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 Rhode Island for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Rhode Island 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. Rhode Island (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.

Orthopedics Rhode Island, Inc (NPI 1407231293)

Orthopedics Rhode Island, Inc is a orthopaedic surgery physician provider located in Warwick, Rhode Island. This profile covers 0 Medicare and 30 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	Orthopedics Rhode Island, Inc
Address	300 Crossings Blvd
City	Warwick
State	RI
ZIP	02886
Taxonomy	Orthopaedic Surgery Physician
NPI Enumerated	July 22, 2015

Payer Source	Total Paid
Medicaid	$2.5M
Medicare	$0

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

30 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	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…	14,170	$90	$1.2M
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…	9,320	$40	$372.6K
97530	The provider uses various activities during direct contact with the patient to improve the patient’s functional performance. Use this code for each 15 minutes of activity.	5,920	$40	$254.7K
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…	4,440	$50	$239.8K
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…	780	$100	$80.8K
97140	Manual therapy is a form of physical therapy which uses the controlled movement and pressure of hands to treat various disorders of soft tissues and joints, eg, chronic back pain. Manual therapy…	2,750	$30	$74.2K
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…	270	$130	$35.4K
20611	In this procedure, the provider inserts a needle through the skin of a patient and into a major joint or bursa, typically the shoulder, hip, knee, or subacromial bursa, and then uses the syringe…	400	$90	$33.7K
97161	The provider, typically a physical therapist, conducts a physical therapy evaluation that includes history to rule out any adverse factors that will affect care; observes whether the patient's…	320	$80	$25.2K
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.	610	$30	$17.6K

Showing 1–10 of 30

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other Rhode Island providers billing the same CPT/HCPCS codes.

Claims Volume vs. Rhode Island Distribution

Orthopedics Rhode Island, Inc — 2 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Rhode Island

Full comparison — all codes billed, vs. Rhode Island median

30 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J1100	Injection, dexamethasone sodium phosphate, 1 mg	14	20	120	$220	$244.1K
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…	20	360	520	$30	$89.2K
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…	20	1,730	220	$70	$75.2K
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…	118	2,050	300	$50	$72.3K
97530	The provider uses various activities during direct contact with the patient to improve the patient’s functional performance. Use this code for each 15 minutes of activity.	10	260	320	$40	$56K
97140	Manual therapy is a form of physical therapy which uses the controlled movement and pressure of hands to treat various disorders of soft tissues and joints, eg, chronic back pain. Manual therapy…	28	250	300	$20	$42.8K
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…	58	300	50	$130	$40.6K
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…	43	350	80	$90	$40.5K
20611	In this procedure, the provider inserts a needle through the skin of a patient and into a major joint or bursa, typically the shoulder, hip, knee, or subacromial bursa, and then uses the syringe…	2	10	160	$110	$30.3K
97161	The provider, typically a physical therapist, conducts a physical therapy evaluation that includes history to rule out any adverse factors that will affect care; observes whether the patient's…	12	70	50	$70	$28.4K

Showing 1–10 of 30

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Orthopedics Rhode Island, Inc	RI	Orthopaedic Surgery Physician	$0	$812.4K
Thomas Rocco	RI	Surgery Physician	$92.7K	$558.4K
Orthopedics Rhode Island, Inc.	RI	Ambulatory Surgical Clinic/Center	$565.9K	$0
Eric Walsh	RI	Orthopaedic Hand Surgery Physician	$67.9K	$336.2K
William Brennan	RI	Orthopaedic Surgery Physician	$99.4K	$301.4K
Jason Tartaglione	RI	Orthopaedic Foot and Ankle Surgery Physician	$61K	$320.6K
Keith Monchik	RI	Sports Medicine (Orthopaedic Surgery) Physician	$70K	$249.1K
Robert Marchand	RI	Orthopaedic Surgery Physician	$314.2K	$0
Maher El Khatib	RI	Anesthesiology Physician	$113.2K	$163.7K
Kenneth Furcolo	RI	Medical Physician Assistant	$42.7K	$206.5K

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
West Bay Residential Services Inc.	RI	Developmentally Disabled Services Day Training Agency	$0	$145.8M
Kent County Memorial Hospital	RI	General Acute Care Hospital	$0	$90.8M
Avatar Residential, Inc.	RI	Developmentally Disabled Services Day Training Agency	$0	$72.9M
Thrive Behavioral Health, Inc.	RI	Community/Behavioral Health Agency	$0	$71.9M
Bayada Home Health Care, Inc.	RI	Home Health Agency	$0	$69.5M
Community Living Of Rhode Island	RI	Developmentally Disabled Services Day Training Agency	$0	$65.7M
J.arthur Trudeau Memorial Center Conversion Waivers	RI	Developmentally Disabled Services Day Training Agency	$0	$57.1M
Gateways To Change, Inc.	RI	Developmentally Disabled Services Day Training Agency	$0	$54.5M
Affinity Physicians LLC.	RI	Internal Medicine Physician	$0	$41.8M
J, Arthur Trudeau Memorial Center	RI	Developmentally Disabled Services Day Training Agency	$0	$33.9M

Orthopedics Rhode Island, Inc — Billing Profile & Reimbursement Data

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Orthopedics Rhode Island, Inc — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

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