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.

Northwest Urology, LLC (NPI 1629461397)

Northwest Urology, LLC is a specialist provider located in Portland, Oregon. This profile covers 0 Medicare and 13 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	Northwest Urology, LLC
Address	9135 Sw Barnes Rd # 637
City	Portland
State	OR
ZIP	97225
Taxonomy	Specialist
NPI Enumerated	March 5, 2015

Payer Source	Total Paid
Medicaid	$1.3M
Medicare	$0

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

13 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	5,160	$140	$717.4K
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…	6,010	$60	$354.5K
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…	2,570	$50	$118.3K
54360	The provider surgically repairs the angulation, or abnormal curvature, of the penis of the patient.	40	$730	$29.2K
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…	240	$110	$26.7K
51798	Providers perform this ultrasound to measure the volume of residual urine in the bladder.	3,450	$10	$24.2K
G2211	Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care…	1,900	$10	$17.1K
52000	In 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…	110	$130	$14.7K
81000	The lab analyst inserts a dip stick into a freshly collected urine specimen, removes the dip stick, and shakes off the excess urine. Alternatively, the analyst may place drops of the urine specimen…	970	$1	$1.9K
81003	The lab analyst inserts a dip stick into a freshly collected urine specimen, removes the dipstick, and shakes off the excess urine. She places the stick onto a mechanical dip stick reader that will…	1,900	$1	$1.9K

Showing 1–10 of 13

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

Northwest Urology, LLC — 1 of 13 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

13 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…	244	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…	395	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…	238	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…	11	530	80	$120	$68.5K
52000	In 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…	5	20	60	$140	$57.4K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	474	570	110	$50	$37.6K
54360	The provider surgically repairs the angulation, or abnormal curvature, of the penis of the patient.	1	10	40	$730	$29.2K
81001	Urinalysis is used to detect substances or cellular material in the urine associated with different metabolic and kidney disorders. It is used to detect urinary tract infections (UTI) and other…	65	100	2,070	$1	$20.5K
G2211	Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care…	29	230	230	$10	$9.5K
51798	Providers perform this ultrasound to measure the volume of residual urine in the bladder.	4	30	230	$10	$8.2K

Showing 1–10 of 13

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Richard Roberts	TN	Anatomic Pathology & Clinical Pathology Physician	$1.3M	$790
Dwight Mirmow	GA	Anatomic Pathology & Clinical Pathology Physician	$671.3K	$0
Jianxiong Bao	NJ	Anatomic Pathology & Clinical Pathology Physician	$549K	$0
James Bresee	OR	Urology Physician	$258.8K	$0
James Tycast	OR	Urology Physician	$228.3K	$0
Sara Spettel	OR	Urology Physician	$175.5K	$0
Daniel Janoff	OR	Urology Physician	$169.7K	$0
Michael Lavelle	OR	Urology Physician	$135.1K	$0
Sasha Druskin	OR	Urology Physician	$121.9K	$0
Brian Shaffer	OR	Urology Physician	$93K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Providence Health & Services - Oregon	OR	General Acute Care Hospital	$0	$36.9M
Providence Health & Services - Oregon	OR	Clinical Pathology Physician	$0	$11.4M
Columbia Medical Alarm, Inc.	OR	Home Health Agency	$0	$6.1M
Childrens Clinic PC	OR	Pediatrics Physician	$0	$4.7M
West Hills Gastroenterology Equipment Corp	OR	Endoscopy Clinic/Center	$861.3K	$3.2M
Chiropractic Art & Science LLC	OR	Health Service Clinic/Center	$0	$2.7M
Hd Industries, LLC	OR	In Home Supportive Care Agency	$0	$2.7M
Trg, LLC	OR	Diagnostic Radiology Physician	$0	$2.4M
Westside Pediatric Clinic PC	OR	Pediatrics Physician	$0	$2.3M
Carlos Ugalde	OR	Oral and Maxillofacial Surgery (Dentist)	$0	$2.3M

Northwest Urology, LLC — Billing Profile & Reimbursement Data

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Northwest Urology, LLC — 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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