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    OpenPayerNPI Medicare & MedicaidJames Macdonald
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    James Macdonald — Billing Profile & Reimbursement Data

    NPI 1184628794 · Annapolis, MD · Adult Reconstructive Orthopaedic Surgery Physician

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    James Macdonald is a adult reconstructive orthopaedic surgery physician provider located in Annapolis, Maryland. This profile covers 17 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 Macdonald
    Address2000 Medical Pkwy
    CityAnnapolis
    StateMD
    ZIP21401
    TaxonomyAdult Reconstructive Orthopaedic Surgery Physician
    NPI EnumeratedJune 10, 2005

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

    Payer SourceTotal Paid
    Medicare$455K
    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.

    17 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    27447In 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…180$1,080$195.1K
    27130In 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…80$1,080$82.9K
    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…620$70$40.9K
    99215The 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…260$130$32.8K
    73564In this procedure, the provider takes four or more X–ray views of the knee joint to check for any fracture, swelling, or reason for pain in the knee area.760$30$25.2K
    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…330$60$19.4K
    J7324Hyaluronan or derivative, orthovisc, for intra-articular injection, per dose170$100$16.6K
    73562In 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.330$30$9.7K
    73502In this diagnostic procedure, the provider takes X–ray images of one hip, either left or right, from two or three projections (directions or angles) to check for any fracture, swelling, or other…270$40$9.4K
    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…100$80$8.2K

    Showing 1–10 of 17

    Medicare: Competitive Analysis & Benchmarks

    How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 17 CPT/HCPCS codes.

    View: State1 / 2

    Full comparison — all codes billed, vs. state median

    17 rows

    CPT/HCPCS CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    27447427030$1,500$72K
    271302218030$1,430$56K
    992148,54010,270150$90$24.1K
    J7324104090$100$15.4K
    992136659,280100$60$12.5K
    992153004,07050$120$10.9K
    2061011584070$50$7.6K
    992055961,91030$160$6.5K
    992037163,63040$80$5K
    735023672050$20$2.6K

    Showing 1–10 of 17

    Related Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Luminis Health Doctors Community Medical Center, Inc.MDGeneral Acute Care Hospital$0$9.9M
    Jason TakseyMDMedical Oncology Physician$3.3M$0
    Ravin GargMDHematology & Oncology Physician$1.9M$0
    Muhammad SiddiqueMDMedical Oncology Physician$1.6M$0
    Adam DuhlNJMaternal & Fetal Medicine Physician$128.8K$1.5M
    David WengMDMedical Oncology Physician$1.5M$0
    Angela PoltrackMDAcute Care Nurse Practitioner$775.9K$0
    Yogesh VohraMDInternal Medicine Physician$595.5K$0
    Paul KingMDAdult Reconstructive Orthopaedic Surgery Physician$502.8K$0
    Suresh MalikMDInternal Medicine Physician$497K$0

    Nearby Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Anne Arundel County Public SchoolsMDLocal Education Agency (LEA)$0$47.7M
    Advanced Pain Management Specialists, LLCMDInterventional Pain Medicine Physician$0$33.8M
    Luminis Health Pathways, Inc.MDAdult Mental Health Clinic/Center$0$14.4M
    Bay Clinical LaboratoriesMDClinical Medical Laboratory$104.9K$9.7M
    Wellspring Therapy Services, LLCMDEarly Intervention Provider Agency$0$9.3M
    Doctors Emergency Service, PAMDEmergency Medicine Physician$0$9.2M
    New Journey, Inc.MDMethadone Clinic$188.3K$8.6M
    Committed To Change,p.c.MDMental Health Clinic/Center (Including Community Mental Health Center)$0$7.9M
    Psychotherapeutic Treatment ServicesMDMental Illness Community Based Residential Treatment Facility$0$7.6M
    Advocate Support Services, Inc.MDCommunity/Behavioral Health Agency$0$7.4M

    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. Maryland Distribution
    James Macdonald — 2 of 17 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Maryland