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

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

Sandra Culbertson (NPI 1962419788)

Field	Value
Entity Type	Individual
Organization	Sandra Culbertson
Address	100 N Academy Ave
City	Danville
State	PA
ZIP	17822
Taxonomy	Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
NPI Enumerated	August 2, 2006

Payer Source	Total Paid
Medicare	$21.1K
Medicaid	$0

Medicare: Complete Services Breakdown

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

7 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	50	$100	$5.4K
57288	The provider places a sling made of fascia or synthetic material under the urethra to support it in the correct position to treat urinary stress incontinence. The procedure can be performed…	10	$410	$4.9K
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…	80	$50	$4.4K
57283	The provider pulls up the vaginal vault that is prolapsing using a vaginal approach and attaches it to a ligament inside the peritoneal lining.	10	$300	$3.2K
51725	A cystometer measures the bladder's capacity, or bladder pressure. It evaluates the contraction and expulsion activities of the bladder, and is used to diagnose certain urinary disorders.	30	$110	$2.9K
51798	Providers perform this ultrasound to measure the volume of residual urine in the bladder.	60	$10	$390
81003	The lab analyst inserts a dip stick into a freshly collected urine specimen, removes the dipstick, and shakes off the excess urine. She places the stick onto a mechanical dip stick reader that will…	40	$1	$80

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 7 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Pennsylvania Distribution

Sandra Culbertson — 0 of 7 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Pennsylvania

Full comparison — all codes billed, vs. state median

7 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
57288	27	30	20	$440	$9.6K
99213	9,789	22,370	70	$60	$7.7K
99204	2,650	10,290	30	$110	$5K
57283	3	10	10	$320	$4.2K
51725	4	10	30	$110	$3.2K
51798	341	500	100	$10	$1.4K
81003	394	1,510	20	$1	$190

Sandra Culbertson — Billing Profile & Reimbursement Data

Sign up for Sandra Culbertson — Billing Profile & Reimbursement Data policy alerts

Sandra Culbertson — Billing Profile & Reimbursement Data

Sign up for Sandra Culbertson — 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