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NPI 1083805675 · Providence, RI · Orthopaedic Surgery Physician
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Edward Paxton is a orthopaedic surgery physician provider located in Providence, Rhode Island. This profile covers 13 Medicare and 7 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 | Edward Paxton |
| Address | 2 Dudley St |
| City | Providence |
| State | RI |
| ZIP | 02905 |
| Taxonomy | Orthopaedic Surgery Physician |
| NPI Enumerated | August 7, 2007 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $111.9K |
| Medicaid | $98.2K |
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
13 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 23472 | In this procedure, the provider performs a total shoulder arthroplasty in which the provider replaces the damaged head of the humerus and the glenoid cavity with prosthetic implants. The provider… | 30 | $1,130 | $32.7K |
| 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… | 230 | $100 | $22.3K |
| 73030 | This particular procedure is for a minimum of 2 X–ray views of the complete shoulder. | 600 | $30 | $15.7K |
| 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… | 160 | $70 | $10.7K |
| 29827 | The provider examines the tissue inside the shoulder joint with an arthroscope. She inserts additional instruments to repair a torn rotator cuff, the grouping of muscles and tendons that surround and… | 10 | $800 | $10.3K |
| 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… | 40 | $130 | $5.4K |
| 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… | 110 | $50 | $4.9K |
| 29828 | The provider examines the tissue inside the shoulder joint with an arthroscope. She inserts additional instruments to repair an unstable biceps tendon, the fibrous band that connects the biceps… | 10 | $400 | $4.4K |
| 73070 | X–rays of the extremities are performed to assess injury, fracture, arthritis, bone spurs, tumors, or congenital abnormalities. Extremity X–rays include the hand, wrist, arm, foot, ankle, hip, leg,… | 70 | $20 | $1.5K |
| 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… | 20 | $70 | $1.3K |
Showing 1–10 of 13
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 13 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
13 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| 29827 | 8 | 10 | 20 | $1,120 | $21.3K |
| 23472 | 3 | 10 | 20 | $900 | $19K |
| 99214 | 398 | 1,950 | 100 | $80 | $11.7K |
| 99213 | 456 | 1,950 | 70 | $60 | $7.4K |
| 29823 | 5 | 10 | 20 | $300 | $5.7K |
| 29828 | 2 | 10 | 10 | $390 | $4.7K |
| 20610 | 36 | 110 | 60 | $50 | $4.6K |
| 99204 | 224 | 740 | 30 | $110 | $4.6K |
| 99203 | 430 | 580 | 30 | $70 | $3.6K |
| 73030 | 2 | 170 | 40 | $20 | $1.1K |
Showing 1–10 of 13
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.
7 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 73030 | This particular procedure is for a minimum of 2 X–ray views of the complete shoulder. | 1,270 | $40 | $44.3K |
| 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… | 340 | $110 | $36.5K |
| 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… | 210 | $70 | $14.4K |
| 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… | 20 | $90 | $1.4K |
| 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… | 10 | $90 | $1K |
| 73070 | X–rays of the extremities are performed to assess injury, fracture, arthritis, bone spurs, tumors, or congenital abnormalities. Extremity X–rays include the hand, wrist, arm, foot, ankle, hip, leg,… | 30 | $30 | $760 |
| J3301 | Injection, triamcinolone acetonide, not otherwise specified, 10 mg | 10 | $10 | $70 |
How this provider's Medicaid billing volume and revenue compare to other Rhode Island providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Rhode Island median
7 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… | 701 | 1,730 | 220 | $70 | $75.2K |
| 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… | 1,172 | 2,050 | 300 | $50 | $72.3K |
| 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… | 282 | 350 | 80 | $90 | $40.5K |
| 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… | 22 | 20 | 40 | $150 | $25.9K |
| 73030 | This particular procedure is for a minimum of 2 X–ray views of the complete shoulder. | 6 | 30 | 70 | $40 | $19.4K |
| 73070 | X–rays of the extremities are performed to assess injury, fracture, arthritis, bone spurs, tumors, or congenital abnormalities. Extremity X–rays include the hand, wrist, arm, foot, ankle, hip, leg,… | 3 | 10 | 200 | $40 | $12.7K |
| J3301 | Injection, triamcinolone acetonide, not otherwise specified, 10 mg | 30 | 30 | 110 | $10 | $2.9K |
Other providers in the same ZIP code as Edward Paxton, ranked by combined Medicare and Medicaid revenue.
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