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

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

Graham Appelbe (NPI 1811378235)

Field	Value
Entity Type	Individual
Organization	Graham Appelbe
Address	1330 Rockefeller Ave Ste 450
City	Everett
State	WA
ZIP	98201
Taxonomy	Gastroenterology Physician
NPI Enumerated	June 11, 2015

Payer Source	Total Paid
Medicare	$18.1K
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
43274	The physician performs an ERCP (a diagnostic procedure that combines upper endoscopy and retrograde (reverse or backward) injection of contrast material, a type of dye, into the biliary ducts to…	20	$320	$5.5K
43238	The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he carries out an ultrasound–guided, intramural or transmural fine needle…	20	$150	$3.3K
45385	The provider examines the colon and rectum using a colonoscope, a long, thin flexible tubular instrument with a light source and camera. He removes one or more tumors, polyps, or other lesions with a…	20	$140	$2.9K
43264	The provider performs a diagnostic procedure that combines upper endoscopy and retrograde (reverse) injection of contrast material, a type of dye, into the biliary ducts to obtain fluoroscopic images…	30	$90	$2.3K
43239	The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis.	50	$50	$2K
43237	The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum; he also inserts an ultrasound transducer through the scope to examine these same…	10	$120	$1.6K
74328	In this procedure, the provider performs imaging supervision and interpretation, S&I, for a separately reportable endoscopic biliary duct catheterization. The provider X–rays the biliary ducts during…	30	$20	$450
G0500	Moderate sedation services provided by the same physician or other qualified health care professional performing a gastrointestinal endoscopic service that sedation supports, requiring the presence…	10	$10	$130

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. Washington Distribution

Graham Appelbe — 0 of 8 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Washington

Full comparison — all codes billed, vs. state median

8 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
45385	277	380	70	$290	$31K
43274	27	30	30	$320	$11.3K
43239	97	370	60	$120	$9.3K
43238	5	20	20	$160	$3.8K
43264	23	40	30	$90	$3.6K
43237	13	20	20	$130	$3.1K
74328	19	30	30	$20	$780
G0500	166	120	50	$1	$330

Graham Appelbe — 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