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

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

Seven Springs Orthopaedics, PC (NPI 1194210005)

Seven Springs Orthopaedics, PC is a sports medicine (orthopaedic surgery) physician provider located in Brentwood, Tennessee. This profile covers 0 Medicare and 44 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	Seven Springs Orthopaedics, PC
Address	317 Seven Springs Way Ste 101
City	Brentwood
State	TN
ZIP	37027
Taxonomy	Sports Medicine (Orthopaedic Surgery) Physician
NPI Enumerated	June 25, 2018

Payer Source	Total Paid
Medicaid	$2.1M
Medicare	$0

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

44 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…	19,890	$30	$556.9K
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…	3,860	$70	$274.3K
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…	13,960	$20	$251.2K
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…	5,340	$40	$224.2K
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.	11,790	$20	$212.3K
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…	3,890	$50	$179.1K
97140	Manual therapy is a form of physical therapy which uses the controlled movement and pressure of hands to treat various disorders of soft tissues and joints, eg, chronic back pain. Manual therapy…	9,590	$10	$134.3K
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…	2,680	$40	$93.9K
97112	Neuromuscular reeducation is a therapeutic treatment (exercise) performed by a physician in an attempt to reduce impairments and restore function through the application of clinical skills and/or…	5,220	$20	$88.7K
97161	The provider, typically a physical therapist, conducts a physical therapy evaluation that includes history to rule out any adverse factors that will affect care; observes whether the patient's…	870	$40	$36.6K

Showing 1–10 of 44

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Tennessee Distribution

Seven Springs Orthopaedics, PC — 2 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Tennessee

Full comparison — all codes billed, vs. Tennessee median

44 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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.	65	340	1,400	$40	$354.2K
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…	546	3,760	610	$40	$202.3K
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…	211	4,050	620	$30	$183.9K
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…	39	350	1,060	$30	$173.8K
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…	52	1,080	120	$80	$90.7K
97112	Neuromuscular reeducation is a therapeutic treatment (exercise) performed by a physician in an attempt to reduce impairments and restore function through the application of clinical skills and/or…	18	120	610	$10	$81K
L4361	Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf	20	30	90	$140	$68.3K
97140	Manual therapy is a form of physical therapy which uses the controlled movement and pressure of hands to treat various disorders of soft tissues and joints, eg, chronic back pain. Manual therapy…	23	170	530	$10	$67.8K
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…	55	1,240	120	$60	$53.1K
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…	5	50	140	$30	$38.8K

Showing 1–10 of 44

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Keith Nord	TN	Orthopaedic Surgery Physician	$257K	$42.3K
Jason Jones	TN	Orthopaedic Surgery Physician	$119.8K	$1.9K
Miranda Grider	TN	Nurse Practitioner	$50.8K	$0
Sean Kaminsky	TN	Orthopaedic Surgery Physician	$48.2K	$0
Gregory Lanier	TN	Medical Physician Assistant	$9.6K	$0
Jennifer Dubois	TN	Family Nurse Practitioner	$6.8K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Senior Solutions At Home, Inc.	TN	In Home Supportive Care Agency	$0	$58.4M
Sitters Etc., Inc.	TN	In Home Supportive Care Agency	$0	$29.6M
App Of Indiana Ed, PLLC	TN	Emergency Medicine Physician	$0	$26.1M
Maxim Healthcare Services, Inc.	TN	Home Health Agency	$0	$22.2M
Easter Seals Tennessee	TN	Community/Behavioral Health Agency	$0	$12.3M
Accupath Diagnostic Laboratories Inc	TN	Clinical Medical Laboratory	$4.4M	$5.4M
Carr PLLC	TN	Emergency Medicine Physician	$0	$9M
Tn Specialty Dental Services, PLLC	TN	Pediatric Dentistry	$0	$8.7M
Verus Healthcare, LLC	TN	Durable Medical Equipment & Medical Supplies	$0	$7.6M
National Addiction Specialists LLC	TN	Addiction Medicine (Internal Medicine) Physician	$0	$6.3M

Seven Springs Orthopaedics, PC — Billing Profile & Reimbursement Data

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Seven Springs Orthopaedics, PC — 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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