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    v1.0.28
    OpenPayerNPI Medicare & MedicaidDavid Paolone
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    David Paolone — Billing Profile & Reimbursement Data

    NPI 1235194846 · Madison, WI · Urology Physician

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    David Paolone is a urology physician provider located in Madison, Wisconsin. This profile covers 30 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
    OrganizationDavid Paolone
    Address1 S Park St
    CityMadison
    StateWI
    ZIP53715
    TaxonomyUrology Physician
    NPI EnumeratedApril 18, 2006

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

    Payer SourceTotal Paid
    Medicare$148K
    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.

    30 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…570$50$29.6K
    52000In this procedure, the provider performs an examination of the interior of the bladder, the urethra, and the ureteric openings by means of a cystourethroscope, a thin flexible or rigid tube with a…150$130$19.7K
    J9217Leuprolide acetate (for depot suspension), 7.5 mg90$130$12K
    52356The provider performs a cystourethroscopy, the inspection of the interior of the bladder, the urethra, prostatic urethra, and ureteric openings using a cystoscope passed through the urethra and into…40$310$11.2K
    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…120$80$10.2K
    99212The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…260$30$8.8K
    52648Transurethral resection of the prostate is performed in cases of BPH (benign prostate hyperplasia) which commonly occurs in middle–aged and elderly men, often causing lower urinary symptoms, with…20$500$8K
    52353The provider performs a cystourethroscopy, the inspection of the interior of the bladder, the urethra, prostatic urethra, and ureteric openings using a cystoscope passed through the urethra and into…30$270$6.9K
    55700Code deleted December 31, 2025.40$150$5.7K
    99202The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves straightforward medical decision making, and/or the provider…130$40$5.6K

    Showing 1–10 of 30

    Medicare: Competitive Analysis & Benchmarks

    How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 30 CPT/HCPCS codes.

    View: State1 / 2

    Full comparison — all codes billed, vs. state median

    30 rows

    CPT/HCPCS CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    J92172830130$130$20.9K
    992143,3369,80080$70$9.2K
    52000516070$120$8.8K
    5235656020$410$8.7K
    992322,5753,49060$60$7.2K
    5235311030$270$6.9K
    5264811010$510$6.6K
    99213939,38060$50$4.7K
    5570097020$170$4K
    992041,1403,39030$100$3.7K

    Showing 1–10 of 30

    Related Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    University Of Wisconsin Hospitals And Clinics AuthorityWIGeneral Acute Care Hospital$0$120M
    University Of Wisconsin Medical Foundation, IncWIMulti-Specialty Clinic/Center$0$15.2M
    University Of Wisconsin System Non PayrollWIClinical Medical Laboratory$0$4M
    St. Joseph's Health Services, Inc.WICritical Access Hospital$0$3.9M
    Anil Rama RaoAZAnatomic Pathology & Clinical Pathology Physician$1.3M$0
    Philip BrunettiAKOphthalmology Physician$1.1M$0
    Noemi BrunnerWIDiagnostic Radiology Physician$35.1K$739.2K
    Nevein IbrahimILDiagnostic Radiology Physician$668.4K$0
    Michael IpCAOphthalmology Physician$635.3K$0
    Gordon CrabtreeWIOphthalmology Physician$618.1K$2.2K

    Nearby Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Dean Health Systems, IncWIAllergy & Immunology Physician$0$26.3M
    Meriter Hospital, Inc.WIGeneral Acute Care Hospital$0$25.5M
    Ssm Health Care Of Wisconsin, Inc.WIGeneral Acute Care Hospital$0$14.7M
    Ssm Health Care Of Wisconsin, IncWIClinical Medical Laboratory$0$6.4M
    Madison Surgery Center, Inc.WIAmbulatory Surgical Clinic/Center$3.6M$549.2K
    Ryan Bros Ambulance LLCWILand Ambulance$1.5M$2.3M
    Madison Emergency Physicians, ScWIEmergency Medicine Physician$0$3.2M
    Dean Health Systems, Inc.WIAmbulatory Surgical Clinic/Center$2M$856.3K
    Emergency Medicine Associates Of Madison, ScWIEmergency Medicine Physician$0$2.1M
    Amol KulkarniWIOphthalmology Physician$2.1M$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. Wisconsin Distribution
    David Paolone — 6 of 25 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Wisconsin