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

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

James Waldorf (NPI 1780674606)

James Waldorf is a plastic surgery physician provider located in Jacksonville, Florida. This profile covers 12 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	James Waldorf
Address	4500 San Pablo Rd S
City	Jacksonville
State	FL
ZIP	32224
Taxonomy	Plastic Surgery Physician
NPI Enumerated	October 22, 2005

Payer Source	Total Paid
Medicare	$22.6K
Medicaid	$0

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

12 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	70	$50	$3.6K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	90	$40	$3.3K
11441	The provider excises a benign (noncancerous) lesion including margins from the face, ears, eyelids, nose, lips, or mucous membrane that is 0.6 to 1.0 cm in diameter and also performs a simple…	20	$100	$2.4K
12051	This CPT® code is used for the intermediate repair of wounds to the face, ears, eyelids, nose, lips, and/or mucous membranes that are 2.5 cm or less in size.	10	$190	$2.3K
99203	The provider sees a new 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 provider…	30	$80	$2.2K
11401	The provider excises a noncancerous lesion, excluding a skin tag, of 0.6 to 1.0 cm in diameter, including margins, from the skin of the trunk, arms, or legs.	20	$90	$2.1K
12032	This CPT® code is used for the intermediate repair of wounds to the scalp, axillae, trunk and/or extremities (excluding hands and feet) that are 2.6 to 7.5 cm in size.	10	$190	$2.1K
11641	The provider excises a cancerous (malignant) lesion, including margins, of 0.6 to 1.0 cm in diameter, from the skin of the face, ears, eyelids, nose, lips.	10	$140	$1.6K
11402	The provider excises a noncancerous lesion, excluding a skin tag, of 1.1 to 2.0 cm in diameter, including margins, from the skin of the trunk, arms, or legs.	10	$100	$1.3K
99202	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves straightforward medical decision making, and/or the provider…	20	$50	$890

Showing 1–10 of 12

James Waldorf — 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

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99213	16,485	30,010	80	$60	$12K
12032	595	600	40	$200	$11.3K
12051	73	90	20	$140	$4.5K
99203	7,291	11,720	40	$70	$4.4K
99212	1,562	6,920	40	$40	$2.9K
11641	36	40	20	$100	$2.7K
11402	249	310	20	$70	$2.3K
11440	17	20	20	$80	$1.9K
11401	22	80	20	$80	$1.8K
11441	1	10	20	$110	$1.8K