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

Why is the Medicaid comparison limited to South Dakota 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. South Dakota (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.

David Jones (NPI 1508061144)

Field	Value
Entity Type	Individual
Organization	David Jones
Address	2120 Live Stronger St
City	Tea
State	SD
ZIP	57064
Taxonomy	Orthopaedic Hand Surgery Physician
NPI Enumerated	June 15, 2007

Payer Source	Total Paid
Medicare	$323.9K
Medicaid	$0

Key Findings

Practice is focused on hand and wrist surgical care with a strong procedural mix centered on enzymatic and operative interventions: the single largest Medicare revenue line is J0775 (collagenase injection) with 2.9K claims, $52 avg paid/claim and $149.8K revenue (46.8% of Medicare revenue), and other top codes include 64721 (carpal tunnel neuroplasty) and 25447 (intercarpal/carpometacarpal arthroplasty). The presence of both enzyme injection (J0775, 20527) and multiple reconstructive/surgical codes (64721, 25447, 64718) indicates a practice that delivers both non‑operative enzymatic management for conditions like Dupuytren’s and definitive surgical care for compressive neuropathies and joint reconstruction.

Revenue is highly concentrated in a very small set of procedures: the precomputed top 3 Medicare codes account for 62.4% of this provider’s total Medicare revenue, and J0775 alone represents 46.8% of Medicare receipts. This level of concentration means changes in utilization or reimbursement for a single therapy, particularly collagenase injections, would materially affect overall Medicare revenue for this clinician.

Payer mix is effectively single‑payer Medicare: lifetime Medicare revenue is $323.9K while there is no Medicaid billing on file. This creates concentrated payer risk and suggests the provider either treats a predominantly Medicare patient panel or bills for services in settings not captured in state Medicaid data.

Competitive standing is mixed by service line: for carpal tunnel surgery (64721) the provider ranks #115 of 3206 providers nationally (96th percentile) and for trigger‑finger release (26055) ranks #101 of 2946 providers nationally (97th percentile), both described as notably above typical national volume — indicating above‑typical procedural activity in these surgical areas. By contrast, the provider’s J0775 volume ranks #25 of 97 providers nationally (73th percentile) and is labeled typical/unremarkable, so the clinician is not a national outlier for collagenase use despite that code driving revenue concentration.

Service delivery appears to combine office evaluation and management with frequent use of injections and diagnostic imaging: E/M codes such as 99214 (154 claims, $14.2K) and 99213 (167 claims, $10.5K) are present alongside high‑percentile usage of joint injection and imaging codes (20600 ranks in the 97th percentile; 73140 ranks in the 97th percentile). This mix suggests an ambulatory practice model that pairs clinic visits and image‑guided or blind injections with operative procedures rather than an exclusively hospital‑based surgical practice.

There are several statistical outliers in national ranking for lower‑volume procedural codes that point to niche expertise: 24305 (tendon lengthening) is ranked #1 of 7 providers nationally (100th percentile; notably above typical national volume) even though it contributes a modest $6.2K (2.0% of Medicare revenue). High percentile ranks on select uncommon hand codes imply focused procedural capabilities that may not be visible from aggregate revenue alone.

Although lifetime Medicare revenue of $323.9K is modest in absolute terms, the provider has a long tenure with NPI enumerated 2007-06-15 (~19 years), consistent with an established, stable practice that has developed concentrated procedural volumes over time. The combination of long tenure and concentrated high‑percentile surgical volumes suggests the provider operates as a specialized hand surgery clinician in a relatively small Medicare market footprint.

Operational implications for payers and network planners: given the near absence of Medicaid billing and the heavy reliance on a few Medicare procedures (62.4% from the top three codes), contracting decisions, utilization management, or changes to coverage for collagenase injections or carpal tunnel surgery could substantially alter this clinician’s revenue profile. Payers should consider targeted credentialing or capacity planning that reflects the provider’s strengths in hand surgery and outpatient procedural care.

Medicare: Complete Services Breakdown

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

32 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J0775	Injection, collagenase, clostridium histolyticum, 0.01 mg	2,880	$50	$149.8K
64721	Neuroplasty or transposition of the median nerve at the carpal tunnel is done to treat a condition called carpal tunnel syndrome (CTS). The carpal tunnel is a narrow tunnel in the wrist through which…	110	$310	$32.5K
25447	The provider performs arthroplasty (joint replacement) of the intercarpal joints (between the small bones in the wrist) or carpometacarpal joints (where the carpal bones of the wrist meet the…	30	$610	$17.2K
26055	Trigger finger, or stenosing tenosynovitis, is when a finger remains in a bent position. It is painful to open or close the finger. A swollen tendon or formation of knots or nodules in the tendon may…	120	$130	$15.2K
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…	150	$90	$14.2K
64718	In this procedure, the provider uses an open approach to incise scar tissue or other sources of pressure to relieve tension on the ulnar nerve at the elbow, which an injury or swelling within the…	30	$410	$12.2K
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…	170	$60	$10.5K
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…	70	$110	$7.8K
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…	90	$80	$7K
26480	In this procedure, the provider transfers or transplants a tendon in the carpometacarpal area or the back of the hand. The carpometacarpal area is the articulation of the wrist’s carpal bones with…	20	$310	$6.5K

Showing 1–10 of 32

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 32 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. South Dakota Distribution

David Jones — 7 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — South Dakota

Full comparison — all codes billed, vs. state median

32 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0775	2	10	3,110	$50	$162.6K
99214	561	1,660	90	$70	$11.4K
64721	1	20	30	$310	$9.5K
25447	2	10	20	$410	$9K
64718	1	10	20	$350	$8.4K
99213	403	1,710	80	$50	$6.4K
24305	1	10	30	$220	$6.2K
26055	1	10	30	$160	$5.9K
26480	2	10	20	$250	$5.1K
99204	139	670	30	$100	$5.1K

Showing 1–10 of 32

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Chad Laurich	SD	Vascular Surgery Physician	$3.2M	$0
NPI 1588636484	—	—	$3.2M	$0
Ryan Geraets	SD	Ophthalmology Physician	$3M	$0
John Bormes	SD	Ophthalmology Physician	$2.6M	$0
Elizabeth Atchison	SD	Ophthalmology Physician	$1.7M	$0
Ashar Luqman	IA	Nephrology Physician	$1.4M	$0
Taylor Slingsby	SD	Retina Specialist (Ophthalmology) Physician	$1.4M	$0
Ty Hanson	SD	Dermatology Physician	$1.2M	$0
Alexander Ringeisen	MN	Retina Specialist (Ophthalmology) Physician	$1.1M	$0
Richard Conklin	SD	Hematology & Oncology Physician	$994.4K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Orthopedic Institute PC	SD	Multi-Specialty Clinic/Center	$0	$567.1K
Michael Adler	SD	Orthopaedic Surgery Physician	$407.3K	$0
Richard Curd	SD	Orthopaedic Hand Surgery Physician	$289.9K	$0
Matthew Mckenzie	SD	Orthopaedic Surgery Physician	$275.6K	$0
Corey Rothrock	SD	Adult Reconstructive Orthopaedic Surgery Physician	$273.3K	$0
Timothy Walker	SD	Orthopaedic Surgery Physician	$261.3K	$0
Jason Hurd	SD	Orthopaedic Surgery Physician	$214.6K	$0
Keith Baumgarten	SD	Orthopaedic Surgery Physician	$210K	$0
James Brunz	SD	Pain Medicine (Anesthesiology) Physician	$202.3K	$0
Matthew Wingate	SD	Orthopaedic Surgery of the Spine Physician	$176K	$0

David Jones — 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