Why are Medicare and Medicaid shown separately instead of combined?

They come from two different CMS data sources with no shared claim identifier, so they can't be reconciled into one number without double-counting or guessing. Every table and chart on this page keeps them fully separate.

Why is there no private/commercial revenue figure?

Private and commercial payer data comes from Transparency in Coverage files, which only publish negotiated rates — not claims or utilization volume. Without a volume figure, no revenue number can be computed for any provider from that data.

What does "Rank" mean in the Competitive Analysis & Benchmarks tables?

For a given CPT/HCPCS code, it's this provider's position by claims volume among all providers billing that same code at that geography level (State, National, or Oregon for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Oregon only?

Medicaid is administered per-state with no single national fee schedule, so a state or national comparison the way Medicare has one isn't available. Oregon (this provider's own state) is the only grouping that's conceptually meaningful.

Why are the numbers rounded to the nearest 10?

To avoid implying more precision than the underlying data supports at a single-provider level. Ratios are kept precise since they're a relative comparison, not a volume or dollar figure.

How current is this data?

The Medicare and Medicaid tables are both single current snapshots, not refreshed on a recurring schedule yet.

South Coast Orthopaedic Associates, PC (NPI 1245284751)

South Coast Orthopaedic Associates, PC is a orthopaedic surgery physician provider located in Coos Bay, Oregon. This profile covers 0 Medicare and 17 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Medicaid: Complete Services Breakdown

Field	Value
Entity Type	Organization
Organization	South Coast Orthopaedic Associates, PC
Address	2699 N 17th St
City	Coos Bay
State	OR
ZIP	97420
Taxonomy	Orthopaedic Surgery Physician
NPI Enumerated	May 20, 2006

Payer Source	Total Paid
Medicaid	$1.3M
Medicare	$0

Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.

17 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	12,900	$20	$270.9K
97530	The provider uses various activities during direct contact with the patient to improve the patient’s functional performance. Use this code for each 15 minutes of activity.	8,140	$30	$211.6K
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…	2,780	$70	$192K
97140	Manual therapy is a form of physical therapy which uses the controlled movement and pressure of hands to treat various disorders of soft tissues and joints, eg, chronic back pain. Manual therapy…	9,570	$20	$153K
97112	Neuromuscular reeducation is a therapeutic treatment (exercise) performed by a physician in an attempt to reduce impairments and restore function through the application of clinical skills and/or…	6,810	$20	$136.3K
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…	2,410	$50	$122.8K
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…	1,340	$80	$108.7K
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…	760	$130	$94.5K
20610	In this procedure, the provider inserts a needle through the skin of a patient and into a major joint or bursa and then uses the syringe attachment to the needle to remove fluid or he may inject a…	1,150	$30	$35.6K
73630	In this diagnostic procedure, the provider takes a minimum of three views of the foot to assess injury, fracture, arthritis, tumor, or congenital abnormality.	370	$20	$6.2K

Showing 1–10 of 17

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other Oregon providers billing the same CPT/HCPCS codes.

Claims Volume vs. Oregon Distribution

South Coast Orthopaedic Associates, PC — 0 of 17 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Oregon

Full comparison — all codes billed, vs. Oregon median

17 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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…	398	1,500	650	$70	$312.4K
97530	The provider uses various activities during direct contact with the patient to improve the patient’s functional performance. Use this code for each 15 minutes of activity.	36	290	770	$60	$252K
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…	411	1,590	590	$50	$236.5K
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	24	350	760	$30	$116.5K
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…	88	600	120	$80	$83.3K
97140	Manual therapy is a form of physical therapy which uses the controlled movement and pressure of hands to treat various disorders of soft tissues and joints, eg, chronic back pain. Manual therapy…	20	350	610	$30	$73.9K
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…	82	530	80	$120	$68.5K
97112	Neuromuscular reeducation is a therapeutic treatment (exercise) performed by a physician in an attempt to reduce impairments and restore function through the application of clinical skills and/or…	10	150	450	$30	$53.8K
99205	The 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…	149	190	60	$200	$45.6K
99212	The 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,…	232	570	110	$50	$37.6K

Showing 1–10 of 17

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Ryan Pederson	OR	Foot & Ankle Surgery Podiatrist	$144.1K	$30.7K
Wesley Johnson	OR	Orthopaedic Surgery Physician	$136.3K	$29.6K
Garry Vallier	OR	Orthopaedic Surgery Physician	$159.8K	$5.2K
Jason Bell	OR	Orthopaedic Surgery Physician	$118K	$17.5K
Shaun Hobson	OR	Orthopaedic Surgery Physician	$127.9K	$0
Maria Smith	OR	Physical Therapist	$100K	$14.7K
Brian Allen	OR	Physician Assistant	$24.6K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
North Bend Medical Center Inc	OR	Multi-Specialty Clinic/Center	$0	$12.4M
Bay Cities Ambulance	OR	Land Ambulance	$1.7M	$9.5M
Bay Area Hospital District	OR	General Acute Care Hospital	$0	$8.7M
Coos County Oregon	OR	Clinic/Center	$0	$8.5M
Cep America LLC	OR	Emergency Medicine Physician	$0	$5.7M
Lincare Inc.	OR	Durable Medical Equipment & Medical Supplies	$0	$3.4M
Coos County Oregon	OR	Public Health or Welfare Agency	$15.8K	$3.2M
Coquille Indian Tribe	OR	Clinic/Center	$0	$2.1M
Bay Clinic	OR	Specialist	$0	$2M
Nbmc Day Surgery Inc	OR	Ambulatory Surgical Clinic/Center	$1.1M	$830.1K

South Coast Orthopaedic Associates, PC — Billing Profile & Reimbursement Data

Sign up for South Coast Orthopaedic Associates, PC — Billing Profile & Reimbursement Data policy alerts

South Coast Orthopaedic Associates, PC — Billing Profile & Reimbursement Data

Sign up for South Coast Orthopaedic Associates, PC — Billing Profile & Reimbursement Data policy alerts

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References