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 Montana for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Montana 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. Montana (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.

Missoula Oral Surgery (NPI 1255620928)

Field	Value
Entity Type	Organization
Organization	Missoula Oral Surgery
Address	3020 S Reserve St
City	Missoula
State	MT
ZIP	59801
Taxonomy	Oral and Maxillofacial Surgery Clinic/Center
NPI Enumerated	April 4, 2011

Payer Source	Total Paid
Medicaid	$8M
Medicare	$0

Key Findings

MISSOULA ORAL SURGERY is effectively a Medicaid-focused practice with no Medicare billing on file and $8M in lifetime Medicaid revenue, indicating a single-payer concentration in publicly insured dental services rather than mixed Medicare/Medicaid outpatient procedures. The absence of Medicare revenue means comparisons to national Medicare peers are not applicable and the provider should be treated as primarily serving Medicaid populations for competitive and utilization analyses.

Three codes account for 57.8% of the provider's total Medicaid revenue, showing a high revenue concentration in a narrow set of services; this level of concentration signals that operational planning and payer negotiations will be disproportionately affected by reimbursement or utilization changes for those top codes. Because the platform precomputed that share, those three codes should be prioritized for any revenue-scenario or risk analyses.

The top Medicaid revenue driver is D7240 ($1.8M, 22.1% of Medicaid revenue; 7.2K claims), which places the practice as the statewide leader for this procedure (ranks #1 of 18 providers, 100th percentile). This positioning suggests the clinic performs a high volume of the service represented by D7240 relative to peers and likely operates a procedural oral surgery caseload that concentrates on whatever D7240 represents.

D7210 is a second major revenue source ($1.5M, 18.9% of Medicaid revenue; 12K claims) and is explicitly described as an extraction requiring removal of bone and/or sectioning of tooth, indicative of complex surgical extractions being a core part of the practice. The provider ranks #1 of 36 in-state and is labeled an extreme outlier, underscoring that complex extractions are delivered here at markedly higher volumes than other Montana providers.

D0367 ($1.3M, 16.9% of Medicaid revenue; 4.9K claims) is the third top code and also ranks #1 in-state (100th percentile), reinforcing that a trio of high-volume, high-revenue procedures dominate the clinic’s Medicaid activity. Together with the code mix that includes D7240 and D7210, the pattern points to an oral and maxillofacial surgery center performing frequent operative procedures rather than primarily routine dental care.

Beyond the top three, the provider shows repeated #1 statewide ranks across many codes (for example D9243, D9239, D7250, D7220, D7311), indicating market leadership across multiple oral surgery–related CPT/HCPCS lines; several of these are described as "notably above typical state volume," which supports characterization as a dominant in-state specialty provider for Medicaid.

There are a few codes where the provider’s volume is more typical or modest compared with peers (for example D7230 ranks #2 of 14 at the 92nd percentile and D7140 ranks #43 of 81 at the 48th percentile), indicating that while the clinic dominates many specialty codes, it does not uniformly outpace peers across every dental procedure and retains a conventional footprint for some routine extractions and diagnostic services.

NPI enumeration dates to 2011-04-04 (approximately 15 years ago), providing a long tenure in the market that is consistent with the high-volume statewide leadership observed; this longevity supports interpretations that the provider’s dominant position emerged over years rather than appearing suddenly.

Medicaid: Complete Services Breakdown

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

16 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
D7240	N/A	7,220	$240	$1.8M
D7210	Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth, and including elevation; includes related cutting of gingiva and bone, removal of tooth structure, minor smoothing of…	11,970	$130	$1.5M
D0367	N/A	4,910	$270	$1.3M
D9243	N/A	7,180	$160	$1.1M
D9239	N/A	6,960	$80	$528.7K
D7230	N/A	2,310	$200	$456.8K
D9310	N/A	6,650	$50	$358.9K
D7241	N/A	810	$320	$256.6K
D7250	N/A	1,640	$120	$200K
D7220	N/A	1,020	$140	$146.4K

Showing 1–10 of 16

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Montana Distribution

Missoula Oral Surgery — 12 of 16 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Montana

Full comparison — all codes billed, vs. Montana median

16 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
D7240	N/A	1	20	1,500	$220	$430.7K
D0367	N/A	1	20	530	$250	$273K
D7210	Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth, and including elevation; includes related cutting of gingiva and bone, removal of tooth structure, minor smoothing of…	1	40	280	$110	$233.2K
D9243	N/A	1	10	170	$150	$212.8K
D7241	N/A	1	10	420	$320	$134.6K
D7230	N/A	2	10	350	$180	$130.4K
D9239	N/A	1	10	110	$70	$99.4K
D9310	N/A	2	40	450	$50	$74.1K
D7140	Extraction, erupted tooth or exposed root (elevation and/or forceps removal)	43	80	290	$50	$59.8K
D7311	N/A	1	10	340	$130	$56K

Showing 1–10 of 16

Nearby Providers

Other providers in the same ZIP code as Missoula Oral Surgery, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Western Montana Mental Health Center	MT	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$87.8M
Opportunity Resources Inc	MT	Developmentally Disabled Services Day Training Agency	$0	$48.5M
Missoula Developmental Service Corp	MT	Non-emergency Medical Transport (VAN)	$0	$33.6M
Express Personnel Services	MT	Nursing Care Agency	$0	$20.4M
3 Rivers Mental Health Solutions LLC	MT	Community/Behavioral Health Agency	$0	$16.7M
Missoula County Public Schools	MT	Local Education Agency (LEA)	$0	$16.3M
Meadowlark Home Care LLC	MT	Home Health Agency	$0	$12.9M
Client Dedicated Services, Inc	MT	Home Health Agency	$0	$10.6M
Children's Dentistry Of The Rockies	MT	Pediatric Dentistry	$0	$10.1M
Missoula Pediatric Dentistry PC	MT	Pediatric Dentistry	$0	$9.3M

Missoula Oral Surgery — Billing Profile & Reimbursement Data

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Missoula Oral Surgery — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References