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

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

Summit Orthopedics, Ltd (NPI 1306899463)

Summit Orthopedics, Ltd is a orthopaedic surgery physician provider located in Woodbury, Minnesota. This profile covers 0 Medicare and 62 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	Summit Orthopedics, Ltd
Address	710 Commerce Dr Ste 200
City	Woodbury
State	MN
ZIP	55125
Taxonomy	Orthopaedic Surgery Physician
NPI Enumerated	May 18, 2006

Payer Source	Total Paid
Medicaid	$6.7M
Medicare	$0

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

62 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…	29,580	$50	$1.3M
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…	30,940	$40	$1.3M
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…	47,580	$20	$1.1M
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…	16,320	$50	$799.5K
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…	9,380	$30	$262.5K
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…	5,060	$50	$253.2K
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…	13,070	$20	$235.2K
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…	1,800	$100	$171.3K
73721	In this diagnostic procedure, the provider performs magnetic resonance imaging of a lower extremity joint without using contrast material.	1,840	$80	$154.4K
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,…	2,940	$30	$97.1K

Showing 1–10 of 62

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Minnesota Distribution

Summit Orthopedics, Ltd — 4 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Minnesota

Full comparison — all codes billed, vs. Minnesota median

62 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…	67	1,180	1,150	$80	$605.7K
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…	69	1,200	1,030	$70	$549.7K
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.	257	260	890	$60	$405.3K
L4361	Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf	7	20	280	$210	$226.1K
99215	The provider sees an established 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…	114	420	230	$90	$186.2K
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…	7	300	700	$30	$135.4K
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…	57	140	820	$30	$115.4K
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…	44	350	150	$90	$110.6K
72148	In this diagnostic procedure, the provider performs magnetic resonance imaging (MRI) of the lumbar spinal canal and contents without using contrast.	14	40	150	$70	$103.5K
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…	9	450	140	$60	$101.3K

Showing 1–10 of 62

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Lahey Clinic Hospital, Inc.	MA	General Acute Care Hospital	$0	$112.9M
North Memorial Health Care	MN	Ambulance	$0	$112.8M
North Memorial Health Care	MN	General Acute Care Hospital	$0	$32.5M
Sasaki Medical LLC	MN	Addiction Medicine (Family Medicine) Physician	$0	$24M
Infinite Health Collaborative, PA	MN	Orthopaedic Surgery Physician	$0	$19.4M
Stellis Health, PA	MN	Multi-Specialty Clinic/Center	$0	$8.6M
Maple Grove Hospital Corporation	MN	General Acute Care Hospital	$0	$7.6M
North Memorial Health Care	MN	Primary Care Clinic/Center	$0	$7.4M
North Memorial Health Care	MN	Hospitalist Physician	$0	$5.6M
North Memorial Health Care	MN	Urgent Care Clinic/Center	$0	$4.5M

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Valhalla Place, LLC	MN	Community/Behavioral Health Agency	$581K	$22.1M
St. Croix Psychiatric, LLC	MN	Psychiatry Physician	$0	$19.9M
Kubei Holding Group Inc	MN	Community/Behavioral Health Agency	$0	$15.5M
Holistic Home Care LLC	MN	Home Health Agency	$0	$14.7M
Redeemer Services, Inc.	MN	Case Management Agency	$0	$14.3M
Greatercare Facilities, LLC	MN	Home Health Agency	$0	$10.4M
B Tek, LLC	MN	Clinical Medical Laboratory	$0	$10.2M
Healtheast Woodwinds Hospital	MN	General Acute Care Hospital	$0	$6.2M
Allina Health System	MN	Family Medicine Physician	$0	$5.5M
Kubei Holdings Group LLC	MN	Home Health Agency	$0	$5.1M

Summit Orthopedics, Ltd — Billing Profile & Reimbursement Data

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Summit Orthopedics, Ltd — 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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