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    OpenPayerNPI Medicare & MedicaidJames Simmons
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    James Simmons — Billing Profile & Reimbursement Data

    NPI 1407855729 · San Antonio, TX · Orthopaedic Surgery of the Spine Physician

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    James Simmons is a orthopaedic surgery of the spine physician provider located in San Antonio, Texas. 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.

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    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeIndividual
    OrganizationJames Simmons
    Address9150 Huebner Rd Ste 290
    CitySan Antonio
    StateTX
    ZIP78240
    TaxonomyOrthopaedic Surgery of the Spine Physician
    NPI EnumeratedJuly 19, 2005

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

    Payer SourceTotal Paid
    Medicare$88K
    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
    22614The provider performs arthrodesis, also known as spinal fusion, to permanently join two vertebrae, the interlocking bones of the spine. The provider applies bone graft material to fuse the spine. The…90$240$20.8K
    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…150$90$13K
    99215The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…90$120$11.6K
    22612The provider performs arthrodesis, also known as spinal fusion, in the lumbar spine (lower back), to permanently join two vertebrae, the interlocking bones of the spine. The provider applies bone…20$410$7.3K
    63047The provider performs a laminectomy (excision of the thin bony plate at the back of a vertebra), facetectomy (excision of an area of a vertebra characterized by its smooth surface), and foraminotomy…20$320$6.3K
    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…110$60$6.3K
    99205The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the provider…50$140$6.3K
    22842The provider places spinal instrumentation at the back of the spine across three to six vertebral segments to correct a spinal deformity during the course of a spinal surgery, such as a spinal…20$300$5.6K
    72082In this diagnostic procedure, the provider takes X–ray images from two or three projections (directions or angles) of the entire thoracic (upper and middle) and lumbar (lower) spine to evaluate the…100$50$5K
    63048At the same session as laminectomy, facetectomy, and foraminotomy on an initial segment for decompression, the provider performs the procedure on an additional vertebral segment.30$70$1.7K

    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
    226129320020$1,380$30.5K
    9921413,48432,500110$80$17.6K
    6304717034020$510$13.2K
    226144021040$210$12.4K
    992151,9958,73040$120$9.2K
    9921311,25829,79070$60$8.4K
    228426119020$410$8.3K
    9920413,53716,38030$110$5.6K
    992059774,32030$150$5.5K
    6304815726030$110$4.2K

    Showing 1–10 of 15

    Related Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Annette GantzTXFamily Nurse Practitioner$607.7K$0
    Thomas WhiteTXInterventional Pain Medicine Physician$561.5K$0
    Dianne LouTXPain Medicine (Anesthesiology) Physician$480.9K$0
    Kenneth WuTXInterventional Pain Medicine Physician$435K$0
    Louis SeadeTXOrthopaedic Surgery Physician$374.4K$0
    Yoann MilletTXInterventional Pain Medicine Physician$360.7K$0
    Michael MoghimiTXOrthopaedic Surgery Physician$355.7K$0
    Eric HeinrichTXOrthopaedic Surgery Physician$349K$0
    John CliftonTXPain Medicine (Anesthesiology) Physician$317.5K$0
    David DodginTXOrthopaedic Surgery Physician$276.3K$0

    Nearby Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Aim Care Home Health Inc.TXIn Home Supportive Care Agency$0$40.3M
    Deer Oaks Geriatric Services P CTXClinical Psychologist$0$17M
    Lhcg Cxxiv, LLCTXIn Home Supportive Care Agency$0$14M
    Richard LaneTXRetina Specialist (Ophthalmology) Physician$4.8M$0
    Sarah HolyTXRetina Specialist (Ophthalmology) Physician$3.5M$0
    Manjulatha BadamTXUndersea and Hyperbaric Medicine (Preventive Medicine) Physician$2.9M$0
    Moises ChicaTXRetina Specialist (Ophthalmology) Physician$2.8M$0
    Calvin MeinTXOphthalmology Physician$2.5M$0
    Sridhar BeeramTXHematology & Oncology Physician$1.8M$0
    Lama HashishTXRheumatology Physician$1.8M$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
    James Simmons — 0 of 15 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Texas