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NPI 1033323258 · Riverside, CT · Dermatology Physician
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Robert Woodbury is a dermatology physician provider located in Riverside, Connecticut. This profile covers 21 Medicare and 1 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)
| Field | Value |
|---|---|
| Entity Type | Individual |
| Organization | Robert Woodbury |
| Address | 1200 E Putnam Ave |
| City | Riverside |
| State | CT |
| ZIP | 06878 |
| Taxonomy | Dermatology Physician |
| NPI Enumerated | May 9, 2007 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $828K |
| Medicaid | $0 |
Provider profile and payer mix: ROBERT WOODBURY is an established dermatology physician with an NPI enumerated on 2007-05-09 (~19 years ago). Lifetime Medicare revenue on file is $828K while reported Medicaid revenue is $0, indicating this practice is effectively single-payer (Medicare) in the available claims data and has no Medicaid billing on file.
Revenue concentration and top drivers: The practice is highly concentrated in a small set of Medicare codes — the top 3 Medicare codes by revenue (99213, 17004, 14021) account for 42.8% of this provider's total Medicare revenue. Those individual contributions are 99213 (17.9%), 17004 (14.4%), and 14021 (10.4%), signaling that a few high-volume procedures drive a large share of revenue.
Procedure mix and business model implications: The code mix (high volumes of 99213 office visits, 17004/17003/17000 lesion destruction codes, and 11102/11103 biopsies) points to a lesion-focused, procedure-driven dermatology practice that emphasizes outpatient lesion treatment and high throughput visits. The large count for add-on code 17003 (10K claims, $60.2K revenue) together with 11102 (936 claims, $72.1K revenue) suggests many encounters involve multiple lesion destructions and frequent biopsy activity.
Clinical-surgical capability and higher-value repairs: Substantial revenue from flap/graft repair codes such as 14021 ($86.2K, 95th percentile; notably above typical) and related codes 14041, 14001, and 14061 indicates capability to perform intermediate-to-complex reconstructive closures after excisions. These higher average-paid codes (for example 14021 avg paid $724) signal that the practice performs surgical excisions with subsequent reconstructive procedures rather than only simple removals.
Competitive standing — national dominance on common dermatology procedures: This provider is a pronounced outlier on several common dermatology codes: 99213 ranks #679 of 457151 (100th percentile; extreme outlier) and 17004 ranks #45 of 9638 (100th percentile; extreme outlier), while 11102 ranks #214 of 18797 (99th percentile; extreme outlier). Those ranks indicate substantially higher-than-typical national volume for office visits, lesion destruction, and biopsy activity compared with peers.
Mohs and specialized oncology services are modest: Mohs surgery codes (17311 and 17312) together represent a modest share of revenue (17311 $35.5K, 4.3% and 17312 $18.1K, 2.2%) and rank in lower percentiles (17311 at the 27th percentile; typical, unremarkable volume and 17312 at the 21th percentile; typical, unremarkable). This pattern implies the practice is not primarily a high-volume Mohs center but does provide some staged excision services.
Operational implications of volume and reimbursement mix: The practice’s reliance on very high claim counts for low–unit-value add-on codes (e.g., 17003: 10K claims at $6 avg paid/claim) together with high-volume office visits suggests a workflow optimized for rapid lesion-focused encounters and procedure throughput. That operational model likely delivers steady Medicare revenue ($828K lifetime) but concentrates revenue in a few procedural lines.
Risk and strategic considerations: Given the effectively single-payer exposure (Medicare $828K vs Medicaid $0) and the fact that top codes account for 42.8% of Medicare revenue, the practice faces concentration risk if reimbursement or utilization patterns shift for those codes. At the same time, the practice’s national outlier status on several core dermatology procedure codes may present opportunities to leverage scale for negotiated payer arrangements or to selectively expand higher-margin services.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
21 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 99213 | The 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… | 2,130 | $70 | $149K |
| 17004 | The provider destroys 15 or more premalignant lesions using techniques such as chemosurgery, cryosurgery, electrosurgery, or others. | 920 | $130 | $119.9K |
| 14021 | The provider repairs lesions in the patient’s scalp, arms, or legs by using the healthy tissues from an adjacent site. This code represents a defect of 10.1 cm2 to 30.0 cm2. | 120 | $720 | $86.2K |
| 11102 | The provider biopsies a single skin lesion using a tangential (side–ways) approach; he shaves off the lesion or scoops it out with a knife or curette. | 940 | $80 | $72.1K |
| 14041 | The provider replaces the lesions in the forehead, cheeks, chin, mouth, neck, axillae or armpits, genitalia, hands, or feet with the healthy tissues from an adjacent site. This code represents a… | 80 | $780 | $61.5K |
| 17003 | In this add–on procedure, the provider destroys a premalignant lesion using techniques such as chemosurgery, cryosurgery, electrosurgery, or others. This code is appropriate for the second through… | 10,040 | $10 | $60.2K |
| 14001 | The provider repairs defects in the patient’s trunk by using healthy tissues from an adjacent body part. This code represents transfer of adjacent tissue for defects that equal 10.1 cm2 and up to… | 80 | $680 | $53.6K |
| 17000 | The provider destroys a premalignant lesion using techniques such as chemosurgery, cryosurgery, electrosurgery, or others. This code reports the destruction of the first or only lesion. | 1,250 | $40 | $46.4K |
| 17311 | Mohs surgery is a multi–staged procedure that is performed to excise a malignant lesion layer by layer, along with histo–pathological assessment. The assessment is performed to ensure that the… | 110 | $310 | $35.5K |
| 14061 | The provider replaces the lesions in the eyelids, nose, ears, or lips, with the healthy tissues from an adjacent site. This code represents a defect of 10.1 cm2 to 30.0 cm2 in size. | 30 | $840 | $25.9K |
Showing 1–10 of 21
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 21 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
21 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| 17311 | 23 | 30 | 300 | $490 | $149.1K |
| 17312 | 23 | 30 | 150 | $350 | $59.2K |
| 14001 | 1 | 10 | 80 | $680 | $53.6K |
| 14021 | 1 | 10 | 60 | $710 | $42.5K |
| 14041 | 1 | 10 | 20 | $740 | $24.5K |
| 14061 | 1 | 10 | 20 | $830 | $20.7K |
| 14060 | 12 | 20 | 20 | $620 | $19.9K |
| 14040 | 5 | 10 | 20 | $570 | $14.9K |
| 99214 | 4,714 | 6,480 | 90 | $90 | $14.2K |
| 11102 | 1 | 270 | 100 | $70 | $9.7K |
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Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
View: By Year1 / 3
Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
1 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 99213 | The 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… | 510 | $0 | $0 |
How this provider's Medicaid billing volume and revenue compare to other Connecticut providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Connecticut median
1 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 99213 | The 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… | 960 | 1,710 | 750 | $30 | $243.3K |
Other providers in the same ZIP code as Robert Woodbury, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Greenwich Emergency Medical Service, Inc. | CT | Ambulance | $734.3K | $1M |
| Marc Hamet | CT | Vascular & Interventional Radiology Physician | $272.5K | $370 |
| Walgreen Co | CT | Pharmacy | $157.2K | $9.1K |
| Jun Xu | CT | Physical Medicine & Rehabilitation Physician | $110.3K | $0 |
| Scott Gelbs | CT | Physical Therapist | $80.2K | $0 |
| Eve Darosa | CT | Physical Therapist | $71.9K | $0 |
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