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    v1.0.28
    OpenPayerNPI Medicare & MedicaidMatthew Grafenberg
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    Matthew Grafenberg — Billing Profile & Reimbursement Data

    NPI 1225001357 · Pinehurst, NC · Otolaryngology Physician

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    Matthew Grafenberg is a otolaryngology physician provider located in Pinehurst, North Carolina. This profile covers 23 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
    OrganizationMatthew Grafenberg
    Address5 Firstvillage Drive
    CityPinehurst
    StateNC
    ZIP28374
    TaxonomyOtolaryngology Physician
    NPI EnumeratedFebruary 9, 2006

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

    Payer SourceTotal Paid
    Medicare$94.8K
    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.

    23 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    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…430$60$25.6K
    99204The 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…200$110$21.2K
    95810Polysomnography refers to the continuous and simultaneous monitoring and recording of various physiological and pathophysiological parameters of sleep for six or more hours with physician review,…80$90$7K
    64582The provider uses an open approach to implant a hypoglossal nerve neurostimulator electrode array and also implants a programmable pulse generator and one or more distal respiratory sensor…10$440$5.7K
    31575The provider uses a flexible laryngoscope to look inside the larynx, or voice box, to detect the presence of any abnormalities. This code applies to diagnostic services.60$90$5.2K
    95165In this procedure, the provider mixes and prepares the antigens for allergen immunotherapy. Use this code when the provider prepares one or more antigens.450$10$5K
    92511The provider examines the nasal passages and throat with an endoscope, a tubular instrument with a light source and camera.60$80$4.5K
    99214The 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…50$90$4.3K
    69210The provider uses an instrument such as a curette, vacuum evacuation, or forceps to remove entrapped wax from a patient's external auditory canal.100$30$3.1K
    95811During the study, the physician monitors the sleep pattern of the patient, along with different bodily functions during the sleep cycle extending over a period of six hours or more.30$80$2.7K

    Showing 1–10 of 23

    Medicare: Competitive Analysis & Benchmarks

    How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 23 CPT/HCPCS codes.

    View: State1 / 2

    Full comparison — all codes billed, vs. state median

    23 rows

    CPT/HCPCS CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    9921413,26418,060110$80$15.1K
    9516597140800$10$13.1K
    958116612040$260$12.1K
    958102714040$250$11.8K
    6458261010$620$8.7K
    850251,4181,92080$10$7.4K
    9921388516,32070$50$7.1K
    364152,0983,49090$10$6.4K
    315759326050$80$5K
    992041358,43030$110$4.8K

    Showing 1–10 of 23

    Related Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Daniel WilliamsNCOrthopaedic Surgery of the Spine Physician$1.2M$0
    Stephen VanceVAMOHS-Micrographic Surgery Physician$924.6K$0
    Alexander LemonsNCOrthopaedic Surgery of the Spine Physician$533.6K$0
    Greg GrieweNCUrology Physician$489.7K$0
    Kurt WohlrabNCOrthopaedic Surgery Physician$415.7K$0
    John MichalakNCUrology Physician$411.2K$0
    Neil ContiNCOrthopaedic Surgery Physician$354.3K$0
    John MooreNCOrthopaedic Surgery Physician$351.7K$0
    Chad RundNCAnatomic Pathology & Clinical Pathology Physician$319.6K$0
    Joshua SesekNCUrology Physician$310.6K$0

    Nearby Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Firsthealth Of The Carolinas, Inc.NCGeneral Acute Care Hospital$0$61.5M
    Sandhills Emergency Physicians PANCEmergency Medical Services (Emergency Medicine) Physician$0$21.1M
    Speech Connections, LLCNCOccupational Therapist$0$19.5M
    Solas Health PLLCNCAnesthesiology Physician$0$13.4M
    Ats Of North Carolina, LLCNCMethadone Clinic$123.2K$7.4M
    Surgery Center Of Pinehurst, LLCNCAmbulatory Surgical Clinic/Center$2M$812.9K
    Pinehurst Medical Clinic, Inc.NCAmbulatory Surgical Clinic/Center$1.4M$985.2K
    Cedar MaloneNCDermatology Physician$1.1M$0
    Sarah VietaNCMOHS-Micrographic Surgery Physician$792.3K$0
    Leah HershmanNCVascular Surgery Physician$543.2K$0

    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. North Carolina Distribution
    Matthew Grafenberg — 1 of 23 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — North Carolina