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

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

Gary Schwartz (NPI 1790758399)

Gary Schwartz is a nephrology physician provider located in Rochester, Minnesota. This profile covers 10 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	Gary Schwartz
Address	200 1st St Sw
City	Rochester
State	MN
ZIP	55905
Taxonomy	Nephrology Physician
NPI Enumerated	February 13, 2006

Payer Source	Total Paid
Medicare	$43.4K
Medicaid	$0

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

10 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…	250	$60	$15.8K
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…	90	$80	$7.2K
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	$90	$5.4K
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,…	110	$40	$4.5K
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…	30	$120	$3.8K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	30	$90	$2.5K
93784	The provider prescribes ambulatory blood pressure monitoring in which a patient wears a device continuously that automatically measures blood pressure at intervals over a period of 24 hours and…	70	$30	$2.4K
99442	N/A	20	$60	$930
99451	A consulting physician or other qualified healthcare professional performs a 5–minute or more consult via telephone, internet, or electronic health record (EHR) and provides a written report to the…	20	$30	$450
99211	An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.	20	$20	$340

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99214	5,552	10,100	70	$80	$8.1K
99215	2,197	4,060	30	$120	$5.9K
99213	350	9,120	50	$50	$4K
99204	1,194	3,340	20	$110	$3.6K
99203	156	2,690	20	$70	$2.3K
99442	274	420	20	$60	$1.4K
99212	42	1,670	20	$30	$1.2K
93784	1	10	20	$30	$930
99211	277	430	30	$10	$710
99451	81	160	20	$30	$610

Gary Schwartz — Billing Profile & Reimbursement Data

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Gary Schwartz — 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