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    v1.0.28
    OpenPayerNPI Medicare & MedicaidClaiborne Whitworth
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    Claiborne Whitworth — Billing Profile & Reimbursement Data

    NPI 1073592796 · Lexington, VA · Urology Physician

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    Claiborne Whitworth is a urology physician provider located in Lexington, Virginia. This profile covers 11 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
    OrganizationClaiborne Whitworth
    Address100 Spotswood Dr
    CityLexington
    StateVA
    ZIP24450
    TaxonomyUrology Physician
    NPI EnumeratedJanuary 11, 2006

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

    Payer SourceTotal Paid
    Medicare$48.3K
    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.

    11 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…140$90$12.5K
    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…160$60$10.2K
    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…80$110$8.9K
    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…40$180$7.4K
    99203The 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…40$80$3.2K
    99441N/A40$40$1.8K
    76857A pelvic ultrasound is a noninvasive procedure used to assess one or more pelvic structures, such as bladder, ovaries, uterus, cervix, and fallopian tubes in females and the bladder, prostate gland,…50$30$1.6K
    99222The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…10$100$1.3K
    51798Providers perform this ultrasound to measure the volume of residual urine in the bladder.70$10$530
    81001Urinalysis is used to detect substances or cellular material in the urine associated with different metabolic and kidney disorders. It is used to detect urinary tract infections (UTI) and other…160$1$470

    Showing 1–10 of 11

    Medicare: Competitive Analysis & Benchmarks

    How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 11 CPT/HCPCS codes.

    View: State1 / 2

    Full comparison — all codes billed, vs. state median

    11 rows

    CPT/HCPCS CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    992146,36212,890140$80$21K
    5200016422080$170$16K
    992134,00812,44090$60$10K
    992041,3506,85040$110$5.9K
    992222,6183,12030$100$4.4K
    992032,0784,92030$70$3.8K
    51798197260150$10$1.6K
    994416931020$30$1.3K
    76857106020$30$1.2K
    810016540040$1$800

    Showing 1–10 of 11

    Related Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Llewellyn LeeTXVascular & Interventional Radiology Physician$834.2K$0
    William JonesVAUrology Physician$468.4K$0
    John MarshVAFamily Medicine Physician$457.4K$5.1K
    William McclungVAFamily Medicine Physician$367.4K$0
    Donald LeeVAFamily Medicine Physician$359.6K$0
    Robert PenceVAFamily Medicine Physician$310.7K$0
    Robert OsborneVAUrology Physician$307.6K$0
    Mark PassarellaVAUrology Physician$290.1K$0
    Julian FagerliVAUrology Physician$268.9K$0
    Mark SchmidtVAUrology Physician$267K$520

    Nearby Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Rockbridge Area Community Services BoardVACommunity/Behavioral Health Agency$0$25.3M
    Carilion Rockbridge Community HospitalVACritical Access Hospital$0$11.8M
    Med-trans CorporationVAAir Ambulance$797.2K$128.5K
    Timothy HarrisonVAOphthalmology Physician$295.8K$2.9K
    Sharon CaddVAPrimary Care Nurse Practitioner$252.5K$6.5K
    Scott DubitVAFamily Medicine Physician$83.2K$670
    Ryan AustinVACertified Registered Nurse Anesthetist$39.3K$0

    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. Virginia Distribution
    Claiborne Whitworth — 0 of 11 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Virginia