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

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

Marcia Canto (NPI 1992763015)

Marcia Canto is a gastroenterology physician provider located in Baltimore, Maryland. This profile covers 10 Medicare and 0 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Provider details (source: NPPES NPI Registry)

Medicare: Complete Services Breakdown

Field	Value
Entity Type	Individual
Organization	Marcia Canto
Address	600 N Wolfe St
City	Baltimore
State	MD
ZIP	21287
Taxonomy	Gastroenterology Physician
NPI Enumerated	May 1, 2006

Payer Source	Total Paid
Medicare	$78.7K
Medicaid	$0

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

10 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
43259	An esophagogastroduodenoscopy is a procedure to view the esophagus, stomach, and duodenum by means of flexible endoscope through the mouth. During this procedure, the physician uses endoscopic…	140	$180	$25.5K
43239	The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis.	240	$80	$19K
45385	The provider examines the colon and rectum using a colonoscope, a long, thin flexible tubular instrument with a light source and camera. He removes one or more tumors, polyps, or other lesions with a…	40	$210	$9.2K
43270	An esophagogastroduodenoscopy (EGD) is a procedure to view the esophagus, stomach, and duodenum by means of flexible endoscope passed through the mouth. During the EGD, the provider passes guidewires…	40	$180	$6.7K
43242	The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where, under endoscopic ultrasound guidance, he carries out a fine needle aspiration or…	30	$220	$6K
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…	40	$100	$3.6K
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…	20	$130	$3K
99215	The provider sees an established 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…	20	$140	$3K
G0105	Colorectal cancer screening; colonoscopy on individual at high risk	10	$150	$1.7K
45380	The provider examines the rectum and colon using a flexible colonoscope, a tubular instrument with a light source and camera, to look for the cause of a patient's symptoms, which may include…	10	$90	$1.1K

Marcia Canto — 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

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
45385	244	360	80	$310	$35.6K
45380	358	370	70	$220	$26.4K
99214	8,441	10,270	150	$90	$24.1K
43239	38	380	80	$140	$17.7K
G0105	211	220	30	$300	$17.3K
99215	3,077	4,070	50	$120	$10.9K
43242	8	20	30	$200	$7.4K
99204	3,691	5,380	40	$120	$7.3K
43259	1	20	30	$170	$6.6K
43270	2	10	20	$170	$4.1K