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

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

Orthovirginia, Inc. (NPI 1265470645)

Orthovirginia, Inc. is a multi-specialty clinic/center provider located in North Chesterfield, Virginia. This profile covers 0 Medicare and 93 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	Orthovirginia, Inc.
Address	1115 Boulders Parkway
City	North Chesterfield
State	VA
ZIP	23225
Taxonomy	Multi-Specialty Clinic/Center
NPI Enumerated	June 4, 2006

Payer Source	Total Paid
Medicaid	$23.8M
Medicare	$0

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

93 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	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…	75,500	$70	$5.3M
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…	86,730	$50	$4.2M
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…	32,410	$100	$3.2M
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…	28,080	$70	$1.9M
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…	68,760	$30	$1.8M
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.	38,400	$40	$1.5M
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…	27,770	$30	$888.8K
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…	36,640	$20	$549.6K
97161	The provider, typically a physical therapist, conducts a physical therapy evaluation that includes history to rule out any adverse factors that will affect care; observes whether the patient's…	8,190	$60	$499.6K
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…	9,780	$40	$381.2K

Showing 1–10 of 93

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Virginia Distribution

Orthovirginia, Inc. — 19 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Virginia

Full comparison — all codes billed, vs. Virginia median

93 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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…	8	400	1,910	$50	$412.6K
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.	15	400	2,060	$60	$407.3K
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…	30	3,520	370	$70	$280.7K
L4361	Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf	6	20	130	$210	$207.7K
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…	21	4,010	290	$50	$199.8K
L3808	Wrist hand finger orthosis, rigid without joints, may include soft interface material; straps, custom fabricated, includes fitting and adjustment	1	10	640	$280	$180.3K
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…	9	200	1,180	$30	$162.8K
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.	21	70	470	$80	$147.7K
97161	The provider, typically a physical therapist, conducts a physical therapy evaluation that includes history to rule out any adverse factors that will affect care; observes whether the patient's…	3	130	520	$90	$144K
64483	This procedure is the injection of an anesthetic agent and/or steroid in the form of a transforaminal epidural injection into a single level (either lumbar or sacral).	1	30	180	$320	$121.7K

Showing 1–10 of 93

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Anne Arundel Dermatology LLC	MD	Dermatology Physician	$0	$7.3M
Mark Jones	VA	Orthopaedic Foot and Ankle Surgery Physician	$667K	$0
Joshua Herzog	VA	Orthopaedic Surgery Physician	$659.3K	$0
Abilio Reis	VA	Orthopaedic Surgery Physician	$472K	$0
William Nordt	VA	Sports Medicine (Orthopaedic Surgery) Physician	$459K	$0
Anthony Gregoria	VA	Physical Therapist	$438.8K	$0
Zdzislaw Ratajczak	VA	Sports Medicine (Family Medicine) Physician	$424.4K	$3.2K
Charles Gibellato	VA	Physical Medicine & Rehabilitation Physician	$426.8K	$0
Charles Franklin	VA	Rheumatology Physician	$425.9K	$0
Michael Wind	VA	Orthopaedic Surgery Physician	$424.6K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Chippenham & Johnston-willis Hospitals Inc	VA	General Acute Care Hospital	$0	$103.7M
Onesource Community Mental Health Services Of Va, Inc.	VA	Community/Behavioral Health Agency	$0	$47.5M
Fidura & Associates, Inc	VA	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$29.9M
Supportive Intervention Services, LLC	VA	Community/Behavioral Health Agency	$0	$29M
Commonwealth Pediatrics	VA	Specialist	$0	$12.6M
Clearview Counseling Services, Inc	VA	Community/Behavioral Health Agency	$0	$11.4M
Abby Home Health Care Inc	VA	Home Health Agency	$0	$11.2M
Assured Development Services LLC.	VA	Intellectual and/or Developmental Disabilities Residential Treatment Facility	$0	$11.2M
Spectrum Transformation Group, LLC	VA	Cognitive & Behavioral Psychologist	$0	$10.5M
Home Is Where The Heart Is Crisis Stabilization	VA	Community/Behavioral Health Agency	$0	$9.3M

Orthovirginia, Inc. — Billing Profile & Reimbursement Data

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Orthovirginia, Inc. — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

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