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    v1.0.28
    OpenPayerNPI Medicare & MedicaidMichael Sugarman
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    Michael Sugarman — Billing Profile & Reimbursement Data

    NPI 1225027956 · Newark, DE · Specialist

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    Michael Sugarman is a specialist provider located in Newark, Delaware. This profile covers 19 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.

    (source: NPPES NPI Registry)

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    Provider details
    FieldValue
    Entity TypeIndividual
    OrganizationMichael Sugarman
    Address774 Christiana Rd
    CityNewark
    StateDE
    ZIP19713
    TaxonomySpecialist
    NPI EnumeratedOctober 15, 2005

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

    Payer SourceTotal Paid
    Medicare$164.6K
    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.

    19 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    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…190$140$26.2K
    61312Hematoma is an unusual collection of blood outside the blood vessels due to internal hemorrhage. Subdural or extradural hematoma is caused by head injuries, and it is a life–threatening condition.…20$1,510$22.7K
    99205The 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…100$170$16.8K
    63042This procedure is laminotomy of one lumbar interspace with decompression of the nerve root(s), and includes a partial facetectomy, foraminotomy, and/or the excision of a herniated intervertebral…10$1,190$15.5K
    22614The provider performs arthrodesis, also known as spinal fusion, to permanently join two vertebrae, the interlocking bones of the spine. The provider applies bone graft material to fuse the spine. The…40$310$13.6K
    63056The provider uses a transpedicular approach to repair a bulging lumbar disc without manipulating the spinal cord. The approach is through the side of the pedicle of one lumbar vertebra, known as a…10$1,130$12.5K
    22842The provider places spinal instrumentation at the back of the spine across three to six vertebral segments to correct a spinal deformity during the course of a spinal surgery, such as a spinal…20$600$9K
    63047The provider performs a laminectomy (excision of the thin bony plate at the back of a vertebra), facetectomy (excision of an area of a vertebra characterized by its smooth surface), and foraminotomy…10$720$8.6K
    22214The provider performs an osteotomy, a bony incision, of a lumbar vertebra, one of the bones in the lower back, to realign the spine and correct spinal deformities. He makes the incision in the…10$600$6.6K
    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…60$110$6.3K

    Showing 1–10 of 19

    Medicare: Competitive Analysis & Benchmarks

    How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 19 CPT/HCPCS codes.

    View: State1 / 2

    Full comparison — all codes billed, vs. state median

    19 rows

    CPT/HCPCS CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    992141,4581,830150$80$25.5K
    6131211020$1,510$22.7K
    62323364060$180$20.4K
    9923344650080$90$15.4K
    72148466080$100$13.9K
    63047192040$340$12.4K
    992155857040$120$11K
    6178331050$180$10.5K
    22614112040$170$10.5K
    22842142020$350$9.3K

    Showing 1–10 of 19

    Related Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Delaware Neurosurgical Group, P.A.DESpecialist$0$1.5M
    Kennedy YalamanchiliDESpecialist$582.5K$0
    Pawan RastogiDENeurological Surgery Physician$397.4K$0
    Paul BoulosDENeurological Surgery Physician$376.8K$0
    Pulak RayPANeurological Surgery Physician$248.8K$0
    Leif-erik BohmanDENeurological Surgery Physician$202.8K$0
    Matthew EppleyDESpecialist$171.1K$0
    Tony Anene-maidohDENeurological Surgery Physician$163.3K$0
    Bernard RaceyDEPhysician Assistant$45.5K$0
    Joseph ReynoldsDESurgical Physician Assistant$44.8K$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.

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    Medicare Revenue by CPT/HCPCS Code
    Claims Volume vs. Delaware Distribution
    Michael Sugarman — 0 of 19 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Delaware