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

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

Karl Westenfelder (NPI 1174502173)

Field	Value
Entity Type	Individual
Organization	Karl Westenfelder
Address	2875 Tina Ave
City	Missoula
State	MT
ZIP	59808
Taxonomy	Urology Physician
NPI Enumerated	January 10, 2006

Payer Source	Total Paid
Medicare	$286.9K
Medicaid	$0

Key Findings

This provider is effectively a single‑payer Medicare practice: lifetime Medicare revenue is $286.9K and there is no Medicaid billing on file. The dataset notes that the top 3 Medicare codes by revenue account for 43.8% of the provider’s total Medicare revenue, signaling a concentrated revenue base within a small set of services.

The top revenue drivers point to a mixed interventional and medical urology practice. J0897 ($46.7K, 16.3% of Medicare revenue) and J9217 ($40.9K, 14.3%) reflect substantial billing for injectable therapies (denosumab and leuprolide), while 55874 ($37.9K, 13.2%) is a prostate‑spacer procedure used during radiation planning, and 52000 ($29.1K, 10.2%) represents routine cystoscopy—together these codes indicate both office‑based management and procedure‑level services tied to prostate cancer care and general urology.

Revenue concentration is notable: J0897, J9217, and 55874 together comprise the precomputed 43.8% share of Medicare revenue, with individual contributions of $46.7K (16.3%), $40.9K (14.3%), and $37.9K (13.2%) respectively. This concentration suggests that a handful of high‑revenue procedures and injectables drive a large portion of the provider’s Medicare receipts.

Competitive standing varies by code: the provider bills J9217 at relatively high national volume (ranks #310 of 3683, 92th percentile, described as "typical, unremarkable volume" in the file), while J0897 is near the middle of the national distribution (ranks #5293 of 10057, 46th percentile) and 55874 is lower relative to peers (ranks #308 of 557, 40th percentile). Taken together, these rank signals indicate the provider is a stronger national participant for leuprolide administration but otherwise operates at typical or modest volumes for the other top procedures.

Office visit and care‑management activity is strong relative to peers, supporting a busy ambulatory practice. High percentiles for core E/M codes—99213 (345 claims, ranks #48855 of 457151, 89th percentile), 99214 (229 claims, 72th percentile), and 99215 (133 claims, 85th percentile)—along with clinical care codes such as 99426 (123 claims, 69th percentile) and 99490 (43 claims, 16th percentile) indicate regular outpatient follow‑up and chronic care management activity driving part of the revenue mix.

Procedural breadth spans endoscopic surgery, diagnostics, and some low‑volume lithotripsy. The provider reports TURP (52601, 16 claims, $8.8K), cystoscopy with stent placement (52332, 41 claims, $3.9K), transrectal ultrasound (76872, 63 claims, $6.7K), and ESWL (50590, 12 claims, $6.5K). ESWL appears at the lower end of national rank (ranks #1032 of 1163, 4th percentile) but is characterized in the data as "typical, unremarkable volume," indicating lithotripsy is offered only rarely.

There is a modest laboratory and diagnostic footprint that supports prostate disease management: PSA testing (84153, 223 claims, $4K, 85th percentile) and post‑void residual/volume ultrasound (51798, 161 claims, $1.3K, 60th percentile) are billed at meaningful volumes. These codes, combined with the procedural and injectable mix, reinforce a clinical focus on prostate disease surveillance and intervention.

The provider’s NPI was enumerated on 2006-01-10 (~20 years ago), indicating long tenure in the market, but lifetime Medicare receipts of $286.9K suggest a relatively modest revenue scale across that tenure. The lack of any Medicaid billing on file further reinforces that this clinician’s payable activity is concentrated in the Medicare population rather than a mixed payer panel.

Medicare: Complete Services Breakdown

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

31 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J0897	Injection, denosumab, 1 mg	2,460	$20	$46.7K
J9217	Leuprolide acetate (for depot suspension), 7.5 mg	300	$140	$40.9K
55874	Under imaging guidance, the provider inserts a needle through the perineum, the area between the anus and the scrotum, and injects one or more biodegradable materials, i.e., material that decomposes…	20	$2,370	$37.9K
52000	In this procedure, the provider performs an examination of the interior of the bladder, the urethra, and the ureteric openings by means of a cystourethroscope, a thin flexible or rigid tube with a…	160	$190	$29.1K
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…	350	$60	$20.7K
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…	230	$90	$20.4K
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…	130	$130	$17.4K
99204	The 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…	90	$110	$10K
52601	During transurethral resection of the prostate (TURP), the surgeon inserts a resectoscope via the urethra and removes a portion of the prostate. This procedure includes several other urological…	20	$550	$8.8K
76872	The provider inserts an ultrasound probe into the rectum and performs a transrectal ultrasound to assess disorders of the prostate, rectum, and surrounding tissues.	60	$110	$6.7K

Showing 1–10 of 31

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 31 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Montana Distribution

Karl Westenfelder — 0 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Montana

Full comparison — all codes billed, vs. state median

31 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
55874	2	10	20	$1,900	$39.9K
J0897	2	10	1,200	$20	$27.2K
J9217	2	10	160	$130	$23.4K
99214	458	1,810	100	$70	$12.4K
52000	6	30	120	$110	$11.4K
52601	4	10	20	$690	$10.3K
99490	27	30	140	$40	$8K
52356	15	20	20	$380	$8K
99215	130	780	40	$100	$7.9K
50590	7	10	10	$550	$7.6K

Showing 1–10 of 31

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Community Hospital Of Anaconda	MT	Pediatric Adolescent Medicine Physician	$0	$1.4M
Carmen Gota	UT	Rheumatology Physician	$1.2M	$0
Community Hospital Of Anaconda	MT	Family Medicine Physician	$0	$1.1M
Community Hospital Of Anaconda	MT	Critical Access Hospital	$0	$1.1M
Community Hospital Of Anaconda	MT	Family Medicine Physician	$0	$669.3K
Brian Bigoni	CA	Diagnostic Radiology Physician	$399.4K	$0
Christopher Wicher	MT	Urology Physician	$251.7K	$0
Jeffrey Redshaw	MT	Urology Physician	$242.8K	$0
Jonathan Fowlkes	MT	Otolaryngology Physician	$100.5K	$121.8K
Garrick Simmons	MT	Urology Physician	$214.6K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Consumer Direct Care Network Virginia	MT	Home Health Agency	$0	$2.1B
Consumer Direct Personal Care, LLC	MT	In Home Supportive Care Agency	$0	$49.1M
Hkj Inc	MT	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$15.2M
We Care Behavioral Health LLC	MT	Clinic/Center	$0	$14.8M
Partners In Home Care, Inc	MT	Nursing Care Agency	$0	$13M
Hkj Inc	MT	Case Management Agency	$0	$11.6M
Sunburst Health LLC	MT	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$6.1M
Providence Health & Services Mt	MT	Family Medicine Physician	$0	$4.9M
Welltower Tenant Group LLC	MT	Assisted Living Facility	$0	$3.8M
Norco, Inc	MT	Durable Medical Equipment & Medical Supplies	$0	$3.8M

Karl Westenfelder — 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