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

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

Tri-state Orthopaedic Surgeons, Inc. (NPI 1073501003)

Tri-state Orthopaedic Surgeons, Inc. is a orthopaedic surgery physician provider located in Evansville, Indiana. This profile covers 0 Medicare and 33 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Medicaid: Complete Services Breakdown

Field	Value
Entity Type	Organization
Organization	Tri-state Orthopaedic Surgeons, Inc.
Address	225 Crosslake Dr
City	Evansville
State	IN
ZIP	47715
Taxonomy	Orthopaedic Surgery Physician
NPI Enumerated	October 13, 2005

Payer Source	Total Paid
Medicaid	$2.7M
Medicare	$0

Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.

33 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…	37,270	$40	$1.6M
99203	The provider sees a new 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 provider…	12,080	$60	$749K
73630	In this diagnostic procedure, the provider takes a minimum of three views of the foot to assess injury, fracture, arthritis, tumor, or congenital abnormality.	4,570	$20	$86.8K
20610	In this procedure, the provider inserts a needle through the skin of a patient and into a major joint or bursa and then uses the syringe attachment to the needle to remove fluid or he may inject a…	3,370	$30	$84.3K
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…	1,360	$50	$68K
76881	In this procedure, the provider uses ultrasound to examine the complete joint for any defect or abnormality. The image appears in real time on a monitor, and a permanent image with interpretation is…	1,670	$30	$56.8K
73610	In this procedure, the provider takes three or more X–ray images of the ankle joint to check for any fracture, swelling, or reason for pain in the ankle area.	1,700	$20	$34.1K
99212	The 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,…	1,070	$20	$22.4K
J3301	Injection, triamcinolone acetonide, not otherwise specified, 10 mg	3,020	$10	$15.1K
72100	The technician takes 2 or 3 views of the vertebrae in the lumbar region which is the lower part of the spine and the sacrum, the area that connects the spine to the pelvis. Lumbosacral spine X–rays…	780	$20	$14.8K

Showing 1–10 of 33

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other Indiana providers billing the same CPT/HCPCS codes.

Claims Volume vs. Indiana Distribution

Tri-state Orthopaedic Surgeons, Inc. — 5 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Indiana

Full comparison — all codes billed, vs. Indiana median

33 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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…	900	2,120	870	$60	$450.6K
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…	98	2,380	920	$50	$376.8K
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	246	490	1,080	$30	$162.7K
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…	525	790	150	$90	$99.4K
99221	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a straightforward or low level of medical…	109	150	130	$100	$81.8K
99203	The provider sees a new 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 provider…	25	890	160	$60	$76.8K
97112	Neuromuscular reeducation is a therapeutic treatment (exercise) performed by a physician in an attempt to reduce impairments and restore function through the application of clinical skills and/or…	139	210	640	$20	$74K
97140	Manual therapy is a form of physical therapy which uses the controlled movement and pressure of hands to treat various disorders of soft tissues and joints, eg, chronic back pain. Manual therapy…	176	320	760	$20	$61.7K
99212	The 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,…	213	880	250	$40	$59.2K
73721	In this diagnostic procedure, the provider performs magnetic resonance imaging of a lower extremity joint without using contrast material.	37	40	50	$60	$49.8K

Showing 1–10 of 33

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Michael Boyd	IN	Orthopaedic Surgery Physician	$503.6K	$0
William Ante	IN	Physical Medicine & Rehabilitation Physician	$458.2K	$0
Paul Perry	IN	Orthopaedic Hand Surgery Physician	$303.9K	$0
Peter Knoll	IN	Orthopaedic Surgery Physician	$275K	$0
Jason Franklin	IN	Pain Medicine (Physical Medicine & Rehabilitation) Physician	$224.8K	$0
Ryan Wetzel	SC	Physical Medicine & Rehabilitation Physician	$211.2K	$0
Jeana Lee	IN	Orthopaedic Surgery Physician	$203.1K	$0
Timothy Hamby	IN	Orthopaedic Surgery Physician	$199.1K	$0
Christopher Sneed	IN	Neurological Surgery Physician	$196.5K	$0
Andrew Saltzman	IN	Orthopaedic Surgery Physician	$184.2K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Indiana Exceptional Medical Care	IN	Internal Medicine Physician	$0	$20.5M
Familia Dental Evansville LLC	IN	Dental Clinic/Center	$0	$9.8M
Affordable Dentures & Implants - Evansville, P.C.	IN	Dentist	$0	$7.3M
Drew Sommerville	IN	Ophthalmology Physician	$6.6M	$10.6K
Ginger Whitler, Inc.	IN	Pediatric Occupational Therapist	$0	$6.4M
Talley Medical-surgical Eye Care Associates PC	IN	Ophthalmology Physician	$0	$5.6M
Andrew Strand	IN	Ophthalmology Physician	$4.3M	$72.1K
Physician Management Services Of Western Indiana, LLC	IN	Family Medicine Physician	$0	$3.8M
Deaconess Hospital, Inc	IN	Psychiatry Physician	$0	$3.3M
Evansville Primary Care LLC	IN	Family Medicine Physician	$0	$2.6M

Tri-state Orthopaedic Surgeons, Inc. — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

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