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    v1.0.28
    OpenPayerNPI Medicare & MedicaidJames Karlson
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    James Karlson — Billing Profile & Reimbursement Data

    NPI 1114915261 · Cambridge, MA · Sports Medicine (Orthopaedic Surgery) Physician

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    James Karlson is a sports medicine (orthopaedic surgery) physician provider located in Cambridge, Massachusetts. This profile covers 14 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
    OrganizationJames Karlson
    Address300 Mount Auburn St
    CityCambridge
    StateMA
    ZIP02138
    TaxonomySports Medicine (Orthopaedic Surgery) Physician
    NPI EnumeratedOctober 12, 2005

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

    Payer SourceTotal Paid
    Medicare$136.3K
    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.

    14 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    20610In 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…400$60$23.8K
    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…280$70$20.4K
    27245In this procedure, the provider performs an open treatment of a femoral fracture between, around, or below the trochanters. He fixes the fracture using an intramedullary implant, or an implant the…20$1,060$15.9K
    29827The 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$920$12.9K
    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…140$90$12.2K
    J7323Hyaluronan or derivative, euflexxa, for intra-articular injection, per dose100$100$9.7K
    29881The provider examines the inside of the knee joint with an arthroscope. She repairs the joint by removing the meniscus, a crescent shaped cartilage cushion, from either the medial or lateral…20$450$9.5K
    99212The 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,…200$50$9.3K
    29880In this procedure, the provider performs arthroscopic examination of the knee joint. She removes the damaged and torn meniscus from the medial and lateral compartments of the knee joint along with…10$490$6.8K
    J0702Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg1,220$10$6.1K

    Showing 1–10 of 14

    Medicare: Competitive Analysis & Benchmarks

    How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 14 CPT/HCPCS codes.

    View: State1 / 2

    Full comparison — all codes billed, vs. state median

    14 rows

    CPT/HCPCS CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    29827558020$930$21.4K
    27245275020$940$18.8K
    2988162010$660$11.9K
    2988062010$720$11.6K
    J7323288070$100$10.2K
    992131,84113,70070$60$8.8K
    29824132020$270$6.5K
    206105898060$50$5.8K
    992033444,29030$80$4.1K
    992121382,66030$40$2.4K

    Showing 1–10 of 14

    Related Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    James PhillipsMAOrthopaedic Surgery Physician$306.9K$43.2K
    Sameer KapasiMAPain Medicine Physician$324.4K$0
    James HillMADiagnostic Radiology Physician$301K$0
    Stephen ParazinMAOrthopaedic Surgery of the Spine Physician$206.5K$0
    Lampros MinosMASurgical Physician Assistant$178.7K$0
    Matthew WergerMAOrthopaedic Surgery Physician$167.2K$0
    Eric CarknerMAOrthopaedic Surgery Physician$157K$0
    Glen RossMAOrthopaedic Surgery Physician$135.2K$0
    Jennifer GreenMASurgery of the Hand (Surgery) Physician$128.2K$0
    Brittany CheneyMAPhysician Assistant$102.4K$0

    Nearby Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Mount Auburn HospitalMAGeneral Acute Care Hospital$0$28M
    Professional Ambulance & Oxygen Svc, IncMALand Ambulance$2.8M$13.4M
    Cambridge Medical Supply IncMADurable Medical Equipment & Medical Supplies$0$5.6M
    Howard YingMAOphthalmology Physician$2.5M$149K
    Shilpa DesaiMAOphthalmology Physician$1.6M$0
    Christopher RobinsonMAOphthalmology Physician$1M$0
    Katherine WangMANeurological Surgery Physician$489.5K$0
    Nelson AwehMAInternal Medicine Physician$425.3K$0
    Kyle PondMACardiovascular Disease Physician$366.6K$1.2K
    Jeffrey LeavittMACardiovascular Disease Physician$356.8K$370

    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. Massachusetts Distribution
    James Karlson — 1 of 14 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Massachusetts