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Top Procedures (performed greater than 10 times in year)
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Green highlighting indicates top quarter - Yellow highlighting indicates top half
Dollars | Ranking | ||||||||
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Procedure Code | Description | Loc*2 | Approved | Growth | Bill | Number | Repeat | US Ranking | Zip3 Ranking |
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Procedure Code | Description | Loc*2 | Approved | Growth | Billx | Number | Repeat | US Ranking | Zip3 Ranking |
*1 The Composite Ranking Score (CRS) is the weighted average percentile score for all procedure rankings for this provider, 0 to 100%. The score is calculated first for each procedure listed on the Provider Ranking by Procedure table, where, for example, 100% means no providers ranked higher, 92% means 8% ranked higher, and 45% means 55% ranked higher. Then these scores are averaged for all the procedures listed for a medical provider on the Provider Ranking by Procedure table, after weighting by approved dollars for that provider, in order to give weight to the procedures that are most significant for that provider. Then, to calculate the Ranking of CRS by Medical Specialty, the CRS percentile is ranked for all providers indicating the same medical specialty. The CRS may be displayed as a rounded percentile, but when ranking, the actual score is used, which is accurate to 4 digits.
Grade A+ is CRS>95, A is CRS>85, A- is CRS>80, B+ is CRS>75, B is CRS>65, B- is CRS>60, C+ is CRS> 55, C is CRS>45, C- is CRS>40, D+ is CRS>35, D is CRS>25, D- is CRS> 20, and F is the rest
*2 Location identifies whether the place of service is a facility (value of 'F') or non-facility (value of 'O'). Non-facility is generally an office setting. Medicare allowed reimbursement for a provider is very different (less) for the same procedure when performed in a facility, such as a hospital, as there is an additional hospital reimbursement, so each combination of Procedure code and Location are presented separately.
*3 The Merit-based Incentive Payment System (MIPS) Score (ranging from 0-100 points), is based on process measures for quality, communication (interoperability), cost, and improvement activities; the score is used by CMS to adjust reimbursement to a provider, with a score under 30 in 2019 resulting in up to 7% lower payment in 2021, and a score over 75 resulting in up to 7% higher payment.
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