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

Why is the Medicaid comparison limited to South Dakota 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. South Dakota (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.

John Wagener (NPI 1972879161)

Field	Value
Entity Type	Individual
Organization	John Wagener
Address	4520 W 69th St
City	Sioux Falls
State	SD
ZIP	57108
Taxonomy	Interventional Cardiology Physician
NPI Enumerated	April 1, 2012

Payer Source	Total Paid
Medicare	$352.5K
Medicaid	$0

Key Findings

JOHN WAGENER is an Interventional Cardiology Physician based in SIOUX FALLS, SD with an NPI enumerated 2012-04-01 (~14 years ago). His lifetime Medicare revenue on file is $352.5K, and there is no Medicaid billing on file, so this practice operates effectively as single‑payer (Medicare) in the available data.

Revenue is concentrated in a small set of high-value interventional and imaging codes: the top 3 Medicare codes by revenue — 33361 ($55.8K, 16.1%), 93306 ($43.1K, 12.5%), and 33418 ($35.6K, 10.3%) — together account for 38.9% of this provider's total Medicare revenue, indicating a focused procedural mix driving a large share of receipts.

The code mix signals a high-acuity structural and interventional service line: 33361 (TAVR percutaneous aortic valve replacement), 33418 (percutaneous mitral valve repair/placement), and multiple coronary angiography/stent and imaging codes (92928, 93458, 93460, 93459) show that the provider performs advanced transcatheter structural interventions and associated intraprocedural imaging and interpretation. Frequent echocardiography codes such as 93306 as well as transesophageal echocardiography (93312) support a workflow centered on procedure‑driven imaging.

On competitive standing for key services, the provider is a high-volume national performer for several leading codes: 33361 ranks #54 of 2679 providers nationally (98th percentile; notably above typical national volume), 93306 ranks #630 of 24624 (97th percentile; notably above typical national volume), and 92928 ranks #181 of 5112 (96th percentile; notably above typical national volume). These ranks indicate above‑typical throughput in TAVR, transthoracic echo, and percutaneous coronary intervention compared with national peers.

Some procedure and imaging codes are extreme outliers in activity relative to peers, highlighting procedural intensity: 93458 ranks #108 of 7990 (99th percentile; extreme outlier, far above typical national volume) and 99205 ranks #736 of 66257 (99th percentile; extreme outlier, far above typical national volume). The combination of high supervisory imaging activity (93458) and high‑complexity new patient E/M (99205) suggests both substantive procedural volumes and high complexity clinic intake.

Other structural/interventional codes are in more typical ranges nationally, which suggests selectivity in case mix: 33418 ranks #40 of 318 (86th percentile; typical, unremarkable volume), 33340 ranks #723 of 1552 (51th percentile; typical, unremarkable volume), and 33419 ranks #28 of 40 (26th percentile; typical, unremarkable volume). This pattern indicates the provider performs certain complex valve procedures at a measured frequency relative to the national distribution.

Ancillary and support services are also present at meaningful volumes: diagnostic EKG 93010 shows typical activity (551 claims, $3.3K revenue; ranks #7171 of 50616, 86th percentile; typical, unremarkable volume), while procedural sedation 99152 appears notably high (263 claims, $2.4K revenue; ranks #400 of 19266, 98th percentile; notably above typical national volume), consistent with frequent catheter‑based and imaging procedures requiring monitored sedation.

From a payer‑mix and operational risk perspective, the absence of any Medicaid billing on file combined with a total Medicare revenue of $352.5K and a 38.9% concentration in the top three codes indicates material dependence on a limited set of Medicare‑reimbursed procedures. For contracting and network planning, this profile denotes specialization in high‑acuity interventional cardiology largely monetized through Medicare rather than a broader mixed‑payer volume base.

Medicare: Complete Services Breakdown

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

33 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
33361	The provider uses a catheter to insert an aortic valve replacement through the lumen of a catheter, in a service known as TAVI or TAVR. This code is specific to inserting the valve using a…	110	$530	$55.8K
93306	The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent…	880	$50	$43.1K
33418	In this procedure, the provider repairs a narrowed and stiff mitral valve using a percutaneous (through the skin) approach. The mitral valve controls the passage of blood from the left atrium of the…	30	$1,270	$35.6K
92928	The provider inserts a catheter through the skin (percutaneous approach) and guides it into the heart's arteries. They deploy one or more stents (small tubes) to keep the artery open and may expand a…	90	$380	$33.6K
93458	In this procedure, the provider performs imaging supervision and interpretation for a coronary angiography with left heart catheterization and intraprocedural injections for left ventriculography. He…	170	$170	$29.8K
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…	160	$130	$21.4K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	270	$60	$16K
78452	In this procedure, the provider performs multiple SPECT studies of the heart to determine the areas of deficient blood flow. The goal of the procedure is to determine areas that have deficient blood…	260	$60	$14.7K
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…	150	$100	$14.1K
99214	The provider sees an established 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…	160	$60	$10.3K

Showing 1–10 of 33

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 33 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. South Dakota Distribution

John Wagener — 4 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — South Dakota

Full comparison — all codes billed, vs. state median

33 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
33361	1	10	60	$540	$30K
92928	4	20	70	$380	$27.7K
93306	8	60	250	$50	$21.4K
33418	1	10	30	$750	$20.4K
33340	7	10	40	$470	$16.1K
93458	3	30	40	$180	$11.9K
99214	543	1,660	90	$70	$11.4K
99232	117	570	80	$60	$9.2K
78452	8	40	140	$60	$8.6K
93580	1	10	10	$660	$7.9K

Showing 1–10 of 33

Related Providers

Other providers that share a Tax Identification Number (TIN) with John Wagener, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Sanford Medical Center Fargo	ND	Family Medicine Physician	$0	$75.9M
Sanford Medical Center	SD	Family Medicine Physician	$0	$68.8M
Avera Mckennan	SD	Family Medicine Physician	$0	$10.6M
Nathan Steinle	CA	Retina Specialist (Ophthalmology) Physician	$9.5M	$0
Avera Mckennan	SD	Psychiatry Physician	$0	$9.1M
Prema Abraham	SD	Retina Specialist (Ophthalmology) Physician	$7.1M	$0
Avera Mckennan	SD	Home Infusion Agency	$0	$6.7M
Avera Mckennan	SD	Air Ambulance	$0	$5.3M
Avera St Marys	SD	Multi-Specialty Clinic/Center	$0	$4.6M
Kyle Thompson	ID	Retina Specialist (Ophthalmology) Physician	$4.5M	$0

Nearby Providers

Other providers in the same ZIP code as John Wagener, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Vance Thompson Vision Surgery Center Prof LLC	SD	Ambulatory Surgical Clinic/Center	$4.5M	$22.7K
Siouxland Oral Surgery	SD	Oral and Maxillofacial Surgery (Dentist)	$0	$3.9M
Avera Home Medical Equipment, LLC	SD	Durable Medical Equipment & Medical Supplies	$0	$3.4M
Ryan Geraets	SD	Ophthalmology Physician	$3M	$0
Anderson-smith Speech Therapy, LLC	SD	Speech-Language Pathologist	$0	$1.9M
Ophthalmology Ltd Eye Surgery Center L L C	SD	Ambulatory Surgical Clinic/Center	$1.8M	$16.2K
Elizabeth Atchison	SD	Ophthalmology Physician	$1.7M	$0
Dakota Vision Center, LLC	SD	Optometrist	$0	$1.2M
Usc Ambulatory Surgical Center Prof LLC	SD	Ambulatory Surgical Clinic/Center	$1.1M	$44.2K
Avera Mckennan	SD	Physical Therapist	$0	$1M

John Wagener — Billing Profile & Reimbursement Data

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Key Findings

Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References