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

Why is the Medicaid comparison limited to Puerto Rico 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. Puerto Rico (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.

Mpl Maxillofacial Surgery, Psc (NPI 1881984920)

Field	Value
Entity Type	Organization
Organization	Mpl Maxillofacial Surgery, Psc
Address	Carr 111 Km 18
City	San Sebastian
State	PR
ZIP	00685
Taxonomy	Oral and Maxillofacial Surgery (Dentist)
NPI Enumerated	April 11, 2011

Payer Source	Total Paid
Medicaid	$3.8M
Medicare	$0

Key Findings

This provider has no Medicare billing on file and reports $3.8M in lifetime Medicaid revenue, making its public payer footprint effectively single-payer Medicaid rather than a mixed Medicare/Medicaid operation. The absence of Medicare revenue suggests analyses of competitive standing and utilization should focus on Medicaid trends and state-level peer comparisons.

Revenue is highly concentrated in a small set of procedure codes: the precomputed top three Medicaid codes account for 91.5% of the provider's total Medicaid revenue. Specifically, D7210 accounts for $1.9M (48.7%), D7240 for $1.2M (31.8%), and D0160 for $425.7K (11.1%), indicating that a very small code set drives the majority of receipts.

The code mix signals a practice concentrated on operative oral surgery, particularly procedures consistent with complex extractions: D7210 (extraction requiring removal of bone and/or sectioning) is the largest single revenue driver. The prominence of D7210 alongside high revenue from D7240 and D0160 suggests the group operates primarily as an oral and maxillofacial surgery practice focused on surgical extractions and related operative services rather than routine preventive or restorative dentistry.

Competitive standing in-state is dominant for several high-volume codes: the provider ranks #1 of 99 for D7210 and is described as an "extreme outlier" at the 100th percentile, and it ranks #1 of 57 for D0160 (also 100th percentile, extreme outlier). D7240 ranks #2 of 26 in-state at the 96th percentile (notably above typical state volume), which together portray this entity as a major, possibly referral-centered provider for these specific surgical procedure lines.

Several secondary codes confirm a concentrated but somewhat broader service mix: D1999 contributes $129.8K (3.4%) and ranks #42 of 953 in-state at the 96th percentile (notably above typical), while D7220 ($111.9K, 2.9%) ranks #3 of 14 at the 85th percentile and is described as typical volume. These smaller revenue streams complement the core surgical extraction workload but do not materially diversify the provider’s Medicaid revenue base.

There is very limited utilization of comprehensive oral evaluations relative to surgical work: D0150 represents only $3.7K (0.1%) of Medicaid revenue and ranks #671 of 906 in-state (26th percentile), indicating the practice does not rely on new-patient comprehensive exams for revenue. This disparity between high surgical volume and low evaluation volume reinforces the interpretation of a specialized surgical referral practice rather than a general dental clinic.

The provider’s NPI was enumerated on 2011-04-11 (~15 years ago), indicating an established presence in the market; the combination of multi-year tenure and extreme-state-level volumes on select codes suggests the practice has built a sustained specialty referral pipeline for oral surgery procedures. Analysts should consider how longevity and local referral relationships could underlie the outsized code volumes observed.

Because Medicaid accounts for the entirety of reported public-payer revenue ($3.8M) and the top three codes concentrate 91.5% of that revenue, the provider has high payer- and code-concentration exposure. This profile implies sensitivity to state Medicaid reimbursement changes or policy shifts affecting those specific codes, so payer-level contract or policy changes could materially affect the practice’s revenue stream.

Medicaid: Complete Services Breakdown

Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.

7 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
D7210	Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth, and including elevation; includes related cutting of gingiva and bone, removal of tooth structure, minor smoothing of…	21,760	$90	$1.9M
D7240	N/A	7,030	$170	$1.2M
D0160	N/A	12,160	$40	$425.7K
D1999	N/A	8,650	$20	$129.8K
D7220	N/A	900	$130	$111.9K
D0330	N/A	2,500	$30	$79.9K
D0150	Comprehensive oral evaluation – new or established patient	150	$20	$3.7K

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other Puerto Rico providers billing the same CPT/HCPCS codes.

Claims Volume vs. Puerto Rico Distribution

Mpl Maxillofacial Surgery, Psc — 4 of 7 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Puerto Rico

Full comparison — all codes billed, vs. Puerto Rico median

7 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
D7240	N/A	2	30	980	$170	$378.3K
D7210	Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth, and including elevation; includes related cutting of gingiva and bone, removal of tooth structure, minor smoothing of…	1	100	150	$80	$83K
D0160	N/A	1	60	330	$40	$60.4K
D7220	N/A	3	10	180	$120	$56.8K
D1999	N/A	42	950	1,350	$10	$35.1K
D0330	N/A	53	540	370	$30	$25.3K
D0150	Comprehensive oral evaluation – new or established patient	671	910	540	$20	$18.1K

Nearby Providers

Other providers in the same ZIP code as Mpl Maxillofacial Surgery, Psc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Jose Rabell	PR	General Practice Dentistry	$0	$3.1M
Laboratorio Clinico Lebron, Inc.	PR	Clinical Medical Laboratory	$600	$1.9M
Centro De Diagnostico Y Tratamiento De San Sebastian Inc	PR	Diagnostic Radiology Physician	$0	$1.9M
Lexmayris Ambulance, Inc.	PR	Land Ambulance	$30.4K	$1.5M
Laboratorio Clinico Irizarry Guasch Inc	PR	Clinical Medical Laboratory	$0	$1.5M
Centro Familiar De Servicios Dentales, Csp	PR	Dentist	$0	$1.3M
Centro De Diagnostico Y Tratamiento De San Sebastian Inc	PR	Health Service Clinic/Center	$0	$1.2M
Stepbysteptherapygroup	PR	Hearing and Speech Clinic/Center	$0	$922.6K
Nicole Quintana	PR	General Practice Dentistry	$0	$886.6K
Confesor Lasalle-ruiz	PR	Cardiovascular Disease Physician	$1.7K	$876.5K

Mpl Maxillofacial Surgery, Psc — Billing Profile & Reimbursement Data

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Mpl Maxillofacial Surgery, Psc — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References