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

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

C & S Medical, LLC (NPI 1780624171)

Field	Value
Entity Type	Organization
Organization	C & S Medical, LLC
Address	537 Stanton Christiana Rd
City	Newark
State	DE
ZIP	19713
Taxonomy	Ambulatory Surgical Clinic/Center
NPI Enumerated	June 7, 2006

Payer Source	Total Paid
Medicare	$1.4M
Medicaid	$0

Key Findings

C & S MEDICAL, LLC reports total Medicare revenue of $1.4M and has no Medicaid billing on file, making its commercial payer footprint effectively single-payer Medicare in the available data. This concentration means the sample here reflects Medicare-only activity rather than a mixed Medicaid/Medicare practice profile.

Revenue is highly concentrated in a small set of reconstructive codes: the precomputed top three codes (14301, 14041, 15572) account for 46.3% of the provider’s total Medicare revenue. Those three appear as 14301 $333.8K (24.5%), 14041 $174.6K (12.8%), and 15572 $122.2K (9.0%), signaling dependence on a narrow set of high-value procedures.

The CPT mix indicates a specialty ambulatory reconstructive/plastic surgery operation focused on skin grafts, local tissue rearrangement, and flap procedures rather than general outpatient care. High-volume procedure codes with substantial revenue include 15004 (792 claims, $99.8K) for graft site preparation and multiple adjacent-tissue transfer codes (14301, 14041, 15002, 15004), consistent with an ASC-style practice performing complex soft-tissue reconstruction on an ambulatory basis.

C & S MEDICAL is a national outlier on several specific reconstructive codes: 14301 ranks #4 of 1015 (100th percentile; extreme outlier), 14041 ranks #5 of 1009 (100th percentile; extreme outlier), and 15004 ranks #1 of 495 (100th percentile; extreme outlier). These rankings indicate the provider is far above typical national volume for multiple high-revenue reconstructive procedures and competes at an unusually high level on those CPTs.

Not all billed services are extreme outliers — some codes show typical or modest national standing, which suggests breadth across reconstructive procedure types rather than uniform dominance. Examples include 21235 ($39.9K; rank #11 of 79, 86th percentile; typical, unremarkable) and 13132 ($22.8K; rank #834 of 3088, 73th percentile; typical, unremarkable), reflecting a mix of both unusually high-volume specialties and more routine reconstructive repairs.

Operational throughput appears substantial for certain ambulatory procedures: 15004 has 792 claims and 14301 has 280 claims, while 14041 has 269 claims, indicating sustained procedural volume rather than one-off high payments. This claim-level activity supports interpretation of the site as a high-volume ambulatory surgical clinic for skin/soft-tissue reconstruction.

Payer risk is concentrated in Medicare given the absence of Medicaid billing; any shifts in Medicare coverage, reimbursement rates, or utilization management for skin grafts and flap procedures could materially affect the practice’s reported revenue. Analysts should treat Medicaid exposure as effectively zero in this dataset and focus competitive and policy sensitivity analyses on Medicare.

The provider’s NPI was enumerated on 2006-06-07 (approximately ~20 years ago), indicating long-standing enrollment that could reflect established referral relationships or an enduring ambulatory surgical presence in Newark, DE. Tenure combined with the high national rankings on specific CPTs strengthens the interpretation of a specialized, high-throughput reconstructive surgery center rather than a transient or low-volume provider.

Medicare: Complete Services Breakdown

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

39 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
14301	The provider replaces the lesions in any area with the healthy tissues from an adjacent site. This code represents a defect of 30.1 cm2 to 60.0 cm2.	280	$1,190	$333.8K
14041	The provider replaces the lesions in the forehead, cheeks, chin, mouth, neck, axillae or armpits, genitalia, hands, or feet with the healthy tissues from an adjacent site. This code represents a…	270	$650	$174.6K
15572	The provider prepares a direct or tubed pedicle skin flap with the patient’s healthy skin and tissue to cover an injury or wound on the body. The provider may or may not transfer the flap to the…	120	$1,010	$122.2K
15004	The provider prepares the skin of a body part with an open wound, burn eschar, or scar contracture to receive a skin graft. This procedure helps in repairing areas of the face, scalp, eyelids, mouth,…	790	$130	$99.8K
15002	The provider incises the skin of a body part with an open wound, burn eschar, or scar contracture to prepare the site to receive a skin graft. This procedure helps in repairing an area of the trunk,…	180	$500	$88.1K
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.	110	$660	$72.7K
14040	The provider repairs lesions in the patient’s forehead, cheeks, chin, mouth, neck, axillae or armpits, genitalia, hands, and/or feet by using healthy tissues from an adjacent site. This code…	110	$590	$64K
14021	The provider repairs lesions in the patient’s scalp, arms, or legs by using the healthy tissues from an adjacent site. This code represents a defect of 10.1 cm2 to 30.0 cm2.	120	$470	$55.3K
14061	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 10.1 cm2 to 30.0 cm2 in size.	70	$620	$45.2K
21235	The provider applies autogenous cartilage graft, taken from the patient’s own ear, to the nose or ear, to repair deformity due to fracture, injury, tumor resection, or congenital defect.	20	$1,740	$39.9K

Showing 1–10 of 39

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 39 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Delaware Distribution

C & S Medical, LLC — 8 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Delaware

Full comparison — all codes billed, vs. state median

39 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
14301	1	10	50	$900	$89.4K
15572	2	10	130	$660	$82.2K
15823	6	10	60	$550	$60.3K
14041	1	10	40	$630	$42.1K
15004	1	10	220	$170	$41.8K
15002	2	10	180	$320	$41.3K
14021	1	10	40	$540	$28.9K
14040	2	10	40	$540	$28K
21235	2	10	30	$800	$24.1K
15731	2	10	20	$930	$22.3K

Showing 1–10 of 39

Nearby Providers

Other providers in the same ZIP code as C & S Medical, LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Associated Retinal Consultants LLC	DE	Ophthalmology Physician	$0	$25.2M
Columbus Medical Services, LLC	DE	Case Management Agency	$0	$18.7M
Christiana Care Health Services Inc	DE	Hospitalist Physician	$0	$13.6M
Caritas Home Health Services, Inc	DE	Home Health Agency	$0	$11.2M
Delaware Center For Maternal Fetal Medicine Of Christiana Care	DE	Maternal & Fetal Medicine Physician	$0	$9.8M
Christiana Care Health Services Inc	DE	Neonatal-Perinatal Medicine Physician	$0	$8.9M
Medical Oncology Hematology Consultants PA	DE	Hematology & Oncology Physician	$0	$7.7M
Christiana Care Quality Partners	DE	Urgent Care Clinic/Center	$0	$7M
Jamal Misleh	DE	Hematology & Oncology Physician	$6.8M	$0
Mid-atlantic Behavioral Health, LLC	DE	Intellectual & Developmental Disabilities Psychologist	$0	$6.5M

C & S Medical, LLC — Billing Profile & Reimbursement Data

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C & S Medical, LLC — 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

Nearby Providers

Frequently Asked Questions

References