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    v1.0.28
    OpenPayerNPI Medicare & MedicaidRoberto Pedraza
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    Roberto Pedraza — Billing Profile & Reimbursement Data

    NPI 1053419614 · Rockville, MD · Urology Physician

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    Roberto Pedraza is a urology physician provider located in Rockville, Maryland. This profile covers 20 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
    OrganizationRoberto Pedraza
    Address9420 Key West Ave.
    CityRockville
    StateMD
    ZIP20850
    TaxonomyUrology Physician
    NPI EnumeratedSeptember 20, 2006

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

    Payer SourceTotal Paid
    Medicare$153K
    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.

    20 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…400$100$40.3K
    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…430$70$30.7K
    76856A pelvic ultrasound is a noninvasive procedure used to assess body parts such as the bladder, ovaries, uterus, cervix, and fallopian tubes in females and the bladder, prostate gland, and seminal…230$90$21K
    52601During transurethral resection of the prostate (TURP), the surgeon inserts a resectoscope via the urethra and removes a portion of the prostate. This procedure includes several other urological…20$650$10.4K
    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…70$130$8.5K
    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…130$60$8.3K
    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…20$350$6.9K
    76775A retroperitoneal ultrasound is a noninvasive procedure used to assess the body parts within the abdomen (i.e. Kidneys, urinary bladder, and aorta). This particular CPT code is used when the…110$50$5.6K
    76770A retroperitoneal ultrasound is a noninvasive procedure used to assess the body parts within the abdomen (i.e.Kidneys, urinary bladder, and aorta). This particular code is used when the ultrasound is…50$100$4.7K
    55899Use 55899 to report procedures in the male genital system that does not have a specific code.40$80$3.2K

    Showing 1–10 of 20

    Medicare: Competitive Analysis & Benchmarks

    How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 20 CPT/HCPCS codes.

    View: State1 / 2

    Full comparison — all codes billed, vs. state median

    20 rows

    CPT/HCPCS CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    52601214020$1,260$29.1K
    5200095200120$140$25.8K
    523565010020$900$25.3K
    992142,29010,270150$90$24.1K
    99490188220110$50$15K
    52310409020$400$13.7K
    992131,2089,280100$60$12.5K
    992041,6555,38040$120$7.3K
    99426488050$50$5.8K
    364158401,420110$10$4.3K

    Showing 1–10 of 20

    Related Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Mohammed RazviMDVascular & Interventional Radiology Physician$3.4M$0
    Yudhishtra MarkanMDHematology & Oncology Physician$3M$0
    Benjamin LowentrittMDUrology Physician$2.1M$0
    Gayatri NimmagaddaMDHematology & Oncology Physician$1.9M$0
    Tehmina AliMDAnatomic Pathology Physician$1.7M$0
    Robert BrooklandMDRadiation Oncology Physician$1.4M$0
    Enrico GiangerusoVAAnatomic Pathology & Clinical Pathology Physician$1.4M$0
    Michael IsaacsonMDUrology Physician$1.3M$0
    Geoffrey NeunerMDRadiation Oncology Physician$1.1M$0
    Michael BalloMDAnatomic Pathology & Clinical Pathology Physician$1.1M$0

    Nearby Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Mep Health, LLCMDEmergency Medicine Physician$0$105.9M
    Montgomery County Public Schools ServicesMDCounselor$0$56.8M
    A Plus Adult Medical Day Care Center CorporationMDAdult Day Care Clinic/Center$0$30.1M
    Pediatrix Medical Group Of The Mid-atlantic PCMDMaternal & Fetal Medicine Physician$0$28.4M
    Adult Day Health, Inc.MDAdult Day Care Clinic/Center$0$17M
    Jarher IncorporatedMDAdult Day Care Clinic/Center$0$12M
    Cornerstone Montgomery, Inc.MDCommunity/Behavioral Health Agency$0$11.6M
    Asthma & Allergy Center LLCMDAllergy & Immunology Physician$0$11.5M
    Montgomery Hospice IncMDCommunity Based Hospice Care Agency$0$10.3M
    Adventist Healthcare, Inc.MDGeneral Acute Care Hospital$0$9.7M

    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. Maryland Distribution
    Roberto Pedraza — 2 of 20 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Maryland