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    OpenPayerNPI Medicare & MedicaidSutter Bay Medical Foundation
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    Sutter Bay Medical Foundation — Billing Profile & Reimbursement Data

    NPI 1164840088 · San Carlos, CA · Ambulatory Surgical Clinic/Center

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    Sutter Bay Medical Foundation is a ambulatory surgical clinic/center provider located in San Carlos, California. This profile covers 36 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 TypeOrganization
    OrganizationSutter Bay Medical Foundation
    Address301 Industrial Rd
    CitySan Carlos
    StateCA
    ZIP94070
    TaxonomyAmbulatory Surgical Clinic/Center
    NPI EnumeratedMarch 29, 2014

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

    Payer SourceTotal Paid
    Medicare$1.3M
    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.

    36 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    45385The provider examines the colon and rectum using a colonoscope, a long, thin flexible tubular instrument with a light source and camera. He removes one or more tumors, polyps, or other lesions with a…250$660$164.4K
    45380The provider examines the rectum and colon using a flexible colonoscope, a tubular instrument with a light source and camera, to look for the cause of a patient's symptoms, which may include…260$480$123.4K
    25609The provider surgically repairs a fracture of the lower radius, the larger of the two lower arm bones, beyond the joint or a separation of the radius from the joint through an incision and fixes…20$5,000$105K
    29848The provider inserts an endoscope into the wrist joint to divide the transverse carpal ligament and reduce compression on the median nerve in the carpal tunnel that results in pain and numbness.90$830$74.8K
    64483This procedure is the injection of an anesthetic agent and/or steroid in the form of a transforaminal epidural injection into a single level (either lumbar or sacral).150$470$68.3K
    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…20$2,630$60.5K
    23410In this procedure, the provider performs an open surgical repair of an acute tear of the rotator cuff in the shoulder. The rotator cuff is a group of four muscles that stabilizes the shoulder joint.20$3,550$60.4K
    43239The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis.190$310$59.2K
    64493The provider injects a diagnostic or therapeutic substance into a single lumbar or sacral paravertebral facet (zygapophyseal) joint, or into the nerves that supply that joint, using imaging guidance…110$440$48.8K
    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…80$630$48.7K

    Showing 1–10 of 36

    Medicare: Competitive Analysis & Benchmarks

    How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 36 CPT/HCPCS codes.

    View: State1 / 2

    Full comparison — all codes billed, vs. state median

    36 rows

    CPT/HCPCS CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    43252131050$730$63.2K
    25609146020$2,220$40K
    453851061,41060$340$33.9K
    298279129020$1,320$30.3K
    6448318479060$240$28.5K
    29828508020$1,390$26.3K
    6463537248040$460$26.3K
    453801181,46060$230$23.8K
    G02606413050$260$21.6K
    2341031020$1,210$20.5K

    Showing 1–10 of 36

    Related Providers

    Other providers that share a Tax Identification Number (TIN) with Sutter Bay Medical Foundation, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Providence Health & Services WashingtonWAPulmonary Disease Physician$0$78.6M
    Columbus Radiology CorpOHDiagnostic Radiology Physician$0$49.9M
    Sutter Valley Medical FoundationCAMulti-Specialty Clinic/Center$0$41.2M
    Children's Hospital And Health System, Inc.WIUrgent Care Clinic/Center$0$17.7M
    Thomas SchlesingerCARetina Specialist (Ophthalmology) Physician$4.3M$7.9M
    Stephen MeffertCARetina Specialist (Ophthalmology) Physician$3.2M$5.5M
    Louis ChangCAOphthalmology Physician$2.2M$5.9M
    Matthew PowersCARetina Specialist (Ophthalmology) Physician$3.7M$4.3M
    Ira SchacharCARetina Specialist (Ophthalmology) Physician$3.9M$4.1M
    Alok BansalCAOphthalmology Physician$3M$4.7M

    Nearby Providers

    Other providers in the same ZIP code as Sutter Bay Medical Foundation, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Natera, Inc.CAClinical Medical Laboratory$133.1M$641.5M
    Grace KimCAEndocrinology, Diabetes & Metabolism Physician$446.8K$0
    Leila ChaychiCAEndocrinology, Diabetes & Metabolism Physician$368.5K$0
    Digestive Care Medical Center IncCAAmbulatory Surgical Clinic/Center$321.1K$0
    Jaret ButlerCAOrthopaedic Hand Surgery Physician$131.4K$0
    David MyersCAIntegrative Medicine Physician$43.4K$0

    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. California Distribution
    Sutter Bay Medical Foundation — 1 of 25 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — California