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

    NPI 1154687861 · Lexington, SC · Orthopaedic Hand Surgery Physician

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    James Mcfadden is a orthopaedic hand surgery physician provider located in Lexington, South Carolina. This profile covers 22 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 Mcfadden
    Address104 Saluda Pointe Dr
    CityLexington
    StateSC
    ZIP29072
    TaxonomyOrthopaedic Hand Surgery Physician
    NPI EnumeratedApril 6, 2012

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

    Payer SourceTotal Paid
    Medicare$196K
    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.

    22 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    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…600$60$38.5K
    23472In 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$1,110$29.9K
    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…290$90$26K
    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…220$80$16.6K
    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…250$50$12.2K
    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…100$110$11.4K
    73030This particular procedure is for a minimum of 2 X–ray views of the complete shoulder.450$20$10.7K
    64721Neuroplasty or transposition of the median nerve at the carpal tunnel is done to treat a condition called carpal tunnel syndrome (CTS). The carpal tunnel is a narrow tunnel in the wrist through which…30$290$8.9K
    26055Trigger finger, or stenosing tenosynovitis, is when a finger remains in a bent position. It is painful to open or close the finger. A swollen tendon or formation of knots or nodules in the tendon may…20$410$7.7K
    64718In this procedure, the provider uses an open approach to incise scar tissue or other sources of pressure to relieve tension on the ulnar nerve at the elbow, which an injury or swelling within the…10$430$6K

    Showing 1–10 of 22

    Medicare: Competitive Analysis & Benchmarks

    How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 22 CPT/HCPCS codes.

    View: State1 / 2

    Full comparison — all codes billed, vs. state median

    22 rows

    CPT/HCPCS CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    992142,5907,860160$80$23.2K
    23472379020$790$21.3K
    64721436040$400$20.4K
    26055597040$260$12.4K
    992135107,690100$60$10.8K
    2061015681070$50$7.3K
    6471892010$440$6.6K
    992047654,52040$110$6.4K
    7322112516050$90$5.3K
    992031032,97030$70$3.9K

    Showing 1–10 of 22

    Related Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Prisma Health University Medical GroupSCFamily Medicine Physician$0$171.7M
    Prisma Health Medical Group-midlandsSCMulti-Specialty Clinic/Center$0$77.6M
    Prisma Health-midlandsSCGeneral Acute Care Hospital$0$74.6M
    Prisma Health-midlandsSCGeneral Acute Care Hospital$0$68.3M
    Centra Medical Group, LLCVAFamily Medicine Physician$0$60.1M
    Prisma Health-midlandsSCGeneral Acute Care Hospital$0$28.1M
    Prisma Health-midlandsSCGeneral Acute Care Hospital$0$11.8M
    Prisma Health Medical Group-midlandsSCOrthopaedic Surgery Physician$0$8.7M
    Prisma Health-midlandsSCGeneral Acute Care Hospital$0$7.4M
    Prisma Health-midlandsSCGeneral Acute Care Hospital$0$6.9M

    Nearby Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Southern Medical Management, LLCSCPediatrics Physician$0$43.9M
    Allcaregivers, Inc.SCNursing Care Agency$0$33.3M
    South Carolina Dept Of Mental Health Accounting OfficeSCMental Health Clinic/Center (Including Community Mental Health Center)$0$32M
    Lexington County EmsSCAmbulance$2.9M$6.9M
    Lexington Health IncSCUrgent Care Clinic/Center$0$8.7M
    Key Care Health Services, LLCSCHome Health Agency$0$8.5M
    Capital City Therapy Group, LLCSCSpecialist$0$7.3M
    Health Promotion SpecialistsSCDental Hygienist$0$6.5M
    Lexington School District OneSCLocal Education Agency (LEA)$0$5.7M
    Lexington Health IncSCPediatric Adolescent Medicine Physician$0$5.7M

    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. South Carolina Distribution
    James Mcfadden — 5 of 22 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — South Carolina