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NPI 1255832002 · Fair Lawn, NJ · Family Nurse Practitioner
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Nyrie Austin is a family nurse practitioner provider located in Fair Lawn, New Jersey. This profile covers 15 Medicare and 8 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.
Provider details (source: NPPES NPI Registry)
| Field | Value |
|---|---|
| Entity Type | Individual |
| Organization | Nyrie Austin |
| Address | 3-18 Cyril Ave |
| City | Fair Lawn |
| State | NJ |
| ZIP | 07410 |
| Taxonomy | Family Nurse Practitioner |
| NPI Enumerated | February 27, 2018 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $15.9M |
| Medicaid | $8.8K |
This provider is overwhelmingly Medicare-driven: lifetime Medicare revenue is $15.9M versus Medicaid revenue of $8.8K, and the top three Medicare codes (Q4262, Q4281, Q4253) together account for 92.3% of Medicare revenue. Q4262 alone represents $10.9M (68.6% of Medicare revenue), showing the business is heavily concentrated in a narrow set of services.
The top Medicare codes indicate a wound-care / skin-substitute service line: Q4262, Q4281, and Q4253 are per-square-centimeter add-on codes for amniotic/placental or engineered skin products, and the provider also bills debridement codes such as 11042 and 11043 and skin-graft codes like 15271. This mix points to clinical activity centered on application of skin substitutes and wound management, with ancillary surgical debridement services supporting that core offering.
Despite the concentration, the provider’s national competitive position on key skin-substitute codes is mixed: Q4262 ranks #13 of 141 (91th percentile) and Q4281 ranks #6 of 33 (84th percentile), yet the file labels those volumes as "typical, unremarkable volume for this code." In practice this means the provider posts relatively high national ranks on major revenue drivers while data commentary frames the volumes as within expected ranges for those codes.
There is at least one strong statistical outlier in national comparisons: 15271 accounts for $80.4K (0.5% of Medicare revenue) and ranks #12 of 1157 (99th percentile; extreme outlier). Although 15271 is a small share of total Medicare revenue, its "extreme outlier" status signals an unusually high relative activity for that specific skin-graft code versus national peers.
Medicaid billing is minimal and highly concentrated: total Medicaid revenue is $8.8K, with the top three Medicaid codes accounting for 90.8% of Medicaid revenue. The leading Medicaid code is 99349 at $5.1K (58.5% of Medicaid revenue), followed by 99347 at $2K (22.2%), indicating the Medicaid activity is driven by home/residence E/M visits rather than skin-substitute sales.
State-level competitive standing on Medicaid is modest: 99349 ranks #62 of 106 in-state (41th percentile) and 99347 ranks #22 of 39 (45th percentile), both described as "typical, unremarkable volume for this code." These rankings suggest the provider is not a leading Medicaid home-visit E/M provider in-state but maintains a measurable presence.
The provider has an active but relatively recent tenure for building this specialized revenue profile: NPI enumerated 2018-02-27 (~8 years ago). Achieving $15.9M in Medicare revenue since enumeration indicates rapid development of a niche service line focused on skin substitutes and related wound care services.
Revenue concentration creates operational sensitivity: with the top three Medicare codes driving 92.3% of Medicare revenue, changes to reimbursement, utilization, or supplier relationships for these add-on skin-substitute codes could materially affect the provider’s topline. Although there is some diversification into home/residence E/M (e.g., 99348, 99345) and debridement (11042), those services represent much smaller revenue shares and do not offset the concentration risk.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
15 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| Q4262 | Dual layer impax membrane, per square centimeter (add-on, list separately in addition to primary procedure) | 11,140 | $980 | $10.9M |
| Q4281 | Barrera sl or barrera dl, per square centimeter (add-on, list separately in addition to primary procedure) | 2,180 | $1,160 | $2.5M |
| Q4253 | Zenith amniotic membrane, per square centimeter (add-on, list separately in addition to primary procedure) | 1,690 | $730 | $1.2M |
| Q4276 | Orion, per square centimeter (add-on, list separately in addition to primary procedure) | 910 | $1,090 | $995.3K |
| 15271 | The provider uses a skin substitute, such as an allograft or xenograft, to cover wounds on the patient’s trunk, arms, and/or legs up to an area of 100 cm2. This code covers up to the first 25 cm2. | 640 | $130 | $80.4K |
| 11042 | The provider uses surgical instruments to remove the dead tissue in skin down to the subcutaneous layer and including the epidermis and dermis, up to the first 20 cm2. | 690 | $100 | $65.6K |
| 99348 | The provider sees an established patient for a home or residence visit involving evaluation and management (E/M). The visit involves low medical decision making or the provider spends at least 30… | 430 | $60 | $24.2K |
| 99345 | The provider sees a new patient for a home or residence visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the provider spends at least 75… | 120 | $150 | $18.5K |
| 99349 | The provider sees an established patient for a home or residence visit involving evaluation and management (E/M). The visit involves moderate medical decision making or the provider spends at least… | 110 | $100 | $11.1K |
| 11043 | The provider uses surgical instruments to remove the dead tissue in muscle and/or fascia, including any debridement of the epidermis, dermis, and subcutaneous tissue, for the first or only 20 cm2 or… | 40 | $190 | $8.1K |
Showing 1–10 of 15
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 15 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
15 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| Q4262 | 1 | 10 | 11,140 | $980 | $10.9M |
| Q4281 | 1 | 10 | 2,180 | $1,160 | $2.5M |
| Q4253 | 1 | 10 | 1,690 | $730 | $1.2M |
| Q4276 | 1 | 10 | 910 | $1,090 | $995.7K |
| 99349 | 276 | 580 | 100 | $90 | $20.7K |
| 99350 | 185 | 290 | 80 | $120 | $18.6K |
| 11043 | 57 | 90 | 60 | $150 | $16.7K |
| 11042 | 16 | 440 | 80 | $80 | $11.6K |
| 99348 | 44 | 510 | 70 | $60 | $8.7K |
| 15271 | 1 | 20 | 50 | $110 | $8.4K |
Showing 1–10 of 15
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
View: By Year1 / 3
Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
8 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 99349 | The provider sees an established patient for a home or residence visit involving evaluation and management (E/M). The visit involves moderate medical decision making or the provider spends at least… | 110 | $50 | $5.1K |
| 99347 | The provider sees an established patient for a home or residence visit involving evaluation and management (E/M). The visit involves straightforward medical decision making or the provider spends at… | 90 | $20 | $2K |
| 99350 | The provider sees an established patient for a home or residence visit involving evaluation and management (E/M). The visit involves high medical decision making or the provider spends at least 60… | 10 | $70 | $880 |
| 99348 | The provider sees an established patient for a home or residence visit involving evaluation and management (E/M). The visit involves low medical decision making or the provider spends at least 30… | 30 | $30 | $810 |
| 1126F | The provider measures the severity of pain in a patient with cancer who receives chemotherapy or radiotherapy during the measurement period. Report this code if the patient does not experience pain. | 20 | $0 | $0 |
| 1160F | No Summary found for this code | 10 | $0 | $0 |
| 1170F | The provider assesses the functional status of a patient with rheumatoid arthritis, or RA. The assessment may evaluate the patient’s level of activities of daily living, or ADL, and or status of… | 10 | $0 | $0 |
| 99072 | The provider uses items, supplies materials, or requires clinical staff time in excess of what is normally used or provided for an office visit or other nonfacility encounter. These additional items… | 20 | $0 | $0 |
How this provider's Medicaid billing volume and revenue compare to other New Jersey providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. New Jersey median
8 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 99350 | The provider sees an established patient for a home or residence visit involving evaluation and management (E/M). The visit involves high medical decision making or the provider spends at least 60… | 44 | 50 | 310 | $20 | $19.1K |
| 99349 | The provider sees an established patient for a home or residence visit involving evaluation and management (E/M). The visit involves moderate medical decision making or the provider spends at least… | 62 | 110 | 160 | $20 | $11.8K |
| 99348 | The provider sees an established patient for a home or residence visit involving evaluation and management (E/M). The visit involves low medical decision making or the provider spends at least 30… | 66 | 90 | 100 | $10 | $5.4K |
| 99347 | The provider sees an established patient for a home or residence visit involving evaluation and management (E/M). The visit involves straightforward medical decision making or the provider spends at… | 22 | 40 | 110 | $10 | $2.5K |
| 99072 | The provider uses items, supplies materials, or requires clinical staff time in excess of what is normally used or provided for an office visit or other nonfacility encounter. These additional items… | 372 | 440 | 140 | $1 | $110 |
| 1126F | The provider measures the severity of pain in a patient with cancer who receives chemotherapy or radiotherapy during the measurement period. Report this code if the patient does not experience pain. | 103 | 120 | 210 | $1 | $70 |
| 1170F | The provider assesses the functional status of a patient with rheumatoid arthritis, or RA. The assessment may evaluate the patient’s level of activities of daily living, or ADL, and or status of… | 88 | 90 | 270 | $1 | $40 |
| 1160F | No Summary found for this code | 201 | 210 | 330 | $1 | $40 |
Other providers in the same ZIP code as Nyrie Austin, ranked by combined Medicare and Medicaid revenue.
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