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 & MedicaidPaul Pflueger
    Ask Trek AI about this page

    Paul Pflueger — Billing Profile & Reimbursement Data

    NPI 1386647998 · Prescott, AZ · Orthopaedic Surgery Physician

    Customize your policy alerts

    Sign up for Paul Pflueger — 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.

    Paul Pflueger is a orthopaedic surgery physician provider located in Prescott, Arizona. This profile covers 15 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
    OrganizationPaul Pflueger
    Address1223 Willow Creek Rd
    CityPrescott
    StateAZ
    ZIP86301
    TaxonomyOrthopaedic Surgery Physician
    NPI EnumeratedMay 27, 2005

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

    Payer SourceTotal Paid
    Medicare$235.1K
    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.

    15 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    J7327Hyaluronan or derivative, monovisc, for intra-articular injection, per dose100$560$55.3K
    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…520$90$47.2K
    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…400$60$25.9K
    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…520$50$24.2K
    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…190$110$21.2K
    29827The provider examines the tissue inside the shoulder joint with an arthroscope. She inserts additional instruments to repair a torn rotator cuff, the grouping of muscles and tendons that surround and…30$830$20.6K
    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…100$70$6.9K
    73564In this procedure, the provider takes four or more X–ray views of the knee joint to check for any fracture, swelling, or reason for pain in the knee area.220$30$6.7K
    73560In this procedure, the provider takes one or two X–ray images of a patient’s knee joint to check for any fracture, swelling, or reason for pain in the knee area.260$30$6.5K
    J7331Hyaluronan or derivative, synojoynt, for intra-articular injection, 1 mg340$20$6.1K

    Showing 1–10 of 15

    Medicare: Competitive Analysis & Benchmarks

    How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 15 CPT/HCPCS codes.

    View: State1 / 2

    Full comparison — all codes billed, vs. state median

    15 rows

    CPT/HCPCS CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    J733116201,190$10$42.4K
    J7327136040$560$34K
    298273310020$1,020$25.4K
    992141,32410,410120$80$20.6K
    992139579,60080$60$9.6K
    29824254020$320$9.4K
    992043195,79040$110$6.7K
    206102795060$50$5.4K
    992037044,10040$70$4K
    735644943050$30$2.6K

    Showing 1–10 of 15

    Related Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Richard BassettAZAdult Reconstructive Orthopaedic Surgery Physician$634.5K$0
    Michael DobsonAZSurgical Physician Assistant$260.4K$0
    Wilford RichardsonAZOrthopaedic Hand Surgery Physician$206.6K$0
    Eric ClelandAZPhysical Therapist$161.8K$0
    Evan SimonsonAZOrthopaedic Foot and Ankle Surgery Physician$141.9K$0
    Megan SitrinAZNurse Practitioner$114.8K$0
    Mark ThieleAZPhysician Assistant$104.8K$0
    Mackenzie PriceAZPhysician Assistant$77.6K$0

    Nearby Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Yavapai Community Hospital AssociationAZGeneral Acute Care Hospital$0$66.2M
    Prescott Healthcare Solutions LLCAZFamily Medicine Physician$0$13.3M
    Summit Behavioral Health Of Az, LLCAZSubstance Abuse Rehabilitation Facility$0$13.3M
    Medical Services Of Prescott, Inc.AZEmergency Medicine Physician$0$12.3M
    Prescott Whipple StageAZTaxi$0$9.2M
    Iyad HamarnehAZMedical Oncology Physician$3.5M$0
    Alan LangerakAZHematology & Oncology Physician$2.7M$0
    Allan Espinosa MorazanAZMedical Oncology Physician$2.2M$0
    Prescott Outpatient Surgical Center LLCAZAmbulatory Surgical Clinic/Center$1.7M$25.7K
    Arizona Institute Of Eye Surgery LLCAZAmbulatory Surgical Clinic/Center$1.4M$24.7K

    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. Arizona Distribution
    Paul Pflueger — 2 of 15 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Arizona