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

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

Michael Higgins (NPI 1982797916)

Field	Value
Entity Type	Individual
Organization	Michael Higgins
Address	3601 Tvc
City	Nashville
State	TN
ZIP	37232
Taxonomy	Anesthesiology Physician
NPI Enumerated	October 2, 2006

Payer Source	Total Paid
Medicare	$21.8K
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
00320	The provider performs anesthesia services for a patient undergoing any procedure on the esophagus, thyroid, larynx, trachea and lymphatic system of the neck when the patient is one year or older.	50	$100	$4.3K
00142	The provider performs anesthesia services for a patient undergoing an eye lens procedure.	90	$50	$4.1K
00140	The provider performs anesthesia services for a patient undergoing an eye procedure.	40	$70	$2.8K
00300	The provider performs anesthesia services for a patient undergoing any procedure on the integumentary system, muscles and nerves of head, neck, and posterior trunk.	30	$90	$2.7K
00145	The provider performs anesthesia services for a patient undergoing vitreoretinal surgery.	20	$100	$2K
00400	The provider performs anesthesia services for a patient undergoing any procedure on the integumentary system on the extremities, anterior trunk and perineum, not otherwise specified.	20	$80	$1.4K
00160	The provider performs anesthesia services for a patient undergoing procedures on the nose and accessory sinuses, hollow chambers in the skull that open into the nasal cavity. Use this code when there…	10	$110	$1.3K
00811	The provider performs anesthesia services for a patient undergoing an unspecified lower intestinal endoscopic procedure where the surgical provider introduces an endoscope into the intestines up to…	30	$50	$1.3K
00103	The provider performs anesthesia services for a patient undergoing a reconstructive procedure of eyelid such as blepharoplasty or ptosis surgery.	20	$70	$1.2K
00812	The provider performs anesthesia services for a patient undergoing a screening colonoscopy during which the surgical provider introduces an endoscope into the intestines below the duodenum, the part…	20	$40	$770

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. Tennessee Distribution

Michael Higgins — 1 of 10 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Tennessee

Full comparison — all codes billed, vs. state median

10 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
00142	130	530	40	$80	$7.4K
00145	46	80	30	$110	$3.8K
00811	366	840	20	$80	$3.3K
00103	49	90	20	$110	$3.1K
00320	11	70	20	$100	$2.7K
00812	233	400	20	$80	$2.6K
00140	17	80	20	$100	$2.5K
00160	19	30	10	$110	$2.1K
00300	4	100	10	$100	$1.7K
00400	30	100	20	$70	$1.2K

Michael Higgins — 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