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    v1.0.28
    OpenPayerNPI Medicare & MedicaidDuncan Burkholder
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    Duncan Burkholder — Billing Profile & Reimbursement Data

    NPI 1467430405 · Lubbock, TX · Gynecology Physician

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    Duncan Burkholder is a gynecology physician provider located in Lubbock, Texas. This profile covers 11 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
    OrganizationDuncan Burkholder
    Address4515 Marsha Sharp Fwy
    CityLubbock
    StateTX
    ZIP79407
    TaxonomyGynecology Physician
    NPI EnumeratedJanuary 9, 2006

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

    Payer SourceTotal Paid
    Medicare$35.4K
    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.

    11 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    51792This procedure measures the electrical activity in the anal or urethral sphincter muscles.80$210$17.1K
    90912The provider, a physician or other qualified healthcare professional, trains a patient to control involuntary bodily functions by altering brain activity, blood pressure, heart rate, and other bodily…70$60$4.4K
    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…40$60$2.1K
    90913The provider, a physician or other qualified healthcare professional, trains a patient to control involuntary bodily functions by altering brain activity, blood pressure, heart rate, and other bodily…70$20$1.8K
    99211An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.110$20$1.7K
    G0101Cervical or vaginal cancer screening; pelvic and clinical breast examination50$40$1.7K
    99212The 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,…40$40$1.6K
    Q0091Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory40$40$1.6K
    99203The 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…20$70$1.4K
    57160In this procedure, the provider fits and inserts a pessary or similar device into the vagina to treat vaginal wall prolapse or other disorders.20$50$1K

    Showing 1–10 of 11

    Medicare: Competitive Analysis & Benchmarks

    How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 11 CPT/HCPCS codes.

    View: State1 / 2

    Full comparison — all codes billed, vs. state median

    11 rows

    CPT/HCPCS CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    5179231020$180$15.7K
    9921320,89929,79070$60$8.4K
    9091291080$50$5.3K
    992037,42510,82030$70$3.4K
    992122,1785,51030$40$2.2K
    57160336020$50$1.7K
    A4562264020$50$1.5K
    Q009111347020$40$1.3K
    G010120594020$40$1.3K
    9091311040$20$980

    Showing 1–10 of 11

    Related Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Philip McdonaldFLDiagnostic Radiology Physician$444.3K$42.8K
    Elliott WagnerCADiagnostic Radiology Physician$392.6K$7.3K
    Ramakrishnan RanganathTXInterventional Cardiology Physician$377.8K$0
    Peter PiampianoTNDiagnostic Radiology Physician$254.4K$20.1K
    Jeffrey HannelTXFamily Medicine Physician$214.7K$0
    Hemmo BosscherTXInterventional Pain Medicine Physician$180.2K$0
    Bhupesh DiheniaTXNeurology Physician$128.6K$0
    Mujtaba MohammedTXDiagnostic Radiology Physician$114.3K$560
    Fatima SalasTXInterventional Pain Medicine Physician$107.8K$0
    Stephen HallierTXAnesthesiology Physician$91.7K$0

    Nearby Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Umc PhysiciansTXFamily Medicine Physician$0$11.1M
    Jason BradleyTXInterventional Cardiology Physician$2.1M$0
    Colbert PerezTXInterventional Cardiology Physician$2M$0
    Manasseh Medical Imaging, IncTXPortable X-ray and/or Other Portable Diagnostic Imaging Supplier$1M$911.2K
    Nayankumar PatelTXNephrology Physician$607.3K$0
    James FayTXPain Medicine (Anesthesiology) Physician$381.7K$0
    Ruben VillaTXNephrology Physician$254.8K$610
    Jordan FultzTXPhysical Therapist$145.6K$0
    Aubrey EdwardsTXPhysical Therapist$109.9K$0
    Robin MiniellyTXAnesthesiology Physician$76.7K$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
    Duncan Burkholder — 1 of 11 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Texas