Loading...

    Explore
    • Policy Monitoring
    • Live Policy Feed
    • Billing Codes
    • NPI Medicare & Medicaid
    • Healthcare Providers
    • Health Insurance Payers
    • States
    • Service Lines
    • Taxonomy Codes
    Lookup tools
    • Billing Code Lookup
    • CPT Modifier Lookup
    • Provider Taxonomy Code Lookup
    • Healthcare Provider & Facility Lookup
    • Health Insurance Payer Lookup
    • Payer Contact Directory

    Policy & Benchmark Tools

    • Prior Authorization Lookup
    • Coverage Criteria Lookup
    • Timely Filing Lookup
    • Billing Code Reimbursement Rates
    • Payer Comparison Dashboard
    • Facility Comparison Dashboard
    • All tools

    Company

    • About OpenPayer
    • Data Sources
    • Trek Health
    OpenPayerby Trek Health
    LinkedInYouTube

    © 2026 Trek Health. All rights reserved.

    OpenPayer is built and maintained by Trek Health.

    v1.0.28
    OpenPayerNPI Medicare & MedicaidJames Mantone
    Ask Trek AI about this page

    James Mantone — Billing Profile & Reimbursement Data

    NPI 1326044041 · Council Bluffs, IA · Orthopaedic Surgery Physician

    Customize your policy alerts

    Sign up for James Mantone — Billing Profile & Reimbursement Data policy alerts

    Get alerted when relevant policies change without checking for updates manually.

    Monitor payer policy activity

    Receive email alerts as soon as relevant payer policies are published or updated.

    James Mantone is a orthopaedic surgery physician provider located in Council Bluffs, Iowa. This profile covers 18 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.

    Table of contents

    Progress1 / 8

    Explore openpayer tools

    • Billing CodesCPT, HCPCS, DRG & more
    • Reimbursement RatesCommercial vs. Medicare rate reports
    • ProvidersHospitals & facilities
    • PayersPlans & market footprint
    • Taxonomy CodesNUCC specialty codes
    • ModifiersCPT modifiers & usage
    • Prior AuthorizationPA policies by payer & drug
    • Timely FilingFiling deadlines by payer
    • Coverage CriteriaMedical necessity by payer
    • Payer ContactsClaims, PA & appeals contacts
    View all tools

    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeIndividual
    OrganizationJames Mantone
    Address808 E Pierce St
    CityCouncil Bluffs
    StateIA
    ZIP51503
    TaxonomyOrthopaedic Surgery Physician
    NPI EnumeratedJune 27, 2005

    Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)

    Payer SourceTotal Paid
    Medicare$107.5K
    Medicaid$0

    Medicare: Total Revenue Breakdown by CPT/HCPCS Code

    Medicare revenue breakdown by CPT/HCPCS procedure code.

    View: Bar Chart1 / 2

    Medicare: Complete Services Breakdown

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

    18 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…40$900$32.3K
    27130In this procedure, the provider surgically replaces the hip joint by prosthesis, or artificial hip joint. He replaces both the femoral and acetabular components with or without using an autograft or…20$890$16.1K
    J7327Hyaluronan or derivative, monovisc, for intra-articular injection, per dose30$550$14.4K
    99213The 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…220$60$12.9K
    99214The 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…100$90$9.1K
    20610In 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…160$50$7K
    99204The 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…30$120$3.6K
    99203The 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…50$60$2.9K
    99223The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…20$130$2.2K
    J3301Injection, triamcinolone acetonide, not otherwise specified, 10 mg1,760$1$1.8K

    Showing 1–10 of 18

    Medicare: Competitive Analysis & Benchmarks

    How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 18 CPT/HCPCS codes.

    View: State1 / 2

    Full comparison — all codes billed, vs. state median

    18 rows

    CPT/HCPCS CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    274479919040$870$41.7K
    2713010014030$790$25.4K
    J7327142030$550$19.9K
    992142,3654,690100$70$14.4K
    992139444,740100$50$8K
    992238071,01040$120$7.3K
    992049751,87030$100$5K
    2061010152050$40$4.2K
    992229611,27030$90$3.8K
    992035491,60030$60$3.2K

    Showing 1–10 of 18

    Related Providers

    Other providers that share a Tax Identification Number (TIN) with James Mantone, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Shenandoah Medical CenterIARural Health Clinic/Center$0$9.4M
    Regional West Physicians ClinicNEFamily Medicine Physician$0$9M
    Shenandoah Medical CenterIACritical Access Hospital$0$2.4M
    Avera St. Luke'sSDFamily Medicine Physician$0$2.3M
    Sakeer HussainIAHematology & Oncology Physician$1.9M$0
    Avera St LukesSDGeneral Acute Care Hospital$0$1.5M
    Richard ConklinSDHematology & Oncology Physician$994.4K$0
    Patrick ParkerGAUrology Physician$783.5K$0
    Avera St Luke'sSDPhysical Therapist$0$607.7K
    Avera St Luke'sSDEmergency Medicine Physician$0$595.8K

    Nearby Providers

    Other providers in the same ZIP code as James Mantone, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Trivium Life ServicesIADevelopmentally Disabled Services Day Training Agency$0$149.2M
    Vocational Development Center IncIADevelopmentally Disabled Services Day Training Agency$0$59M
    Rem Iowa Community Services, IncIAIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility$0$54.3M
    Focus-family Options & Community Supports, IncIADevelopmentally Disabled Services Day Training Agency$0$41.2M
    Council Bluffs Community School DistrictIALocal Education Agency (LEA)$0$17.5M
    Family Connections, IncIACase Management Agency$0$15.1M
    Alegent Health Bergan Mercy Health SystemIAGeneral Acute Care Hospital$0$13M
    Jennie Edmundson Memorial HospitalIAGeneral Acute Care Hospital$0$9.8M
    Alegent Creighton ClinicIAFamily Medicine Physician$0$9.6M
    City Of Council BluffsIAAmbulance$425.7K$6.2M

    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.

    Medicare Revenue by CPT/HCPCS Code
    Claims Volume vs. Iowa Distribution
    James Mantone — 0 of 17 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Iowa