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NPI 1336101005 · Coeur D Alene, ID · Diagnostic Radiology Physician
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Douglas Rusnack is a diagnostic radiology physician provider located in Coeur D Alene, Idaho. This profile covers 37 Medicare and 1 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 | Douglas Rusnack |
| Address | 601 Front Avenue |
| City | Coeur D Alene |
| State | ID |
| ZIP | 83814 |
| Taxonomy | Diagnostic Radiology Physician |
| NPI Enumerated | April 6, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $350.1K |
| Medicaid | $310 |
This provider’s code mix—heavy use of 78815 (PET/CT), 74177 (CT abdomen/pelvis with contrast), and 74176 (CT abdomen/pelvis without contrast)—is consistent with a diagnostic radiology practice focused on advanced cross-sectional and oncologic imaging rather than primary care or procedural medicine. The presence of multiple CT and MRI abdominal/pelvic codes and PET/CT suggests the practice services oncology and acute abdominal diagnostic workflows, with ancillary ultrasound and DXA (77080) fills indicating a broader outpatient imaging portfolio.
Revenue concentration on Medicare is substantial and focused: the precomputed top three Medicare codes (78815, 74177, 74176) account for 48.7% of the provider’s total Medicare revenue, indicating dependence on a small set of high-value imaging studies to drive billing. That concentration implies that changes in utilization, referral patterns, or reimbursement for those specific codes would materially affect the provider’s Medicare revenue.
Payer mix is effectively single-payer dominated: lifetime Medicare revenue is $350.1K while lifetime Medicaid revenue is only $308, so Medicare is the overwhelming source of payor revenue and Medicaid is negligible in scale for this provider. Practically, this makes the provider’s financial exposure and referral strategy highly sensitive to Medicare policy and market competition rather than state Medicaid dynamics.
For national competitive standing on select CT/MRI codes the provider is a high-volume outlier: 74176 ranks #94 of 22168 providers nationally (100th percentile; labeled an "extreme outlier") and 71250 ranks #325 of 21854 (99th percentile; "extreme outlier"). 74177 also ranks highly at #1053 of 23621 (96th percentile; "notably above typical"). These percentile positions indicate the provider is a major national participant for several CT services, likely reflecting high throughput CT capacity or a strong referral pipeline for abdominal/thoracic imaging.
Not all services are high-volume nationally: 78815 (PET/CT) generates $64.4K and ranks #2668 of 6566 (59th percentile; "typical, unremarkable volume for this code"), so while PET/CT contributes meaningfully to Medicare revenue it is not the provider’s strongest national specialty relative to peers. Similarly, several ultrasound and other imaging codes sit in more typical national percentiles, showing the practice mixes very high-volume CT/MRI with more routine volumes for ancillary modalities.
The Medicaid footprint is minimal and concentrated: the single Medicaid code on file is 71045, which accounts for 100.0% of the provider’s Medicaid revenue ($308) and ranks #40 of 51 in-state (22th percentile; "typical, unremarkable volume for this code"). This pattern underscores that the provider is not a significant Medicaid imaging vendor in Idaho and has virtually no Medicaid-driven service diversification.
Tenure data show the NPI was enumerated on 2006-04-06 (~20 years ago), indicating a long-established presence in COEUR D ALENE, ID. The sustained, concentrated Medicare billing profile combined with long tenure suggests a stable imaging operation that has developed specific high-volume service lines (notably CT and some MRI).
Specific statistical labels reinforce operational character: the dataset flags 74176 and 71250 as "extreme outlier" volumes and 74177 and 74181 as "notably above typical," which together signal that the provider is an outlier concentrator of high-volume CT and select MRI studies. Analysts should interpret those labels as evidence of unusually high throughput on particular cross-sectional imaging services rather than as a measure of clinical appropriateness or quality.
Medicare revenue breakdown by CPT/HCPCS procedure code.
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The CPT/HCPCS codes generating the most Medicare revenue for this provider.
37 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 78815 | PET and CT scans are both standard imaging tools that allow doctors to evaluate the location and metabolic actions of tumors or cancer inside the body before beginning an active treatment regimen.… | 80 | $860 | $64.3K |
| 74177 | The provider performs computed tomography of the abdomen and pelvis with contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs. | 410 | $140 | $57.4K |
| 74176 | The provider performs computed tomography of the abdomen and pelvis without contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs. | 490 | $90 | $43.4K |
| 71250 | In this diagnostic procedure, the provider performs a computed tomography, or CT, examination of the thorax without using contrast material. | 550 | $80 | $41.2K |
| 74178 | The provider performs computed tomography of the abdomen and pelvis without contrast material in one or both body regions followed by contrast material in one or both body regions and additional… | 80 | $200 | $16.8K |
| 71260 | In this diagnostic procedure, the provider performs a computed tomography, or CT, examination of the thorax using contrast material. | 230 | $70 | $16.6K |
| 74183 | The provider performs magnetic resonance imaging of the structures and organs of the abdomen, initially without control and then with additional sequences after injection of contrast. | 70 | $220 | $16.4K |
| 72197 | In this diagnostic procedure, the provider performs magnetic resonance imaging (MRI) of the pelvis first without using contrast and again after injecting contrast material. | 60 | $230 | $13.6K |
| A9552 | Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries | 50 | $280 | $12.7K |
| 71275 | In this procedure, the provider performs a computed tomographic angiography, or CTA imaging of the chest to get detailed images of the blood vessels but not the heart. He performs this study using a… | 130 | $60 | $8.1K |
Showing 1–10 of 37
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 37 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
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.
1 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 71045 | In this diagnostic procedure, the provider performs a single radiological view of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and nearby… | 90 | $1 | $270 |
How this provider's Medicaid billing volume and revenue compare to other Idaho providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Idaho median
1 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 71045 | In this diagnostic procedure, the provider performs a single radiological view of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and nearby… | 40 | 50 | 1,070 | $10 | $35K |
Other providers in the same ZIP code as Douglas Rusnack, ranked by combined Medicare and Medicaid revenue.
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