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.

Ortho Montana, Psc (NPI 1174515878)

Ortho Montana, Psc is a orthopaedic surgery physician provider located in Billings, Montana. This profile covers 0 Medicare and 31 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Medicaid: Complete Services Breakdown

Field	Value
Entity Type	Organization
Organization	Ortho Montana, Psc
Address	2900 12th Ave N
City	Billings
State	MT
ZIP	59101
Taxonomy	Orthopaedic Surgery Physician
NPI Enumerated	August 18, 2005

Payer Source	Total Paid
Medicaid	$1M
Medicare	$0

Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.

31 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	5,210	$70	$353.9K
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…	2,590	$110	$280K
99203	The 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…	1,700	$110	$178.5K
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…	320	$160	$51.4K
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	1,590	$30	$47.8K
73610	In this procedure, the provider takes three or more X–ray images of the ankle joint to check for any fracture, swelling, or reason for pain in the ankle area.	1,190	$30	$32.2K
99202	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves straightforward medical decision making, and/or the provider…	260	$70	$18.1K
73100	In this procedure, the provider takes two X–ray images of a patient’s wrist to check for any fracture, swelling, or reason of pain in the wrist area.	430	$30	$12K
64721	Neuroplasty 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	$400	$10.9K
99212	The 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,…	280	$30	$9.4K

Showing 1–10 of 31

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other Montana providers billing the same CPT/HCPCS codes.

Claims Volume vs. Montana Distribution

Ortho Montana, Psc — 3 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. Montana median

31 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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…	117	530	580	$70	$224.6K
97530	The provider uses various activities during direct contact with the patient to improve the patient’s functional performance. Use this code for each 15 minutes of activity.	177	200	1,110	$60	$207.2K
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…	94	520	730	$40	$196.4K
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…	38	130	100	$120	$49.4K
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	68	160	1,050	$10	$45.3K
99203	The 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…	22	190	130	$70	$37.2K
64721	Neuroplasty 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…	2	10	40	$360	$12.9K
99202	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves straightforward medical decision making, and/or the provider…	22	100	60	$40	$10.3K
99212	The 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,…	104	240	170	$1	$10.3K
20611	In this procedure, the provider inserts a needle through the skin of a patient and into a major joint or bursa, typically the shoulder, hip, knee, or subacromial bursa, and then uses the syringe…	4	10	40	$70	$9.2K

Showing 1–10 of 31

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Zachary Scheer	MT	Orthopaedic Surgery Physician	$379.2K	$0
Michael Groover	MT	Adult Reconstructive Orthopaedic Surgery Physician	$370.4K	$0
Steven Klepps	MT	Orthopaedic Surgery Physician	$224.9K	$0
Anthony Roccisano	MT	Orthopaedic Surgery of the Spine Physician	$214.1K	$0
Thomas Owen	MT	Orthopaedic Hand Surgery Physician	$141.2K	$0
Michael Yorgason	MT	Orthopaedic Foot and Ankle Surgery Physician	$120.9K	$0
Zachary Molyneaux	MT	Physician Assistant	$76K	$0
Jessica Hart	MT	Sports Medicine (Orthopaedic Surgery) Physician	$69.3K	$0
James Neal	FL	Orthopaedic Surgery Physician	$69.1K	$0
Tyler Miller	MT	Physician Assistant	$68.7K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Billings Clinic	MT	General Practice Physician	$0	$53.8M
Rimrock Foundation	MT	Substance Use Disorder Rehabilitation Clinic/Center	$0	$44.9M
Scl Health Medical Group - Billings LLC	MT	Clinic/Center	$0	$32.2M
Residential Support Services	MT	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$30.6M
Billings Public School District 2	MT	Local Education Agency (LEA)	$0	$19.2M
South Central Montana Regional Mental Health Center	MT	Clinic/Center	$0	$16.6M
Billings Clinic	MT	Emergency Care Clinic/Center	$0	$15.7M
Community Solutions Incorporated	MT	Clinical Medical Laboratory	$0	$14.1M
Scl Health Montana	MT	General Acute Care Hospital	$0	$13.5M
Benefis Community Care, Inc.	MT	Case Management Agency	$0	$10.8M

Ortho Montana, Psc — Billing Profile & Reimbursement Data

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Ortho Montana, Psc — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

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