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

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

Craig Dufresne (NPI 1972525392)

Field	Value
Entity Type	Individual
Organization	Craig Dufresne
Address	8501 Arlington Blvd Ste 420
City	Fairfax
State	VA
ZIP	22031
Taxonomy	Plastic and Reconstructive Surgery Physician
NPI Enumerated	July 24, 2006

Payer Source	Total Paid
Medicare	$28.8K
Medicaid	$0

Medicare: Complete Services Breakdown

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…	70	$80	$5.4K
11604	The provider excises a cancerous (malignant) lesion, including margins, of 3.1 to 4.0 cm in diameter, from the skin of the trunk, arms, or legs.	10	$280	$3.9K
12032	This CPT® code is used for the intermediate repair of wounds to the scalp, axillae, trunk and/or extremities (excluding hands and feet) that are 2.6 to 7.5 cm in size.	20	$190	$3K
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…	30	$100	$2.9K
11603	The provider excises a cancerous (malignant) lesion, including margins, of 2.1 to 3.0 cm in diameter, from the skin of the trunk, arms, or legs.	10	$240	$2.8K
11402	The provider excises a noncancerous lesion, excluding a skin tag, of 1.1 to 2.0 cm in diameter, including margins, from the skin of the trunk, arms, or legs.	20	$110	$2.5K
12031	This CPT® code is used for the intermediate repair of wounds to the scalp, axillae, trunk, and/or extremities (excluding hands and feet) that are 2.5 cm or less in size.	10	$190	$2.4K
11602	The provider excises a cancerous (malignant) lesion, including margins, of 1.1 to 2.0 cm in diameter, from the skin of the trunk, arms, or legs.	20	$150	$2.3K
11401	The provider excises a noncancerous lesion, excluding a skin tag, of 0.6 to 1.0 cm in diameter, including margins, from the skin of the trunk, arms, or legs.	20	$100	$2.1K
11442	The provider excises a benign (noncancerous) lesion including margins from the face, ears, eyelids, nose, lips, or mucous membrane that is 1.1 to 2.0 cm in diameter and also performs a simple…	10	$130	$1.5K

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 10 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Virginia Distribution

Craig Dufresne — 0 of 10 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Virginia

Full comparison — all codes billed, vs. state median

10 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
12032	153	190	30	$200	$12.6K
99213	7,261	12,440	90	$60	$10K
11604	23	30	20	$190	$4.6K
12031	34	50	20	$170	$4.4K
11602	126	150	30	$100	$4.4K
11603	92	100	20	$120	$4K
99203	2,595	4,920	30	$70	$3.8K
11442	5	10	20	$100	$2.8K
11401	7	20	20	$100	$2.5K
11402	15	60	20	$80	$1.7K

Craig Dufresne — 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