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NPI 1104130574 · Atlanta, GA · Foot Surgery Podiatrist
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Ryan Ellsworth is a foot surgery podiatrist provider located in Atlanta, Georgia. This profile covers 24 Medicare and 3 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 | Ryan Ellsworth |
| Address | 505 Fairburn Rd Sw Ste 100 |
| City | Atlanta |
| State | GA |
| ZIP | 30331 |
| Taxonomy | Foot Surgery Podiatrist |
| NPI Enumerated | July 28, 2010 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $9.1M |
| Medicaid | $1.3K |
Practice profile and tenure: RYAN ELLSWORTH is a Foot Surgery Podiatrist with an NPI enumerated on 2010-07-28 (~16 years ago), indicating long-standing Medicare participation and an established outpatient procedural practice in ATLANTA, GA. The code mix and tenure suggest a specialty practice oriented around procedural wound care and podiatric services rather than primary care or broad outpatient management.
Medicare revenue scale and concentration: The provider’s Medicare activity drives the business financially, reporting Total Medicare revenue of $9.1M. Revenue is highly concentrated — the precomputed top 3 Medicare codes account for 94.1% of this provider's total Medicare revenue — indicating the practice depends on a narrow set of high-revenue items.
Top Medicare service line implication: The three highest-revenue Medicare codes are Q4204 ($4M, 44.1%), Q4250 ($3.2M, 35.4%), and Q4248 ($1.3M, 14.7%), all skin-substitute/amniotic membrane allograft add-on codes. This concentration in per-square-centimeter allograft products implies an operational model that heavily uses and bills for biologic skin substitutes and graft materials as the primary revenue-driving service line in wound/limb-sparing care.
Competitive standing on flagship products: For the two largest Medicare codes, Q4204 and Q4250, the provider ranks #1 nationally among peers (each listed as 100th percentile and described as notably above typical national volume), making RYAN ELLSWORTH a dominant national biller for those specific biologic graft products. By contrast, Q4248 ranks #4 of 18 (82th percentile) and is described as typical, indicating leadership on some products while participation on others is more in line with peers.
Notable high-volume outliers and procedural breadth: Beyond the Q42xx suite, select codes show unusually high relative activity: 64455 ranks #7 of 868 providers (99th percentile; labeled an extreme outlier), and 76882 ranks #173 of 5542 (97th percentile; notably above typical). These high percentiles for a steroid/anesthetic digital nerve injection and limited extremity ultrasound indicate the practice pairs high-volume biologic product use with frequent procedural injections and point-of-care imaging.
Revenue and payer mix imbalance: Medicaid activity is negligible compared with Medicare — Total Medicaid revenue is $1.3K versus $9.1M in Medicare, effectively making this a Medicare-centric practice for revenue and utilization. The precomputed top 3 Medicaid codes account for 100.0% of Medicaid revenue, with 99203 alone representing $1.1K (80.7% of Medicaid revenue), which underscores minimal Medicaid exposure.
State-level Medicaid competitiveness: On the small amount of Medicaid billing, the provider’s in-state ranks are low to middling: 99203 ranks #295 of 314 providers in-state (0th percentile) and 99309 ranks #48 of 52 (6th percentile), indicating the provider is not a major Medicaid-facing participant in Georgia. The Medicaid profile is consistent with a practice that either does not seek Medicaid patients or is limited in its Medicaid panel access.
Strategic implications and operational risk: The extreme dependence on a narrow set of high-cost biologic add-on codes (top 3 = 94.1% of Medicare revenue) creates business sensitivity to changes in coverage, reimbursement, or supply pricing for those products. Payers and analysts should consider this concentration when evaluating contracting leverage, utilization management, and potential audit focus on high-dollar per-square-centimeter allograft billing patterns.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
24 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| Q4204 | Xwrap, per square centimeter (add-on, list separately in addition to primary procedure) | 3,730 | $1,080 | $4M |
| Q4250 | Amnioamp-mp, per square centimeter (add-on, list separately in addition to primary procedure) | 2,680 | $1,200 | $3.2M |
| Q4248 | Dermacyte amniotic membrane allograft, per square centimeter (add-on, list separately in addition to primary procedure) | 1,670 | $800 | $1.3M |
| Q4259 | Celera dual layer or celera dual membrane, per square centimeter (add-on, list separately in addition to primary procedure) | 470 | $780 | $367.5K |
| 15271 | The provider uses a skin substitute, such as an allograft or xenograft, to cover wounds on the patient’s trunk, arms, and/or legs up to an area of 100 cm2. This code covers up to the first 25 cm2. | 280 | $110 | $31.5K |
| 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… | 360 | $70 | $24.2K |
| 15275 | The provider uses a skin substitute, such as an allograft or xenograft, to cover wounds on the face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, up to… | 180 | $120 | $22K |
| 11042 | The provider uses surgical instruments to remove the dead tissue in skin down to the subcutaneous layer and including the epidermis and dermis, up to the first 20 cm2. | 250 | $50 | $13.5K |
| 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… | 130 | $90 | $11.3K |
| 93923 | Noninvasive arterial diagnostic procedures are performed to examine the rate of blood flow in an area and to assess the presence of a blockage in the upper and lower extremity arteries.… | 110 | $90 | $9.3K |
Showing 1–10 of 24
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 24 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
24 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| Q4204 | 1 | 10 | 3,730 | $1,080 | $4M |
| Q4250 | 1 | 10 | 2,680 | $1,200 | $3.2M |
| Q4248 | 1 | 10 | 1,670 | $800 | $1.3M |
| Q4259 | 1 | 10 | 470 | $780 | $367.5K |
| 99214 | 6,548 | 13,640 | 120 | $80 | $17.8K |
| 99308 | 272 | 500 | 150 | $50 | $17.4K |
| 11721 | 255 | 310 | 240 | $30 | $10.6K |
| 99213 | 1,457 | 13,360 | 80 | $60 | $9.2K |
| 15271 | 4 | 40 | 50 | $100 | $9K |
| 11042 | 28 | 240 | 70 | $70 | $8.3K |
Showing 1–10 of 24
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.
3 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 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… | 10 | $90 | $1.1K |
| 99309 | The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or the provider… | 20 | $20 | $260 |
| 99308 | The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a low level of medical decision making and/or the provider… | 20 | $0 | $0 |
How this provider's Medicaid billing volume and revenue compare to other Georgia providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Georgia median
3 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 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… | 295 | 310 | 90 | $90 | $136.3K |
| 99309 | The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or the provider… | 48 | 50 | 320 | $10 | $89K |
| 99308 | The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a low level of medical decision making and/or the provider… | 52 | 60 | 200 | $10 | $23.1K |
Other providers in the same ZIP code as Ryan Ellsworth, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Peacewerks Center For Well-being | GA | Clinical Social Worker | $0 | $365.5K |
| Stacey Brinkley | GA | Family Nurse Practitioner | $320.8K | $0 |
| Keith Evans | GA | Physical Therapist | $285.9K | $0 |
| Southwest Atlanta Vascular Care, LLC | GA | Ambulatory Surgical Clinic/Center | $264.2K | $0 |
| Latoya Nelson | GA | Mental Health Counselor | $0 | $254.7K |
| Johnetta Barnes | GA | Professional Counselor | $0 | $216.4K |
| Georgia's Families In Transition LLC | GA | Community/Behavioral Health Agency | $0 | $164.5K |
| Sammy Mugambi | GA | Nephrology Physician | $161K | $0 |
| Lester Freeman | GA | Pediatrics Physician | $0 | $158.6K |
| Fidelia Osinubi | GA | Family Medicine Physician | $156.7K | $0 |
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