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    v1.0.28
    OpenPayerNPI Medicare & MedicaidMichael Avallone
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    Michael Avallone — Billing Profile & Reimbursement Data

    NPI 1013273036 · Santa Maria, CA · Urology Physician

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    Michael Avallone is a urology physician provider located in Santa Maria, California. This profile covers 39 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.

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    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeIndividual
    OrganizationMichael Avallone
    Address116 S Palisade Dr Ste 110
    CitySanta Maria
    StateCA
    ZIP93454
    TaxonomyUrology Physician
    NPI EnumeratedApril 3, 2012

    Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)

    Payer SourceTotal Paid
    Medicare$502.8K
    Medicaid$0

    Medicare: Total Revenue Breakdown by CPT/HCPCS Code

    Medicare revenue breakdown by CPT/HCPCS procedure code.

    View: Bar Chart1 / 2

    Medicare: Complete Services Breakdown

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

    39 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    99214The 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…1,610$100$154.8K
    J9217Leuprolide acetate (for depot suspension), 7.5 mg380$130$49.5K
    J0897Injection, denosumab, 1 mg2,520$20$47.9K
    99213The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…680$70$46K
    52000In this procedure, the provider performs an examination of the interior of the bladder, the urethra, and the ureteric openings by means of a cystourethroscope, a thin flexible or rigid tube with a…220$200$43.5K
    99204The 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…250$110$28K
    J0585Injection, onabotulinumtoxina, 1 unit2,200$10$11K
    99212The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…270$40$11K
    50386In this procedure, the provider removes an internally dwelling ureteral stent using a transurethral approach and imaging guidance. He does not use an endoscope to perform the procedure.20$680$10.2K
    52356The provider performs a cystourethroscopy, the inspection of the interior of the bladder, the urethra, prostatic urethra, and ureteric openings using a cystoscope passed through the urethra and into…30$330$9.7K

    Showing 1–10 of 39

    Medicare: Competitive Analysis & Benchmarks

    How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 39 CPT/HCPCS codes.

    View: State1 / 2

    Full comparison — all codes billed, vs. state median

    39 rows

    CPT/HCPCS CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    J0897731,0303,060$20$91.4K
    J0585914007,640$1$86K
    99214837,970120$90$23.2K
    J92171320130$130$22.1K
    645668210130$100$16.5K
    52000872070$180$16K
    992139134,66080$70$13.2K
    52356817020$620$13.1K
    522871812030$310$12.8K
    517291411030$300$12.1K

    Showing 1–10 of 39

    Related Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Sansum ClinicCAMulti-Specialty Clinic/Center$0$24.4M
    Nathan SteinleCARetina Specialist (Ophthalmology) Physician$9.5M$0
    Daniel WatrousCARheumatology Physician$4M$5M
    Stephen CouvillionCARetina Specialist (Ophthalmology) Physician$6.4M$0
    Alessandro CastellarinCARetina Specialist (Ophthalmology) Physician$5.4M$0
    William PaceCANuclear Medicine Physician$4.1M$0
    Dante PieramiciCARetina Specialist (Ophthalmology) Physician$3.7M$0
    Daniel GreenwaldCAMedical Oncology Physician$3.5M$0
    Ma'an NasirCARetina Specialist (Ophthalmology) Physician$3M$0
    Julian DavisCAHematology & Oncology Physician$2.7M$0

    Nearby Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Community Health Centers Of The Central Coast IncCAFederally Qualified Health Center (FQHC)$0$49.6M
    Lags Spine And Sportscare Medical Centers IncCAPain Medicine (Physical Medicine & Rehabilitation) Physician$0$33.4M
    General Dentistry For Children: Dental Group Of Kleinsasser Dental CorCAGeneral Practice Dentistry$0$28.8M
    Pediatric Medical Group Of Santa Maria IncCAPediatrics Physician$0$27.7M
    Community Health Centers Of The Central Coast IncCAFederally Qualified Health Center (FQHC)$0$23.3M
    The Endoscopy Center Of Santa Maria LLCCAAmbulatory Surgical Clinic/Center$2.3M$7.4M
    Cypress Ambulatory Surgery CenterCAAmbulatory Surgical Clinic/Center$1.3M$3.9M
    Pierre LabrecqueCASpecialist$226.8K$3.2M
    Premier Surgery Center Of Santa Maria LLCCAAmbulatory Surgical Clinic/Center$1.9M$476.7K
    Dignity HealthCAHome Infusion Therapy Pharmacy$1.5M$873K

    Frequently Asked Questions

    References

    1. 1.Medicare Physician & Other Practitioner by Provider and Service. CMS.gov.Provider-level Medicare Part B utilization and payment data.
    2. 2.NPPES NPI Registry. CMS.gov.National Provider Identifier registry used for provider enumeration and taxonomy metadata.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

    Medicare Revenue by CPT/HCPCS Code
    Claims Volume vs. California Distribution
    Michael Avallone — 2 of 25 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — California