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

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

Regional Orthopaedic Associates PA (NPI 1194735779)

Regional Orthopaedic Associates PA is a orthopaedic surgery physician provider located in Wilmington, Delaware. This profile covers 0 Medicare and 48 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	Regional Orthopaedic Associates PA
Address	1941 Limestone Rd Ste 101
City	Wilmington
State	DE
ZIP	19808
Taxonomy	Orthopaedic Surgery Physician
NPI Enumerated	August 8, 2006

Payer Source	Total Paid
Medicaid	$2.8M
Medicare	$0

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

48 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	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…	10,900	$70	$806.5K
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…	3,660	$120	$439.2K
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…	6,220	$50	$323.2K
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…	1,650	$100	$157K
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…	2,140	$70	$143.4K
20610	In 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…	3,680	$40	$128.8K
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…	3,670	$30	$106.3K
95886	The provider assesses the electrical activity of a muscle in the extremity and related paraspinal areas. At the same session as a separately reportable nerve conduction study. He studies five or more…	1,090	$70	$74.3K
64483	This 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).	340	$180	$59.3K
99205	The provider sees a new 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 provider…	330	$140	$47.2K

Showing 1–10 of 48

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Delaware Distribution

Regional Orthopaedic Associates PA — 1 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Delaware

Full comparison — all codes billed, vs. Delaware median

48 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	30	50	1,030	$60	$292.3K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	62	80	940	$30	$277.8K
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…	52	500	1,130	$50	$235.1K
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…	97	540	1,100	$40	$185.3K
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…	41	90	2,360	$20	$181.1K
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…	24	150	230	$90	$110.4K
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…	50	50	930	$20	$104.7K
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…	11	180	220	$90	$101.5K
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…	29	190	240	$60	$90.8K
20610	In 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…	5	10	1,860	$20	$90K

Showing 1–10 of 48

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Dynamic Therapy Services LLC	DE	Physical Therapist	$0	$12.8M
Steven Dellose	DE	Orthopaedic Surgery Physician	$1M	$0
Selina Xing	DE	Pain Medicine (Physical Medicine & Rehabilitation) Physician	$910.2K	$300
James Rubano	DE	Orthopaedic Surgery Physician	$902.4K	$0
Mark Eskander	DE	Orthopaedic Surgery of the Spine Physician	$564K	$0
John Rowlands	DE	Interventional Pain Medicine Physician	$419K	$0
Nick Patel	DE	Orthopaedic Surgery Physician	$345K	$0
Brian Galinat	DE	Orthopaedic Surgery Physician	$268K	$0
Peter Townsend	DE	Orthopaedic Surgery Physician	$250.4K	$0
Amir Abdel Kader	DE	Pain Medicine (Anesthesiology) Physician	$244.7K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
State Of Delaware	DE	Local Education Agency (LEA)	$0	$9.2M
Jp Nacchia & Associates, Inc.	DE	In Home Supportive Care Agency	$0	$8.2M
Macklyn Home Care	DE	Home Health Agency	$0	$6.2M
Journeys LLC	DE	Mental Health Counselor	$0	$5M
Resouces For Human Development, Inc.	DE	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$4.3M
Robert M Collins Dds PA	DE	Pediatric Dentistry	$0	$3.2M
Rockland Surgery Center, L.P.	DE	Anesthesiology Physician	$2.4M	$280K
Limestone Medical Center, LLC	DE	Ambulatory Surgical Clinic/Center	$2.3M	$242.7K
Pace, Inc.	DE	Adult Mental Health Clinic/Center	$0	$2.3M
Jmk Behavior, LLC	DE	Intellectual & Developmental Disabilities Psychologist	$0	$2.2M

Regional Orthopaedic Associates PA — 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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