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

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

Tucson Orthopaedic Institute Professional Corporation (NPI 1437193265)

Field	Value
Entity Type	Organization
Organization	Tucson Orthopaedic Institute Professional Corporation
Address	5301 E Grant Rd
City	Tucson
State	AZ
ZIP	85712
Taxonomy	Orthopaedic Surgery Physician
NPI Enumerated	June 15, 2006

Payer Source	Total Paid
Medicaid	$10.2M
Medicare	$0

Medicaid: Complete Services Breakdown

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

83 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	56,830	$50	$2.6M
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…	24,070	$70	$1.6M
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.	25,470	$30	$789.4K
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…	27,840	$30	$696K
97112	Neuromuscular reeducation is a therapeutic treatment (exercise) performed by a physician in an attempt to reduce impairments and restore function through the application of clinical skills and/or…	22,270	$30	$623.6K
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…	9,260	$60	$583.2K
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…	5,200	$90	$483.9K
95886	The provider assesses the electrical activity of a muscle in the extremity and related paraspinal areas. At the same session as a separately reportable nerve conduction study. He studies five or more…	2,460	$120	$295.4K
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…	12,480	$20	$237.1K
73630	In this diagnostic procedure, the provider takes a minimum of three views of the foot to assess injury, fracture, arthritis, tumor, or congenital abnormality.	7,870	$30	$196.7K

Showing 1–10 of 83

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Arizona Distribution

Tucson Orthopaedic Institute Professional Corporation — 6 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Arizona

Full comparison — all codes billed, vs. Arizona median

83 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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.	34	510	1,320	$60	$454.9K
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…	408	3,040	750	$50	$343.9K
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…	33	480	960	$40	$308.1K
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…	44	2,780	600	$50	$267K
64483	This procedure is the injection of an anesthetic agent and/or steroid in the form of a transforaminal epidural injection into a single level (either lumbar or sacral).	25	80	350	$160	$259.1K
L4361	Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf	10	20	250	$170	$202.2K
95886	The provider assesses the electrical activity of a muscle in the extremity and related paraspinal areas. At the same session as a separately reportable nerve conduction study. He studies five or more…	12	60	210	$120	$165.3K
97112	Neuromuscular reeducation is a therapeutic treatment (exercise) performed by a physician in an attempt to reduce impairments and restore function through the application of clinical skills and/or…	13	260	790	$30	$160.7K
99244	The provider sees a patient for an office or other outpatient consultation involving evaluation and management (E/M). The E/M involves a moderate level of medical decision making or the provider…	156	180	120	$120	$157.9K
L3809	Wrist hand finger orthosis, without joint(s), prefabricated, off-the-shelf, any type	5	10	140	$120	$144.7K

Showing 1–10 of 83

Related Providers

Other providers that share a Tax Identification Number (TIN) with Tucson Orthopaedic Institute Professional Corporation, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Kyung Chen	AZ	Interventional Pain Medicine Physician	$540.3K	$0
Bradley Holt	AZ	Interventional Pain Medicine Physician	$473.4K	$0
Russell Cohen	AZ	Adult Reconstructive Orthopaedic Surgery Physician	$399.1K	$0
Kevin Bowers	AZ	Sports Medicine (Orthopaedic Surgery) Physician	$341.1K	$0
John Maltry	AZ	Adult Reconstructive Orthopaedic Surgery Physician	$312.4K	$0
John Wild	AZ	Sports Medicine (Orthopaedic Surgery) Physician	$285.2K	$0
Troy Virgil Taduran	AZ	Sports Medicine (Neuromusculoskeletal Medicine) Physician	$278.5K	$0
Chad Hills	AZ	Orthopaedic Surgery Physician	$229.4K	$0
Edward Petrow	AZ	Adult Reconstructive Orthopaedic Surgery Physician	$217.6K	$0
Christopher Stevens	AZ	Orthopaedic Hand Surgery Physician	$217K	$0

Nearby Providers

Other providers in the same ZIP code as Tucson Orthopaedic Institute Professional Corporation, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Tucson Medical Center	AZ	General Acute Care Hospital	$0	$127.3M
Codac Health Recovery And Wellness	AZ	Community/Behavioral Health Agency	$0	$97.8M
Children's Clinics For Rehabilitative Services	AZ	Multi-Specialty Clinic/Center	$0	$58.8M
Nsi-nursing Service Inc.	AZ	Home Health Agency	$0	$29.8M
Tmc Medical Network	AZ	Multi-Specialty Clinic/Center	$0	$20.3M
Arlene Bautista	AZ	Family Nurse Practitioner	$16.8M	$0
I-groupsmedicaltransportaion@wheelchair	AZ	Non-emergency Medical Transport (VAN)	$0	$15.5M
Bodycentral Physical Therapy P C	AZ	Physical Therapy Clinic/Center	$0	$14.5M
Arizona Oncology Associates PC	AZ	Specialist	$0	$13.9M
Child & Family Support Services, Inc	AZ	Community/Behavioral Health Agency	$0	$13.4M

Tucson Orthopaedic Institute Professional Corporation — Billing Profile & Reimbursement Data

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Tucson Orthopaedic Institute Professional Corporation — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References