Loading...

    Explore
    • Policy Monitoring
    • Live Policy Feed
    • Billing Codes
    • NPI Medicare & Medicaid
    • Healthcare Providers
    • Health Insurance Payers
    • States
    • Service Lines
    • Taxonomy Codes
    Lookup tools
    • Billing Code Lookup
    • CPT Modifier Lookup
    • Provider Taxonomy Code Lookup
    • Healthcare Provider & Facility Lookup
    • Health Insurance Payer Lookup
    • Payer Contact Directory

    Policy & Benchmark Tools

    • Prior Authorization Lookup
    • Coverage Criteria Lookup
    • Timely Filing Lookup
    • Billing Code Reimbursement Rates
    • Payer Comparison Dashboard
    • Facility Comparison Dashboard
    • All tools

    Company

    • About OpenPayer
    • Data Sources
    • Trek Health
    OpenPayerby Trek Health
    LinkedInYouTube

    © 2026 Trek Health. All rights reserved.

    OpenPayer is built and maintained by Trek Health.

    v1.0.28
    OpenPayerNPI Medicare & MedicaidJames Baker
    Ask Trek AI about this page

    James Baker — Billing Profile & Reimbursement Data

    NPI 1588879860 · Edgewood, KY · Orthopaedic Hand Surgery Physician

    Customize your policy alerts

    Sign up for James Baker — Billing Profile & Reimbursement Data policy alerts

    Get alerted when relevant policies change without checking for updates manually.

    Monitor payer policy activity

    Receive email alerts as soon as relevant payer policies are published or updated.

    James Baker is a orthopaedic hand surgery physician provider located in Edgewood, Kentucky. This profile covers 18 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.

    Table of contents

    Progress1 / 8

    Explore openpayer tools

    • Billing CodesCPT, HCPCS, DRG & more
    • Reimbursement RatesCommercial vs. Medicare rate reports
    • ProvidersHospitals & facilities
    • PayersPlans & market footprint
    • Taxonomy CodesNUCC specialty codes
    • ModifiersCPT modifiers & usage
    • Prior AuthorizationPA policies by payer & drug
    • Timely FilingFiling deadlines by payer
    • Coverage CriteriaMedical necessity by payer
    • Payer ContactsClaims, PA & appeals contacts
    View all tools

    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeIndividual
    OrganizationJames Baker
    Address560 S Loop Rd
    CityEdgewood
    StateKY
    ZIP41017
    TaxonomyOrthopaedic Hand Surgery Physician
    NPI EnumeratedMay 11, 2007

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

    Payer SourceTotal Paid
    Medicare$117.9K
    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.

    18 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    26055Trigger 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…80$300$24.8K
    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…210$110$23.3K
    29848The provider inserts an endoscope into the wrist joint to divide the transverse carpal ligament and reduce compression on the median nerve in the carpal tunnel that results in pain and numbness.70$310$21.2K
    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…200$90$16.8K
    25609The provider surgically repairs a fracture of the lower radius, the larger of the two lower arm bones, beyond the joint or a separation of the radius from the joint through an incision and fixes…10$780$10.2K
    64718In 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…10$370$5.1K
    73130In this procedure, the provider takes a minimum of three X–ray images of a patient’s hand to check for any fracture, swelling, or reason of pain in the hand.110$30$2.9K
    20550Aponeurosis is an abnormal sheet like extension of the tendon. Injection of a tendon or ligament is the medical therapeutic procedure to reduce the aponeurosis formation.70$40$2.6K
    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$2.4K
    73110The 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.100$20$2.4K

    Showing 1–10 of 18

    Medicare: Competitive Analysis & Benchmarks

    How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 18 CPT/HCPCS codes.

    View: State1 / 2

    Full comparison — all codes billed, vs. state median

    18 rows

    CPT/HCPCS CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    2984811040$360$15.9K
    992142,2577,230110$70$14.1K
    2560931020$590$9.4K
    2605523030$250$8.1K
    992135,2357,25080$50$7.7K
    6471841010$390$6.9K
    99204393,20030$100$4.8K
    992031,9312,38030$70$2.9K
    20600758030$30$1.9K
    205502513030$40$1.6K

    Showing 1–10 of 18

    Related Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Orthocincy Orthopaedics & Sports Medicine PscKYOrthopaedic Surgery Physician$0$9.4M
    Suresh NayakOHOrthopaedic Surgery Physician$362K$0
    Aarti SinglaOHPain Medicine (Physical Medicine & Rehabilitation) Physician$341.6K$0
    Michael WallsKYInterventional Pain Medicine Physician$299.2K$0
    Matthew HummelKYOrthopaedic Surgery Physician$275.3K$0
    Jonathon SpanyerOHOrthopaedic Surgery Physician$246.4K$0
    Tyler KellerKYOrthopaedic Surgery Physician$225.3K$0
    Ronald AuerINOrthopaedic Surgery Physician$207.9K$0
    Brian RottinghausOHOrthopaedic Surgery Physician$199.5K$0
    David RhoadsKYOrthopaedic Surgery Physician$192.9K$0

    Nearby Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    St Elizabeth Medical Center, IncKYGeneral Acute Care Hospital$41.7K$188.3M
    Transitions, Inc.KYSubstance Abuse Rehabilitation Facility$0$31.3M
    Compass Emergency Physicians PscKYEmergency Medicine Physician$0$28.8M
    Bluegrass Behavioral Health Group, LLCKYBehavior Analyst$0$23.7M
    Redwood School And Rehabilitation CenterKYChild Intellectual and/or Developmental Disabilities Respite Care$0$12M
    Radiology Associates Of Northern Kentucky, PLLCKYDiagnostic Radiology Physician$0$9.4M
    Redwood School And Rehabilitation CenterKYCommunity Health Clinic/Center$0$9.2M
    Interim Healthcare Of Cincinnati, IncKYHome Health Agency$0$7.9M
    New Perceptions IncKYDevelopmentally Disabled Services Day Training Agency$0$6.5M
    St Elizabeth Medical Center, IncKYCommunity Based Hospice Care Agency$0$3M

    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. Kentucky Distribution
    James Baker — 4 of 18 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Kentucky