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

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

Tennessee Orthopaedic Alliance PA (NPI 1538153937)

Tennessee Orthopaedic Alliance PA is a orthopaedic surgery physician provider located in Nashville, Tennessee. This profile covers 0 Medicare and 71 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Medicaid: Complete Services Breakdown

Field	Value
Entity Type	Organization
Organization	Tennessee Orthopaedic Alliance PA
Address	8 City Blvd
City	Nashville
State	TN
ZIP	37209
Taxonomy	Orthopaedic Surgery Physician
NPI Enumerated	August 31, 2005

Payer Source	Total Paid
Medicaid	$5.6M
Medicare	$0

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

71 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…	56,390	$30	$1.7M
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…	23,910	$50	$1.1M
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…	13,080	$60	$785K
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…	26,930	$30	$780.9K
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…	4,620	$80	$383.3K
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…	2,230	$50	$113.7K
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…	3,430	$30	$85.7K
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.	3,100	$20	$71.3K
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).	860	$80	$68.4K
L4361	Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf	380	$170	$63K

Showing 1–10 of 71

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Tennessee Distribution

Tennessee Orthopaedic Alliance PA — 6 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Tennessee

Full comparison — all codes billed, vs. Tennessee median

71 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.	129	340	1,400	$40	$354.2K
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…	134	3,760	610	$40	$202.3K
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…	73	4,050	620	$30	$183.9K
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…	16	350	1,060	$30	$173.8K
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…	42	1,080	120	$80	$90.7K
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…	67	120	610	$10	$81K
95910	In this procedure, the provider performs seven or eight nerve conduction studies, a diagnostic test to evaluate the function, especially the electrical conduction ability of the motor and sensory…	9	10	60	$80	$70.7K
L4361	Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf	8	30	90	$140	$68.3K
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…	57	170	530	$10	$67.8K
72148	In this diagnostic procedure, the provider performs magnetic resonance imaging (MRI) of the lumbar spinal canal and contents without using contrast.	61	80	150	$90	$61.8K

Showing 1–10 of 71

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Oral Facial Surgery Center, LLC	TN	Ambulatory Surgical Clinic/Center	$202.4K	$5.8M
Tnmo Healthcare, LLC	TN	Community Based Hospice Care Agency	$0	$5.7M
Nephrology Associates, PC	TN	Nephrology Physician	$0	$3.4M
Urology Surgery Center LP	TN	Ambulatory Surgical Clinic/Center	$2.9M	$0
Gautam Jayram	TN	Urology Physician	$340.5K	$0
Marcy Abel	TN	Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician	$311.6K	$0
Jane Siegel	TN	Orthopaedic Hand Surgery Physician	$240.5K	$0
William Carpenter	TN	Adult Reconstructive Orthopaedic Surgery Physician	$218.1K	$0
Lucas Burton	TN	Adult Reconstructive Orthopaedic Surgery Physician	$191.1K	$0
Ryan Snowden	TN	Orthopaedic Surgery Physician	$187.3K	$0

Tennessee Orthopaedic Alliance PA — Billing Profile & Reimbursement Data

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Tennessee Orthopaedic Alliance PA — 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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Henry Igid	NV	Hematology & Oncology Physician	$922K	$0
James Eby	TN	Physical Medicine & Rehabilitation Physician	$309.5K	$22.2K
Matthew Barrett	TN	Orthopaedic Surgery Physician	$304.4K	$0
Edward Mackey	TN	Orthopaedic Surgery Physician	$291.4K	$0
Lucas Routh	TN	Orthopaedic Surgery Physician	$285K	$0
Joseph Wade	TN	Orthopaedic Surgery Physician	$272.2K	$0
Harold Cates	TN	Orthopaedic Surgery Physician	$260.4K	$0
Philip Karpos	TN	Orthopaedic Surgery Physician	$251.4K	$0
William Devries	TN	Orthopaedic Surgery Physician	$250.8K	$0
Kenneth Sykes	TN	Interventional Pain Medicine Physician	$240.6K	$0