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

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

Troy Wagner (NPI 1790732204)

Troy Wagner is a surgical physician assistant provider located in Billings, Montana. This profile covers 11 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	Troy Wagner
Address	2900 12th Ave N
City	Billings
State	MT
ZIP	59101
Taxonomy	Surgical Physician Assistant
NPI Enumerated	May 28, 2006

Payer Source	Total Paid
Medicare	$19.6K
Medicaid	$0

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

11 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…	140	$40	$5.7K
23472	In this procedure, the provider performs a total shoulder arthroplasty in which the provider replaces the damaged head of the humerus and the glenoid cavity with prosthetic implants. The provider…	30	$160	$4K
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	$60	$3.7K
25447	The provider performs arthroplasty (joint replacement) of the intercarpal joints (between the small bones in the wrist) or carpometacarpal joints (where the carpal bones of the wrist meet the…	20	$90	$1.3K
20610	In this procedure, the provider inserts a needle through the skin of a patient and into a major joint or bursa and then uses the syringe attachment to the needle to remove fluid or he may inject a…	40	$30	$1.2K
20600	In this procedure, the provider inserts a needle through the skin of a patient and into a small joint or bursa and then uses the syringe attachment to the needle to remove fluid or he may inject a…	50	$20	$1.2K
20550	Aponeurosis is an abnormal sheet like extension of the tendon. Injection of a tendon or ligament is the medical therapeutic procedure to reduce the aponeurosis formation.	30	$20	$660
20605	In this procedure, the provider inserts a needle through the skin of a patient and into an intermediate joint or bursa and then uses the syringe attachment to the needle to remove fluid or he may…	20	$30	$630
25310	The provider transfers a tendon from one location in the forearm or wrist to another to replace a damaged or diseased tendon and restore motion of the hand.	10	$40	$490
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…	10	$40	$410

Showing 1–10 of 11

Troy Wagner — 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
23472	15	30	20	$720	$18.8K
99214	1,170	1,810	100	$70	$12.4K
25447	12	20	20	$490	$8.8K
99213	544	1,730	90	$50	$7.2K
20610	109	210	40	$40	$3.3K
25310	4	10	10	$200	$3.2K
99203	663	700	30	$70	$3.1K
99212	434	540	30	$30	$1.8K
20550	28	40	40	$40	$1.6K
20600	11	40	30	$30	$1.4K