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

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

James Rubano (NPI 1134169667)

Field	Value
Entity Type	Individual
Organization	James Rubano
Address	1941 Limestone Rd Ste 101
City	Wilmington
State	DE
ZIP	19808
Taxonomy	Orthopaedic Surgery Physician
NPI Enumerated	June 6, 2006

Payer Source	Total Paid
Medicare	$902.4K
Medicaid	$0

Key Findings

This provider generates $902.4K in total Medicare revenue and has no Medicaid billing on file, so their publicly observed payer activity is effectively single-payer (Medicare) in scale. The absence of any Medicaid claims means Medicaid does not contribute to their reported revenue mix and leaves Medicare as the dominant payer exposure to monitor for contracting and reimbursement risk.

Revenue concentration is high: the precomputed top 3 Medicare codes by revenue account for 52.2% of this provider's total Medicare revenue, driven by J7327 (21.7%), 27447 (18.3%), and 99215 (12.2%). This indicates that a small set of services—hyaluronan injections, knee arthroplasty, and high-complexity E/M visits—are the primary revenue drivers for the practice.

The code mix points to an orthopaedic surgery practice that combines high-volume office-based treatment with operative care. Large volumes of intra-articular injection codes (J7327 and J7324), numerous joint injections without imaging guidance (20610), and major joint arthroplasty codes (27447, 27130) suggest a workflow spanning clinic-based procedures, image-guided pain interventions, and definitive surgical joint replacement.

For several high-revenue services this provider ranks as a national outlier: J7327 ranks #9 of 1365 providers (99th percentile; extreme outlier), 27447 ranks #195 of 12089 providers (98th percentile; extreme outlier), and 99215 ranks #456 of 145531 providers (100th percentile; extreme outlier). These rankings indicate the provider is a major national-level contributor for hyaluronan injections, a high-volume knee replacement surgeon relative to peers, and unusually high in high-complexity office visits.

Additional procedure-level outlier signals reinforce a knee-focused, high-throughput practice model: 20610 has 977 claims and ranks #180 of 39752 providers (100th percentile; extreme outlier), 64624 has 125 claims and ranks #5 of 521 providers (99th percentile; extreme outlier), and 73562 has 680 claims and ranks #142 of 26819 providers (99th percentile; extreme outlier). Together these suggest consistently high volumes of joint injections, genicular neurolysis, and knee imaging that support both nonoperative care and procedural pain services.

Clinical complexity and patient management intensity are substantial: 99215 shows 837 claims and $109.6K revenue (12.2% of Medicare revenue), and 99205 appears with 255 claims and $39.8K revenue (4.4%). The mix of many high-level E/M visits alongside procedural codes implies the practice handles a large number of medically complex consultations in addition to procedure throughput.

The lack of Medicaid billing (none — no Medicaid billing on file) means the provider’s revenue and utilization profile should be interpreted without Medicaid population exposure; analyses focused on Medicare trends will capture nearly all of the reported payer activity. For network planning or market-share estimates in Delaware, treat this profile as effectively Medicare-centric rather than representing a broader payor mix.

The provider has a long tenure in the national registry, with NPI enumerated 2006-06-06 (~20 years ago), which supports the view that these billing patterns reflect an established, sustained practice footprint rather than a short-term anomaly. Longitudinal monitoring of the same high-volume codes (notably J7327, 27447, 99215) will be most informative for changes in service mix or market behavior.

Medicare: Complete Services Breakdown

The CPT/HCPCS codes generating the most Medicare revenue for this provider.

25 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J7327	Hyaluronan or derivative, monovisc, for intra-articular injection, per dose	350	$560	$196.1K
27447	In this procedure, the provider replaces the damaged weight bearing surfaces of both the medial and lateral compartments in the knee joint using implants of metal or other strong materials. The…	160	$1,010	$164.8K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	840	$130	$109.6K
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…	890	$90	$81.1K
27130	In this procedure, the provider surgically replaces the hip joint by prosthesis, or artificial hip joint. He replaces both the femoral and acetabular components with or without using an autograft or…	70	$1,010	$67.5K
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…	980	$50	$50.8K
99205	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the provider…	260	$160	$39.8K
64624	The provider uses a chemical, heat, or radiofrequency as a neurolytic agent to destroy branches of the genicular nerves that supply the knee joint; imaging guidance is included, if performed, so it…	130	$310	$38.9K
64640	Neurolysis is the destruction of nerves responsible for carrying pain information. The destruction includes the use of chemical, heat, or radiofrequency techniques.	390	$100	$38.4K
73562	In this procedure, the provider takes three X–ray images of a patient’s knee joint to check for any fracture, swelling, or reason for pain in the knee area.	680	$30	$21.1K

Showing 1–10 of 25

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 25 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Delaware Distribution

James Rubano — 9 of 24 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Delaware

Full comparison — all codes billed, vs. state median

25 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
27447	4	50	50	$810	$52K
J7327	2	20	30	$560	$38.9K
27130	3	40	40	$700	$28.9K
64624	1	10	90	$300	$26.1K
99214	143	1,830	150	$80	$25.5K
64640	1	10	190	$100	$24K
J7324	6	10	200	$100	$18K
72148	55	60	80	$100	$13.9K
99213	432	1,810	120	$60	$13.6K
20610	7	120	60	$50	$12.4K

Showing 1–10 of 25

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Dynamic Therapy Services LLC	DE	Physical Therapist	$0	$12.8M
Regional Orthopaedic Associates PA	DE	Orthopaedic Surgery Physician	$0	$2.8M
Steven Dellose	DE	Orthopaedic Surgery Physician	$1M	$0
Selina Xing	DE	Pain Medicine (Physical Medicine & Rehabilitation) Physician	$910.2K	$300
Mark Eskander	DE	Orthopaedic Surgery of the Spine Physician	$564K	$0
John Rowlands	DE	Interventional Pain Medicine Physician	$419K	$0
Nick Patel	DE	Orthopaedic Surgery Physician	$345K	$0
Brian Galinat	DE	Orthopaedic Surgery Physician	$268K	$0
Peter Townsend	DE	Orthopaedic Surgery Physician	$250.4K	$0
Amir Abdel Kader	DE	Pain Medicine (Anesthesiology) Physician	$244.7K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
State Of Delaware	DE	Local Education Agency (LEA)	$0	$9.2M
Jp Nacchia & Associates, Inc.	DE	In Home Supportive Care Agency	$0	$8.2M
Macklyn Home Care	DE	Home Health Agency	$0	$6.2M
Journeys LLC	DE	Mental Health Counselor	$0	$5M
Resouces For Human Development, Inc.	DE	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$4.3M
Robert M Collins Dds PA	DE	Pediatric Dentistry	$0	$3.2M
Rockland Surgery Center, L.P.	DE	Anesthesiology Physician	$2.4M	$280K
Limestone Medical Center, LLC	DE	Ambulatory Surgical Clinic/Center	$2.3M	$242.7K
Pace, Inc.	DE	Adult Mental Health Clinic/Center	$0	$2.3M
Jmk Behavior, LLC	DE	Intellectual & Developmental Disabilities Psychologist	$0	$2.2M

James Rubano — Billing Profile & Reimbursement Data

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Key Findings

Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References