Loading...

    Explore
    • Policy Monitoring
    • Live Policy Feed
    • Billing Codes
    • NPI Medicare & Medicaid
    • Healthcare Providers
    • Health Insurance Payers
    • States
    • Service Lines
    • Taxonomy Codes
    Lookup tools
    • Billing Code Lookup
    • CPT Modifier Lookup
    • Provider Taxonomy Code Lookup
    • Healthcare Provider & Facility Lookup
    • Health Insurance Payer Lookup
    • Payer Contact Directory

    Policy & Benchmark Tools

    • Prior Authorization Lookup
    • Coverage Criteria Lookup
    • Timely Filing Lookup
    • Billing Code Reimbursement Rates
    • Payer Comparison Dashboard
    • Facility Comparison Dashboard
    • All tools

    Company

    • About OpenPayer
    • Data Sources
    • Trek Health
    OpenPayerby Trek Health
    LinkedInYouTube

    © 2026 Trek Health. All rights reserved.

    OpenPayer is built and maintained by Trek Health.

    v1.0.28
    OpenPayerNPI Medicare & MedicaidThomas Waterbury
    Ask Trek AI about this page

    Thomas Waterbury — Billing Profile & Reimbursement Data

    NPI 1225392160 · Sioux Falls, SD · Interventional Cardiology Physician

    Customize your policy alerts

    Sign up for Thomas Waterbury — Billing Profile & Reimbursement Data policy alerts

    Get alerted when relevant policies change without checking for updates manually.

    Monitor payer policy activity

    Receive email alerts as soon as relevant payer policies are published or updated.

    Thomas Waterbury is a interventional cardiology physician provider located in Sioux Falls, South Dakota. This profile covers 25 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.

    Table of contents

    Progress1 / 8

    Explore openpayer tools

    • Billing CodesCPT, HCPCS, DRG & more
    • Reimbursement RatesCommercial vs. Medicare rate reports
    • ProvidersHospitals & facilities
    • PayersPlans & market footprint
    • Taxonomy CodesNUCC specialty codes
    • ModifiersCPT modifiers & usage
    • Prior AuthorizationPA policies by payer & drug
    • Timely FilingFiling deadlines by payer
    • Coverage CriteriaMedical necessity by payer
    • Payer ContactsClaims, PA & appeals contacts
    View all tools

    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeIndividual
    OrganizationThomas Waterbury
    Address4520 W 69th St
    CitySioux Falls
    StateSD
    ZIP57108
    TaxonomyInterventional Cardiology Physician
    NPI EnumeratedJune 26, 2012

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

    Payer SourceTotal Paid
    Medicare$196.1K
    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.

    25 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    93306The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent…680$50$33.4K
    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…350$100$33.1K
    92928The provider inserts a catheter through the skin (percutaneous approach) and guides it into the heart's arteries. They deploy one or more stents (small tubes) to keep the artery open and may expand a…80$380$28.6K
    93458In this procedure, the provider performs imaging supervision and interpretation for a coronary angiography with left heart catheterization and intraprocedural injections for left ventriculography. He…160$170$26.1K
    78452In this procedure, the provider performs multiple SPECT studies of the heart to determine the areas of deficient blood flow. The goal of the procedure is to determine areas that have deficient blood…300$60$17K
    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…210$70$14.8K
    99232The 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…160$60$9.4K
    92978In this add–on procedure, the provider advances a catheter into a coronary vessel or previously placed graft using ultrasound or optical coherence tomography to view the extent of the blockage,…80$70$5.6K
    99223The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…40$130$4.4K
    93010The provider interprets and reports on the results of a routine 12–lead (or more) electrocardiogram.560$10$3.3K

    Showing 1–10 of 25

    Medicare: Competitive Analysis & Benchmarks

    How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 25 CPT/HCPCS codes.

    View: State1 / 2

    Full comparison — all codes billed, vs. state median

    25 rows

    CPT/HCPCS CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    9292872070$380$27.7K
    933061060250$50$21.4K
    9345843040$180$11.9K
    992144261,66090$70$11.4K
    9923218357080$60$9.2K
    78452740140$60$8.6K
    93454152040$150$7.5K
    9922318034040$130$7.5K
    99204267030$100$5.1K
    9345951020$190$3.6K

    Showing 1–10 of 25

    Related Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Sanford Medical Center FargoNDFamily Medicine Physician$0$75.9M
    Sanford Medical CenterSDFamily Medicine Physician$0$68.8M
    Avera MckennanSDFamily Medicine Physician$0$10.6M
    Avera MarshallMNCritical Access Hospital$0$10M
    Avera MckennanSDPsychiatry Physician$0$9.1M
    Avera MckennanSDHome Infusion Agency$0$6.7M
    Avera MckennanSDAir Ambulance$0$5.3M
    Affiliated Community Medical Centers, LtdMNMulti-Specialty Clinic/Center$0$4.7M
    Avera St MarysSDMulti-Specialty Clinic/Center$0$4.6M
    Regional Health Services Of Howard CountyIARural Health Clinic/Center$0$4.2M

    Nearby Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Vance Thompson Vision Surgery Center Prof LLCSDAmbulatory Surgical Clinic/Center$4.5M$22.7K
    Siouxland Oral SurgerySDOral and Maxillofacial Surgery (Dentist)$0$3.9M
    Avera Home Medical Equipment, LLCSDDurable Medical Equipment & Medical Supplies$0$3.4M
    Ryan GeraetsSDOphthalmology Physician$3M$0
    Anderson-smith Speech Therapy, LLCSDSpeech-Language Pathologist$0$1.9M
    Ophthalmology Ltd Eye Surgery Center L L CSDAmbulatory Surgical Clinic/Center$1.8M$16.2K
    Elizabeth AtchisonSDOphthalmology Physician$1.7M$0
    Dakota Vision Center, LLCSDOptometrist$0$1.2M
    Usc Ambulatory Surgical Center Prof LLCSDAmbulatory Surgical Clinic/Center$1.1M$44.2K
    Avera MckennanSDPhysical Therapist$0$1M

    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. South Dakota Distribution
    Thomas Waterbury — 1 of 25 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — South Dakota