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    OpenPayerNPI Medicare & MedicaidOwen Ellington
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    Owen Ellington — Billing Profile & Reimbursement Data

    NPI 1396703310 · Humble, TX · Hematology & Oncology Physician

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    Owen Ellington is a hematology & oncology physician provider located in Humble, Texas. This profile covers 17 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.

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    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeIndividual
    OrganizationOwen Ellington
    Address14007 Cole Point Dr
    CityHumble
    StateTX
    ZIP77396
    TaxonomyHematology & Oncology Physician
    NPI EnumeratedMay 1, 2006

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

    Payer SourceTotal Paid
    Medicare$11.5M
    Medicaid$0

    Key Findings

    Medicare dominance and payer mix: This provider has $11.5M in total Medicare revenue on file and no Medicaid billing on file, making the practice effectively single-payer with Medicare accounting for the entirety of reported public-payer revenue. Analysts should treat Medicare patterns as the primary driver of this provider’s public reimbursement profile rather than attempting a dual-payer comparison.

    Extreme revenue concentration in three Q‑codes: The provider’s top three Medicare codes by revenue — Q4262 ($7.7M, 67.2%), Q4253 ($3.1M, 27.2%), and Q4188 ($201.2K, 1.7%) — are precomputed to account for 96.1% of total Medicare revenue. This indicates an unusually narrow revenue base where amniotic membrane/implant add-on products dominate receipts.

    Service-line implications — amniotic membrane and wound-care focus: The highest-revenue codes (Q4262, Q4253, Q4188) are per-square-centimeter amniotic membrane add-ons, which, together with significant billing for debridement and skin-substitute codes such as 11042 ($193.7K, 1.7%) and 15271 ($67.8K, 0.6%), point to an operation oriented around biologic grafting and wound management rather than traditional office-based Hematology & Oncology E/M visits. This mix suggests the practice’s revenue model is closely tied to procedural and implanted biologic product use.

    Competitive standing on top product codes: For the leading product codes the provider is a solid but not dominant national participant — Q4262 ranks #18 of 141 providers (88th percentile; typical, unremarkable volume) and Q4253 ranks #15 of 73 providers (81th percentile; typical, unremarkable volume). By contrast, Q4188 is minimal relative to peers (rank #46 of 47, 2th percentile; typical, unremarkable volume), indicating the provider’s market strength is concentrated in specific product brands or formulations rather than across all amniotic membrane products.

    Notable statistical outliers in procedural and home-visit volumes: Several non‑Q codes show extreme standing versus national peers, including 11042 (rank #32 of 10712, 100th percentile; extreme outlier), 99348 (rank #36 of 11547, 100th percentile; extreme outlier), and 15271 (rank #15 of 1157, 99th percentile; extreme outlier). These labels signal unusually high national volumes for surgical debridement, home/residence evaluation and management visits, and use of skin substitutes relative to typical providers and merit further operational review.

    High home-visit activity: Home/residence E/M codes appear in the top billing list with 99348 at 2.1K claims ($123.9K, 1.1%) ranked #36 of 11547 (100th percentile; extreme outlier) and 99342 at 266 claims ($14.6K, 0.1%) ranked #50 of 2463 (98th percentile; notably above typical national volume). This suggests an established component of the practice is delivered in patient residences, which may reflect targeted post‑operative, wound‑care, or homebound patient management services.

    Established tenure with potential operational stability: The provider’s NPI was enumerated on 2006-05-01 (~20 years ago), indicating long-standing enrollment in Medicare and a sustained operational presence. Given the duration plus concentrated high-dollar code use, the provider appears to have an entrenched service line around the identified procedural and product-driven activities.

    Revenue sensitivity and business risk: Because a very large share of Medicare revenue is tied to specific per‑square‑centimeter amniotic membrane codes (Q4262 and Q4253) and a handful of high-volume procedural codes, the provider’s topline is likely sensitive to changes in reimbursement, supply availability, or coding practice for those products and procedures. Payer contract negotiations, product pricing, or clinical guidelines affecting use of these biologic grafts could materially affect overall revenue more than changes to routine E/M reimbursement would.

    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.

    17 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    Q4262Dual layer impax membrane, per square centimeter (add-on, list separately in addition to primary procedure)7,530$1,030$7.7M
    Q4253Zenith amniotic membrane, per square centimeter (add-on, list separately in addition to primary procedure)4,310$730$3.1M
    Q4188Amnioarmor, per square centimeter (add-on, list separately in addition to primary procedure)270$750$201.2K
    11042The provider uses surgical instruments to remove the dead tissue in skin down to the subcutaneous layer and including the epidermis and dermis, up to the first 20 cm2.1,900$100$193.7K
    99348The provider sees an established patient for a home or residence visit involving evaluation and management (E/M). The visit involves low medical decision making or the provider spends at least 30…2,100$60$123.9K
    15271The provider uses a skin substitute, such as an allograft or xenograft, to cover wounds on the patient’s trunk, arms, and/or legs up to an area of 100 cm2. This code covers up to the first 25 cm2.560$120$67.8K
    99342The provider sees a new patient for a home or residence visit involving evaluation and management (E/M). The visit involves a low level of medical decision making or the provider spends at least 30…270$60$14.6K
    11000The provider uses surgical instruments to debride the dead tissue in skin for up to 10 percent of the body surface.400$40$14K
    87798The lab analyst performs a test for an infectious agent not specified in another code using an amplified nucleic acid probe technique. Use this code if you know the laboratory technique is amplified…370$30$12.4K
    15275The provider uses a skin substitute, such as an allograft or xenograft, to cover wounds on the face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, up to…90$120$11.7K

    Showing 1–10 of 17

    Medicare: Competitive Analysis & Benchmarks

    How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 17 CPT/HCPCS codes.

    View: State1 / 2

    Full comparison — all codes billed, vs. state median

    17 rows

    CPT/HCPCS CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    Q42622301,580$1,010$2.5M
    Q4253210730$650$1.1M
    87798192300790$30$265.1K
    Q4188110270$740$201.1K
    8764020025070$30$25.9K
    8764112117080$30$23.2K
    8750014819080$30$21.7K
    8765117730030$30$18.6K
    11042779090$70$13K
    15271312070$100$9.9K

    Showing 1–10 of 17

    Related Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Richard ParkCAInternal Medicine Physician$31.7M$0
    Nyrie AustinNJFamily Nurse Practitioner$15.9M$8.8K
    Patrick BlackCAPhysical Therapist$14M$0
    Joseph PalumboWVEmergency Medicine Physician$7.9M$44.3K
    Shelita JonesTXFamily Nurse Practitioner$6.7M$0
    Kellie KingTXFamily Nurse Practitioner$5.3M$0
    Jamie Kate AdocCAFamily Nurse Practitioner$4.7M$0
    Raymond WawrowskiOHPhysician Assistant$4.7M$0
    Thuy VoCAFamily Nurse Practitioner$4.4M$0
    Siya OlosoTXFamily Nurse Practitioner$4.1M$0

    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. Texas Distribution
    Owen Ellington — 7 of 17 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Texas