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

Why is the Medicaid comparison limited to Maryland 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. Maryland (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 Albertoli (NPI 1780686337)

Field	Value
Entity Type	Individual
Organization	James Albertoli
Address	56 Thomas Johnson Dr
City	Frederick
State	MD
ZIP	21702
Taxonomy	Plastic and Reconstructive Surgery Physician
NPI Enumerated	August 12, 2005

Payer Source	Total Paid
Medicare	$52.2K
Medicaid	$0

Medicare: Complete Services Breakdown

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

8 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	140	$120	$17K
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…	190	$70	$12.6K
14020	The provider repairs the defects in the patient’s scalp, arms, and/or legs by using healthy tissues from an adjacent site. This code represents services for defects of 10 cm2 or less.	20	$340	$6.8K
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…	20	$330	$5.3K
14000	In an adjacent tissue transfer (ATT) of the trunk, the provider transfers a skin part to another skin segment on the trunk. This code is for an ATT 10 cm2 in size or less.	10	$360	$4.3K
13132	The provider repairs a wound measuring 2.6 cm to 7.5 cm in size of the cheeks, chin, mouth, neck, axillae, genitalia, hands, and/or feet, which may require scar revision, debridement extensive…	20	$180	$3.7K
13121	This is for a complex repair of a wound to the scalp, arms, and/or legs. This wound should be 2.6 to 7.5 cm in size.	10	$140	$1.8K
64450	The provider injects an anesthetic agent, steroid, or both close to a peripheral nerve or branch not represented by another code. Report this code for one or more injections during a single procedure.	40	$20	$650

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 8 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Maryland Distribution

James Albertoli — 0 of 8 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Maryland

Full comparison — all codes billed, vs. state median

8 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
13132	38	50	80	$220	$21.4K
14040	18	20	20	$530	$20.7K
14020	10	10	30	$540	$17.4K
99213	3,039	9,280	100	$60	$12.5K
13121	50	60	30	$230	$12.2K
14000	8	10	20	$460	$10K
99204	474	5,380	40	$120	$7.3K
64450	19	70	20	$40	$3.1K

James Albertoli — Billing Profile & Reimbursement Data

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James Albertoli — 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