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.

Butte Orthopedic And Fracture Clinic PC (NPI 1326146556)

Butte Orthopedic And Fracture Clinic PC is a orthopaedic surgery physician provider located in Butte, Montana. This profile covers 0 Medicare and 12 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	Butte Orthopedic And Fracture Clinic PC
Address	435 S Crystal St
City	Butte
State	MT
ZIP	59701
Taxonomy	Orthopaedic Surgery Physician
NPI Enumerated	September 20, 2006

Payer Source	Total Paid
Medicaid	$317.2K
Medicare	$0

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

12 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	3,110	$50	$164.9K
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…	700	$90	$59.2K
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,…	1,180	$30	$37.9K
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…	530	$70	$37.1K
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…	270	$30	$9K
72110	In this diagnostic procedure, the provider performs at least four X–ray views of the lumbosacral spine to evaluate the patient's spine for the presence of abnormal curves, fractures, or cancer.	160	$30	$5K
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…	10	$120	$1.4K
99202	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves straightforward medical decision making, and/or the provider…	20	$60	$900
73110	The provider takes at least three X–ray images of a patient’s complete wrist to check for any fracture, swelling, or reason of pain in the wrist area.	20	$30	$530
73610	In this procedure, the provider takes three or more X–ray images of the ankle joint to check for any fracture, swelling, or reason for pain in the ankle area.	20	$20	$460

Showing 1–10 of 12

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

Butte Orthopedic And Fracture Clinic PC — 0 of 12 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

12 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…	274	530	580	$70	$224.6K
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…	139	520	730	$40	$196.4K
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…	122	130	100	$120	$49.4K
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…	116	160	1,050	$10	$45.3K
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…	37	190	130	$70	$37.2K
99202	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves straightforward medical decision making, and/or the provider…	82	100	60	$40	$10.3K
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,…	51	240	170	$1	$10.3K
73610	In this procedure, the provider takes three or more X–ray images of the ankle joint to check for any fracture, swelling, or reason for pain in the ankle area.	43	50	260	$10	$5.6K
73110	The provider takes at least three X–ray images of a patient’s complete wrist to check for any fracture, swelling, or reason of pain in the wrist area.	37	40	300	$10	$5K
73562	In this procedure, the provider takes three X–ray images of a patient’s knee joint to check for any fracture, swelling, or reason for pain in the knee area.	33	40	110	$10	$2.7K

Showing 1–10 of 12

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Bsw, Inc.	MT	Developmentally Disabled Services Day Training Agency	$0	$20.4M
Benefis Community Care, Inc.	MT	Case Management Agency	$0	$14.6M
State Of Montana	MT	Substance Abuse Rehabilitation Facility	$0	$12.7M
Scl Health Medical Group-butte LLC	MT	Family Medicine Physician	$0	$9.9M
Butte Public Schools	MT	Local Education Agency (LEA)	$0	$6.9M
Community, Counseling & Correctional Services, Inc.	MT	Substance Use Disorder Rehabilitation Clinic/Center	$0	$3.8M
Butte School District #1	MT	Mental Health Counselor	$0	$3.8M
Ryan Todorovich	MT	General Practice Dentistry	$0	$3.1M
Lindsey Todorovich	MT	General Practice Dentistry	$0	$2.9M
Silver Bow County Developmental Disabilities Council, Inc.	MT	Developmentally Disabled Services Day Training Agency	$0	$2.2M

Butte Orthopedic And Fracture Clinic PC — Billing Profile & Reimbursement Data

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Butte Orthopedic And Fracture Clinic PC — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Anthony Russo	MT	Orthopaedic Surgery of the Spine Physician	$166.5K	$0
Eric Spears	MT	Physical Therapist	$94.1K	$0
Nick Blavatsky	MT	Orthopaedic Surgery Physician	$59.7K	$0