
City	Ann Arbor
State	MI
ZIP	48109
Taxonomy	Obstetrics & Gynecology Physician
NPI Enumerated	June 5, 2014

Payer Source	Total Paid
Medicare	$11.6K
Medicaid	$0

Medicare: Complete Services Breakdown

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

5 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…	60	$70	$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	$3.5K
64566	In this procedure, the provider applies electrical stimulation to the posterior tibial nerve by inserting a needle electrode through the skin.	90	$20	$2.1K
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…	40	$40	$1.9K
57160	In this procedure, the provider fits and inserts a pessary or similar device into the vagina to treat vaginal wall prolapse or other disorders.	20	$30	$460

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 5 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Michigan Distribution

Payton Schmidt — 0 of 5 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Michigan

Full comparison — all codes billed, vs. state median

5 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99214	9,716	15,470	80	$80	$11.4K
99213	9,171	14,810	60	$60	$6.6K
64566	9	30	60	$50	$4.4K
99204	2,140	6,280	30	$110	$4.2K
57160	21	30	30	$50	$1.5K

Payton Schmidt — Billing Profile & Reimbursement Data

Sign up for Payton Schmidt — Billing Profile & Reimbursement Data policy alerts

Payton Schmidt — Billing Profile & Reimbursement Data

Sign up for Payton Schmidt — 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