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

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

Heart Care Center, LLC (NPI 1982105458)

Field	Value
Entity Type	Organization
Organization	Heart Care Center, LLC
Address	450 N New Ballas Rd Ste 270
City	Saint Louis
State	MO
ZIP	63141
Taxonomy	Ambulatory Surgical Clinic/Center
NPI Enumerated	February 21, 2018

Payer Source	Total Paid
Medicare	$156.3K
Medicaid	$0

Medicare: Complete Services Breakdown

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

3 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
33228	The provider removes a previously placed pacemaker pulse generator from the patient and replaces it with a new one. The provider performs this procedure primarily for artificial regulation of heart…	20	$5,770	$86.5K
33285	The provider inserts a cardiac rhythm monitor with self–contained electrodes into a pocket in the tissues beneath the patient's skin and programs the device according to manufacturer’s directions.	10	$5,380	$64.5K
33286	The provider removes a cardiac rhythm monitor from a pocket in the tissues below the patient’s skin.	20	$250	$5.3K

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 3 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Missouri Distribution

Heart Care Center, LLC — 0 of 3 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Missouri

Full comparison — all codes billed, vs. state median

3 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
33285	17	30	20	$710	$12.1K
33228	9	30	10	$620	$9.2K
33286	2	10	20	$190	$3.4K

Heart Care Center, LLC — Billing Profile & Reimbursement Data

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Heart Care Center, LLC — 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