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

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

Rachel Forbes (NPI 1871640755)

Field	Value
Entity Type	Individual
Organization	Rachel Forbes
Address	3601 The Vanderbilt Clinic
City	Nashville
State	TN
ZIP	37232
Taxonomy	Transplant Surgery Physician
NPI Enumerated	January 4, 2007

Payer Source	Total Paid
Medicare	$58.9K
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
50360	The provider transplants a kidney and ureter from a cadaver or living donor into a recipient. The provider does not remove a kidney (nephrectomy) from the recipient.	30	$1,680	$43.6K
99231	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a straightforward or low level of medical…	130	$40	$4.7K
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…	20	$100	$2.5K
50323	The provider makes a donor kidney, from a cadaver, ready for transplantation through a standard back table preparation.	30	$80	$2.1K
49422	The provider removes an existing tunneled intraperitoneal catheter that a provider uses to drain a recurrent accumulation of fluid in the abdomen.	20	$120	$2K
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	10	$130	$1.5K
99205	The provider sees a new 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 provider…	10	$120	$1.4K
50327	The provider performs backbench venous reconstruction to extend the renal vein on a kidney from either a cadaver or living donor prior to transplantation.	10	$90	$1.1K

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. Tennessee Distribution

Rachel Forbes — 0 of 8 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Tennessee

Full comparison — all codes billed, vs. state median

8 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
50360	4	20	20	$1,360	$30K
99215	1,764	2,710	40	$110	$8.3K
99223	3,045	3,130	40	$120	$8K
99205	1,149	1,300	20	$140	$4.9K
99231	155	1,110	40	$40	$3.1K
49422	2	10	10	$110	$1.6K
50323	2	20	20	$70	$1.5K
50327	1	10	10	$80	$1.1K

Rachel Forbes — Billing Profile & Reimbursement Data

Sign up for Rachel Forbes — Billing Profile & Reimbursement Data policy alerts

Rachel Forbes — Billing Profile & Reimbursement Data

Sign up for Rachel Forbes — Billing Profile & Reimbursement Data policy alerts

Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Frequently Asked Questions

References