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

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

Umpqua Orthopedics PC (NPI 1548319379)

Umpqua Orthopedics PC is a specialist provider located in Roseburg, Oregon. This profile covers 0 Medicare and 17 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	Umpqua Orthopedics PC
Address	277 Nw Medical Loop
City	Roseburg
State	OR
ZIP	97471
Taxonomy	Specialist
NPI Enumerated	January 10, 2007

Payer Source	Total Paid
Medicaid	$1.2M
Medicare	$0

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

17 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…	7,910	$40	$348.1K
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…	3,160	$70	$227.2K
20611	In this procedure, the provider inserts a needle through the skin of a patient and into a major joint or bursa, typically the shoulder, hip, knee, or subacromial bursa, and then uses the syringe…	3,770	$50	$195.9K
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…	1,450	$120	$169.3K
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…	1,830	$80	$142.9K
J3301	Injection, triamcinolone acetonide, not otherwise specified, 10 mg	4,190	$10	$25.2K
73560	In this procedure, the provider takes one or two X–ray images of a patient’s knee joint to check for any fracture, swelling, or reason for pain in the knee area.	590	$20	$13K
76881	In this procedure, the provider uses ultrasound to examine the complete joint for any defect or abnormality. The image appears in real time on a monitor, and a permanent image with interpretation is…	240	$50	$12.2K
73565	In this procedure, the provider takes X–ray images of a patient’s knees while the patient is in a standing position facing the X–ray machine to check for any fracture, swelling, or reason for pain in…	460	$30	$11.9K
J1040	Injection, methylprednisolone acetate, 80 mg	190	$20	$3.2K

Showing 1–10 of 17

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Oregon Distribution

Umpqua Orthopedics PC — 3 of 16 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Oregon

Full comparison — all codes billed, vs. Oregon median

17 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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…	369	1,500	650	$70	$312.4K
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…	197	1,590	590	$50	$236.5K
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…	69	600	120	$80	$83.3K
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…	51	530	80	$120	$68.5K
76881	In this procedure, the provider uses ultrasound to examine the complete joint for any defect or abnormality. The image appears in real time on a monitor, and a permanent image with interpretation is…	4	10	210	$50	$24K
20611	In this procedure, the provider inserts a needle through the skin of a patient and into a major joint or bursa, typically the shoulder, hip, knee, or subacromial bursa, and then uses the syringe…	1	20	100	$60	$23.1K
76942	Ultrasonography uses sound waves of higher frequencies (above the normal hearing capacity of a healthy human, i.e., 20 kHz) to visualize inner organs. When the sound waves pass through the human…	11	20	70	$30	$18.6K
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…	42	60	70	$40	$17.2K
73110	The provider takes at least three X–ray images of a patient’s complete wrist to check for any fracture, swelling, or reason of pain in the wrist area.	44	50	220	$20	$9.1K
73030	This particular procedure is for a minimum of 2 X–ray views of the complete shoulder.	33	70	130	$10	$7.2K

Showing 1–10 of 17

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Sandesh Pandit	OR	Sports Medicine (Family Medicine) Physician	$165.4K	$0
Michael Krnacik	OR	Orthopaedic Surgery Physician	$102.6K	$0
Lisa Hobart	OR	Physician Assistant	$69.5K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Commonspirit Oregon	OR	General Acute Care Hospital	$0	$29.3M
Centennial Medical Group East, LLC	OR	Rural Health Clinic/Center	$0	$15.3M
Roseburg Therapy LLC	OR	Mental Health Counselor	$0	$14.2M
Rick's Medical Supply, LLC	OR	Durable Medical Equipment & Medical Supplies	$0	$9.6M
Cep America LLC	OR	Emergency Medicine Physician	$0	$4.5M
Humberto Villalvazo	OR	Family Medicine Physician	$4.3M	$0
Liann W Drechsel Dmd PC	OR	Pediatric Dentistry	$0	$3.9M
Centennial Medical Group Inc.	OR	Surgery Physician	$0	$3.8M
Cow Creek Band Of Umpqua Tribe Of Indians	OR	Federally Qualified Health Center (FQHC)	$0	$3.4M
Valley View Mental Health Services, Inc	OR	Professional Counselor	$0	$3.1M

Umpqua Orthopedics PC — Billing Profile & Reimbursement Data

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Umpqua Orthopedics PC — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

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