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NPI 1205078987 · Paducah, KY · Pain Medicine Physician
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John Ruxer is a pain medicine physician provider located in Paducah, Kentucky. This profile covers 35 Medicare and 24 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.
Provider details (source: NPPES NPI Registry)
| Field | Value |
|---|---|
| Entity Type | Individual |
| Organization | John Ruxer |
| Address | 5925 Old Hwy 60 West |
| City | Paducah |
| State | KY |
| ZIP | 42001 |
| Taxonomy | Pain Medicine Physician |
| NPI Enumerated | March 27, 2009 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $1M |
| Medicaid | $274.3K |
Practice profile and tenure: JOHN RUXER is a Pain Medicine Physician with an NPI enumerated 2009-03-27 (~17 years ago), indicating a long-standing presence in the market. The billing mix and procedural codes are consistent with an interventional pain practice that combines high-volume clinic visits with image-guided spinal procedures and device-based interventions.
Payer scale and mix: Lifetime Medicare revenue is reported as $1M while lifetime Medicaid revenue is $274.3K, so Medicare represents the larger revenue stream for this provider. Both payers are active in this profile, but Medicare contributes the majority of reported lifetime public-payer revenue.
Medicare revenue concentration: the precomputed top 3 Medicare codes by revenue account for 39.3% of this provider's total Medicare revenue, indicating meaningful concentration among a small set of services. Those high-revenue Medicare codes include 99214, 62323, and 64635, which together drive a large share of the practice’s Medicare receipts.
Medicaid revenue concentration: the precomputed top 3 Medicaid codes by revenue account for 67.2% of this provider's total Medicaid revenue, reflecting even greater revenue dependence on a narrow set of services for Medicaid. The Medicaid top codes are 99214, 62323, and 99213, with 99214 alone representing $85.3K (31.2% of Medicaid revenue).
Service-line implications — interventional focus: high-revenue procedure codes billed to Medicare such as 62323 (lumbar/sacral epidural injections), 64635 (neurolytic destruction of lower back joint nerves), and 63650 (epidural electrode placement) indicate the practice performs image-guided spinal injections and neuromodulation/device procedures in addition to office-based care. The E/M codes 99214 and 99213 appear as revenue drivers across both payers, signaling a substantial outpatient clinic volume combined with procedure throughput.
High-volume procedural and testing activity: frequent use of 80307 (instrumented presumptive drug testing) and definitive drug testing codes (G0481 on Medicare) alongside numerous injection and neurolysis codes suggests an integrated pain-management workflow that includes monitoring for controlled substances and procedure follow-up. On Medicaid, 80307 appears with 877 claims and $26.3K revenue, underscoring its role in the Medicaid billing mix.
Competitive standing — Medicare national outlier status: for several lead Medicare codes this provider ranks at or near extreme national volume percentiles — 99214 ranks as an “extreme outlier” nationally (100th percentile), 62323 is an “extreme outlier” (99th percentile), and 64635 is “notably above typical national volume” (98th percentile). Those ranks indicate this provider is a major national outlier by volume for core interventional pain procedures and high-complexity office visits.
Competitive standing — Medicaid in-state position: by contrast, Medicaid ranks are more typical statewide: 99214 is at the 68th percentile in-state, 62323 is at the 55th percentile in-state, and 99213 is at the 58th percentile in-state. The provider’s Medicaid footprint looks like a solid, mid-tier participant within Kentucky for these same service lines rather than the national dominance seen in Medicare data.
Medicare revenue breakdown by CPT/HCPCS procedure code.
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The CPT/HCPCS codes generating the most Medicare revenue for this provider.
35 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… | 2,160 | $90 | $190.2K |
| 62323 | The provider injects a diagnostic or a therapeutic substance, such as pain medication or a steroid, into the space around the spinal nerves of the lumbar (lower back) or sacral (caudal, or tailbone)… | 610 | $180 | $107.8K |
| 64635 | Under fluoroscopic or CT guidance, the provider applies an agent to a lower back joint to destroy nerve tissue. | 210 | $450 | $96.5K |
| 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… | 1,550 | $60 | $91.5K |
| 63650 | In this procedure, the provider places electrodes in the epidural space to relieve pain and reduce or eliminate spasms. | 70 | $1,220 | $85.4K |
| 99490 | The clinical staff provides services directed by the provider to support and coordinate a patient’s care across multiple disciplines. The patient has two or more chronic conditions that place the… | 1,770 | $50 | $81.3K |
| 80307 | The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date. | 950 | $60 | $56.9K |
| 64636 | In this add on procedure, the provider destroys the facet joint nerve of a lumbar or sacral spinal segment using neurolytic agents like heat, electric current, or a chemical compound. He makes use of… | 210 | $250 | $52.5K |
| 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… | 310 | $120 | $37.2K |
| 64493 | The provider injects a diagnostic or therapeutic substance into a single lumbar or sacral paravertebral facet (zygapophyseal) joint, or into the nerves that supply that joint, using imaging guidance… | 180 | $180 | $32.2K |
Showing 1–10 of 35
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 35 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
View: By Year1 / 3
Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
24 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… | 1,900 | $50 | $85.3K |
| 62323 | The provider injects a diagnostic or a therapeutic substance, such as pain medication or a steroid, into the space around the spinal nerves of the lumbar (lower back) or sacral (caudal, or tailbone)… | 410 | $130 | $52.4K |
| 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… | 1,700 | $30 | $45.8K |
| L0651 | Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces… | 60 | $570 | $33.2K |
| 80307 | The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date. | 880 | $30 | $26.3K |
| 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… | 130 | $80 | $10.4K |
| 64635 | Under fluoroscopic or CT guidance, the provider applies an agent to a lower back joint to destroy nerve tissue. | 20 | $220 | $5.2K |
| J1040 | Injection, methylprednisolone acetate, 80 mg | 430 | $10 | $3.5K |
| 99406 | The provider counsels the patient on how to stop tobacco use. The counseling lasts more than three minutes, up to 10 minutes. | 330 | $10 | $3K |
| 64636 | In this add on procedure, the provider destroys the facet joint nerve of a lumbar or sacral spinal segment using neurolytic agents like heat, electric current, or a chemical compound. He makes use of… | 30 | $100 | $2.6K |
Showing 1–10 of 24
How this provider's Medicaid billing volume and revenue compare to other Kentucky providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Kentucky median
24 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| G0481 | Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but… | 83 | 80 | 990 | $60 | $912.2K |
| 80307 | The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date. | 208 | 340 | 2,700 | $40 | $673.3K |
| 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… | 1,399 | 3,340 | 1,020 | $30 | $296K |
| 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… | 778 | 2,460 | 580 | $40 | $245K |
| 62323 | The provider injects a diagnostic or a therapeutic substance, such as pain medication or a steroid, into the space around the spinal nerves of the lumbar (lower back) or sacral (caudal, or tailbone)… | 36 | 80 | 260 | $190 | $182.3K |
| 64635 | Under fluoroscopic or CT guidance, the provider applies an agent to a lower back joint to destroy nerve tissue. | 26 | 40 | 80 | $330 | $181.6K |
| 64636 | In this add on procedure, the provider destroys the facet joint nerve of a lumbar or sacral spinal segment using neurolytic agents like heat, electric current, or a chemical compound. He makes use of… | 26 | 40 | 60 | $140 | $91.4K |
| 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… | 499 | 1,020 | 120 | $70 | $62K |
| 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… | 267 | 410 | 110 | $60 | $50.4K |
| 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… | 1,088 | 1,400 | 130 | $50 | $45.8K |
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Other providers in the same ZIP code as John Ruxer, ranked by combined Medicare and Medicaid revenue.
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