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    v1.0.28
    OpenPayerNPI Medicare & MedicaidNPI 1255394771
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    NPI 1255394771 — Billing Profile & Reimbursement Data

    NPI 1255394771 · XX · healthcare

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    NPI 1255394771 is a healthcare provider located in Unspecified Location. This profile covers 10 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. Note: "XX" is a placeholder CMS uses when a provider's practice-location state wasn't reported — not a traditional US state; claims coded under it are grouped and benchmarked here the same way a traditional state would be.

    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeIndividual
    OrganizationNPI 1255394771
    Address
    City
    StateXX (Unspecified Location)
    ZIP
    TaxonomyN/A
    NPI Enumerated
    NPI DeactivatedJanuary 15, 2026

    (source: CMS Medicare & Medicaid claims data)

    Medicare: Total Revenue Breakdown by CPT/HCPCS Code

    Medicare revenue breakdown by CPT/HCPCS procedure code.

    View: Bar Chart1 / 2

    Medicare Revenue by CPT/HCPCS Code

    Medicare: Complete Services Breakdown

    The CPT/HCPCS codes generating the most Medicare revenue for this provider.

    10 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    27447In this procedure, the provider replaces the damaged weight bearing surfaces of both the medial and lateral compartments in the knee joint using implants of metal or other strong materials. The…20$6,770$108.4K
    29827The provider examines the tissue inside the shoulder joint with an arthroscope. She inserts additional instruments to repair a torn rotator cuff, the grouping of muscles and tendons that surround and…20$2,220$39.9K
    28285The provider repairs a hammertoe deformity, a painful condition in which the toe remains permanently bent in a downward position.40$630$23.4K
    29881The provider examines the inside of the knee joint with an arthroscope. She repairs the joint by removing the meniscus, a crescent shaped cartilage cushion, from either the medial or lateral…20$970$18.5K
    29880In this procedure, the provider performs arthroscopic examination of the knee joint. She removes the damaged and torn meniscus from the medial and lateral compartments of the knee joint along with…20$910$16.4K
    45380The provider examines the rectum and colon using a flexible colonoscope, a tubular instrument with a light source and camera, to look for the cause of a patient's symptoms, which may include…30$420$14.2K
    29823The provider examines the tissue inside the shoulder joint with an arthroscope. He inserts additional instruments and excises extensive damaged tissues in the shoulder joint caused by trauma to the…20$780$12.5K
    64721Neuroplasty or transposition of the median nerve at the carpal tunnel is done to treat a condition called carpal tunnel syndrome (CTS). The carpal tunnel is a narrow tunnel in the wrist through which…20$590$10.5K
    43239The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis.40$210$8K
    26055Trigger finger, or stenosing tenosynovitis, is when a finger remains in a bent position. It is painful to open or close the finger. A swollen tendon or formation of knots or nodules in the tendon may…10$490$5.4K

    Medicare: Competitive Analysis & Benchmarks

    How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 10 CPT/HCPCS codes. Note: this provider's state, "XX," is a placeholder CMS uses when a provider's practice-location state wasn't reported — not a traditional US state; the State panel below benchmarks against other providers coded under the same designation.

    View: State1 / 2

    Claims Volume vs. Unspecified Location Distribution
    NPI 1255394771 — 0 of 0 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Unspecified Location

    Full comparison — all codes billed, vs. state median

    10 rows

    CPT/HCPCS CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    26055890N/A$N/A$N/A
    274472780N/A$N/A$N/A
    2828530N/A$N/A$N/A
    29823200N/A$N/A$N/A
    29827430N/A$N/A$N/A
    29880100N/A$N/A$N/A
    29881150N/A$N/A$N/A
    432393400N/A$N/A$N/A
    453802880N/A$N/A$N/A
    64721580N/A$N/A$N/A

    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.

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    Lifetime revenue by payer source
    Payer SourceTotal Paid
    Medicare$257.2K
    Medicaid$0