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

Why is the Medicaid comparison limited to Wyoming 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. Wyoming (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.

William Lighthart (NPI 1427004647)

Field	Value
Entity Type	Individual
Organization	William Lighthart
Address	555 E Broadway Ave
City	Jackson
State	WY
ZIP	83001
Taxonomy	Adult Reconstructive Orthopaedic Surgery Physician
NPI Enumerated	May 26, 2006

Payer Source	Total Paid
Medicare	$293.1K
Medicaid	$0

Key Findings

This provider is effectively a single‑payer Medicare practice: total Medicare revenue is $293.1K and there is no Medicaid billing on file, so Medicaid does not meaningfully contribute to the payer mix. The practice’s NPI was enumerated 2006-05-26 (~20 years ago), consistent with an established solo or small-group orthopaedic operation focused on Medicare beneficiaries.

Revenue is highly concentrated in three codes: the top 3 Medicare codes account for 61.9% of the provider’s total Medicare revenue, driven by 27447 ($105.3K, 36.0%), 27130 ($58.2K, 19.9%), and 99213 ($17.6K, 6.0%). This concentration indicates that major joint replacement procedures and routine office E/M visits dominate the financial picture.

The code mix aligns with an adult reconstructive orthopaedic specialty focused on high-volume joint replacement and post‑op outpatient care: 27447 and 27130 represent knee and hip arthroplasty as the primary revenue drivers, while 99212/99213/99214 volumes and several therapy codes (97110, 97140, 97112) show substantial follow‑up and conservative care throughput. Injectable and procedural codes (20610, J7325, J7321, J1030) further imply the practice provides in‑clinic joint injections and viscosupplementation as adjunct services.

Competitive standing for the primary surgical code 27447 is strong: 27447 ranks #777 of 12089 providers nationally (93th percentile) and is described as notably above typical national volume for this code, signaling above‑peer TKA throughput. By contrast, 27130 ranks #1067 of 8062 (86th percentile) with a characterization of typical, unremarkable volume, indicating solid but less exceptional hip arthroplasty activity relative to national peers.

Ambulatory and follow‑up care volumes are elevated: 99212 appears at high relative volume (413 claims, rank #1615 of 99011, 98th percentile) and is noted as notably above typical national volume, while 99213 (280 claims, rank #65527 of 457151, 86th percentile) is characterized as typical, unremarkable volume. This pattern suggests a substantial clinic throughput for established patients, likely reflecting routine post‑operative visits and ongoing conservative management.

Imaging and diagnostic utilization is concentrated and above peers for plain radiographs: knee X‑ray 73564 (297 claims) ranks #754 of 20494 (96th percentile) and is noted as notably above typical national volume, and hip X‑ray 73502 (285 claims) ranks #887 of 33225 (97th percentile). In contrast, advanced imaging such as MRI of a lower extremity joint (73721) is rarely billed (12 claims) and sits near the low end of national ranks (3th percentile), indicating reliance on plain films within this practice.

Injection and procedural services are frequent but generate modest revenue per unit: 20610 shows 283 claims and $12.2K revenue and is characterized as typical, unremarkable volume, while viscosupplementation J7325 has 960 claims for $6.7K revenue and is also described as typical, unremarkable volume. The combination of many low‑priced injection claims and a smaller number of high‑value arthroplasty claims explains why procedure mix drives clinical activity but overall Medicare revenue remains in the low hundreds of thousands.

Operational implication from tenure and mix: with an NPI active since 2006-05-26 (~20 years) and a business model concentrated on joint replacement plus high clinic volume for established patients, this provider appears to operate as an experienced orthopaedic reconstructive clinician whose Medicare revenue stream is surgery‑centric and not supplemented by Medicaid business. The absence of Medicaid billing suggests limited participation in state programs or a patient panel skewed toward Medicare beneficiaries.

Medicare: Complete Services Breakdown

The CPT/HCPCS codes generating the most Medicare revenue for this provider.

23 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
27447	In this procedure, the provider replaces the damaged weight bearing surfaces of both the medial and lateral compartments in the knee joint using implants of metal or other strong materials. The…	110	$980	$105.3K
27130	In this procedure, the provider surgically replaces the hip joint by prosthesis, or artificial hip joint. He replaces both the femoral and acetabular components with or without using an autograft or…	60	$990	$58.2K
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…	280	$60	$17.6K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	410	$40	$16.1K
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…	890	$20	$16K
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…	140	$90	$12.4K
20610	In 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…	280	$40	$12.2K
73564	In 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.	300	$30	$9.8K
73502	In this diagnostic procedure, the provider takes X–ray images of one hip, either left or right, from two or three projections (directions or angles) to check for any fracture, swelling, or other…	290	$30	$9.7K
J7325	Hyaluronan or derivative, synvisc or synvisc-one, for intra-articular injection, 1 mg	960	$10	$6.7K

Showing 1–10 of 23

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 23 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Wyoming Distribution

William Lighthart — 7 of 23 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Wyoming

Full comparison — all codes billed, vs. state median

23 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
27447	1	50	20	$1,010	$32.5K
27130	1	30	30	$1,190	$30.8K
97110	143	350	690	$20	$17K
99214	296	780	100	$80	$14.8K
97530	258	270	330	$20	$13.5K
J7321	4	10	130	$60	$10.7K
97112	253	280	370	$20	$10.6K
97140	267	340	490	$20	$10.4K
99213	159	850	110	$60	$9.9K
J7325	6	10	1,060	$10	$8.2K

Showing 1–10 of 23

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Rutland Hospital, Inc.	VT	Psychiatric Hospital Unit	$396.2K	$13.3M
Rutland Hospital, Inc	VT	Emergency Medicine Physician	$0	$1.8M
Rutland Hospital, Inc.	VT	Specialist	$0	$1M
Rutland Hospital, Inc.	VT	General Acute Care Hospital	$0	$948.8K
Jennifer Fauntleroy	VT	Psychiatry Physician	$65.4K	$712.9K
Rutland Hospital, Inc.	VT	Specialist	$0	$653.6K
Philip Ginsburg	VT	Gastroenterology Physician	$628K	$0
James Fitts	CA	Cardiovascular Disease Physician	$389.7K	$0
Rutland Hospital, Inc.	VT	Specialist	$0	$345K
Eric Marsh	VT	Surgery Physician	$273.7K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Teton County Hospital District	WY	General Practice Physician	$0	$549.7K
Heather Thomas	WY	Case Manager/Care Coordinator	$0	$492.1K
La Familia Counseling Services	WY	Professional Counselor	$0	$417.9K
Teton Outpatient Services LLC	WY	Ambulatory Surgical Clinic/Center	$400.5K	$0
Tbt, LLC	WY	Community/Behavioral Health Agency	$0	$363.6K
Afton Cobb	WY	MOHS-Micrographic Surgery Physician	$357.5K	$0
Mary Roberts	WY	Case Manager/Care Coordinator	$0	$268.5K
Christopher Hills	WY	Orthopaedic Surgery Physician	$221.5K	$0
Jennifer Bradof	WY	Clinical Social Worker	$25.7K	$135.6K
Karin L Klee Md	WY	Pediatrics Physician	$0	$145.4K

William Lighthart — Billing Profile & Reimbursement Data

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Key Findings

Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References