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    v1.0.28
    OpenPayerNPI Medicare & MedicaidJohn Mccarthy
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    John Mccarthy — Billing Profile & Reimbursement Data

    NPI 1477662179 · O Fallon, MO · Urology Physician

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    John Mccarthy is a urology physician provider located in O Fallon, Missouri. This profile covers 24 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
    OrganizationJohn Mccarthy
    Address20 Progress Point Pkwy Ste 202
    CityO Fallon
    StateMO
    ZIP63368
    TaxonomyUrology Physician
    NPI EnumeratedAugust 29, 2006

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

    Payer SourceTotal Paid
    Medicare$159.8K
    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.

    24 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    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…550$60$31.8K
    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…350$90$29.9K
    J9217Leuprolide acetate (for depot suspension), 7.5 mg140$130$18.9K
    99490The clinical staff provides services directed by the provider to support and coordinate a patient’s care across multiple disciplines. The patient has two or more chronic conditions that place the…340$50$16.5K
    52000In this procedure, the provider performs an examination of the interior of the bladder, the urethra, and the ureteric openings by means of a cystourethroscope, a thin flexible or rigid tube with a…90$160$14.7K
    99204The 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…90$110$9.9K
    99426Clinical staff members, directed by a physician or other qualified healthcare professional, perform management and care plan services for a patient with a complex chronic condition, expected to last…150$50$7K
    55700Code deleted December 31, 2025.40$150$5.4K
    74178The provider performs computed tomography of the abdomen and pelvis without contrast material in one or both body regions followed by contrast material in one or both body regions and additional…20$270$4.6K
    76872The provider inserts an ultrasound probe into the rectum and performs a transrectal ultrasound to assess disorders of the prostate, rectum, and surrounding tissues.50$90$4K

    Showing 1–10 of 24

    Medicare: Competitive Analysis & Benchmarks

    How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 24 CPT/HCPCS codes.

    View: State1 / 2

    Full comparison — all codes billed, vs. state median

    24 rows

    CPT/HCPCS CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    J92172470100$130$17.7K
    992141,3348,960100$80$13.9K
    9949050190180$40$13.8K
    520006617080$150$12.8K
    9943974120160$30$9.2K
    992133008,73070$50$7K
    55700138020$200$5.3K
    523325211020$190$4.9K
    992045114,36030$100$4.8K
    992221,8943,10030$100$4.3K

    Showing 1–10 of 24

    Related Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Eric SutphenMORadiation Oncology Physician$1.9M$0
    Marcus JonesMODiagnostic Radiology Physician$1.2M$0
    William DunnILRadiation Oncology Physician$1.1M$0
    Sushilkumar TibrewalaILGastroenterology Physician$131.6K$807K
    Mustafa HindiILEmergency Medicine Physician$107.8K$744.8K
    Mack MccainILGastroenterology Physician$92.3K$702.2K
    Arvind DurvasanAZNephrology Physician$639.3K$8.9K
    Paul HintonMOInternal Medicine Physician$369.6K$166.4K
    Travis BullockMOUrology Physician$533.7K$0
    Beth LevyMOCytopathology Physician$532.6K$0

    Nearby Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Air Evac Ems, Inc.MOAir Ambulance$1.5M$4.5M
    Saadia RazaMOMOHS-Micrographic Surgery Physician$549.7K$0
    Brian MeekMOPain Medicine Physician$268.9K$0
    Angela SprayMODermatology Physician$206K$0
    Steven SchneiderMOUrology Physician$194.5K$0
    Robert SciortinoMOOrthopaedic Surgery Physician$177.5K$0
    Kevin QuigleyMOSports Medicine (Orthopaedic Surgery) Physician$128.8K$0
    Daniel CrenshawMOPhysical Therapist$104K$0
    Scott ArbaughMOBehavioral Neurology & Neuropsychiatry Physician$91K$0
    Jason SchlautmanMOEmergency Medicine Physician$86.1K$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. Missouri Distribution
    John Mccarthy — 1 of 22 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Missouri