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    v1.0.28
    OpenPayerNPI Medicare & MedicaidThomas Bormes
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    Thomas Bormes — Billing Profile & Reimbursement Data

    NPI 1639156995 · Mount Pleasant, WI · Urology Physician

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    Thomas Bormes is a urology physician provider located in Mount Pleasant, Wisconsin. This profile covers 14 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.

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    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeIndividual
    OrganizationThomas Bormes
    Address8400 Washington Ave
    CityMount Pleasant
    StateWI
    ZIP53406
    TaxonomyUrology Physician
    NPI EnumeratedDecember 28, 2005

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

    Payer SourceTotal Paid
    Medicare$101.9K
    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.

    14 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    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…600$80$48.9K
    52000In 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$170$18.3K
    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…50$110$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…100$60$5.7K
    51798Providers perform this ultrasound to measure the volume of residual urine in the bladder.560$10$3.9K
    55700Code deleted December 31, 2025.20$170$3.3K
    99215The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…30$130$3.2K
    99233The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…40$90$3.1K
    51741Uroflowmetry (UFR) is the process of measuring how much liquid the patient excretes from the bladder. It is measured in cubic centimeters per second. The rate is the ratio of volume over time.340$10$2.7K
    52310The provider performs a simple cystourethroscopy, the inspection of the interior of the bladder, the urethra, prostatic urethra, and ureteric openings using a cystoscope passed through the urethra…10$180$2.2K

    Showing 1–10 of 14

    Medicare: Competitive Analysis & Benchmarks

    How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 14 CPT/HCPCS codes.

    View: State1 / 2

    Full comparison — all codes billed, vs. state median

    14 rows

    CPT/HCPCS CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    992141349,80080$70$9.2K
    520002116070$120$8.8K
    992331,4232,11060$90$8.7K
    992152,0053,32030$110$6.3K
    992132,7609,38060$50$4.7K
    55700287020$170$4K
    52310425020$190$4K
    992046053,39030$100$3.7K
    52332719020$120$2.6K
    992032,0362,82030$60$2.4K

    Showing 1–10 of 14

    Related Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Aurora Medical Group, Inc.WICertified Registered Nurse Anesthetist$2.2K$139.2M
    Jeffrey BahrWIInternal Medicine Physician$3.1M$356.4K
    Rahul SawlaniWIDiagnostic Radiology Physician$329.3K$29.7K
    Prakash ShahWICardiovascular Disease Physician$341K$15.1K
    Steven KenzerWIRheumatology Physician$269.6K$0
    Sarah ReimerWIDiagnostic Radiology Physician$234.1K$0
    Vikram NangiaWIClinical Cardiac Electrophysiology Physician$211.8K$0
    Mack KarnesWIDiagnostic Radiology Physician$207.2K$150
    Ali KhanWIInterventional Cardiology Physician$202.5K$0
    Harsh ShahWIDiagnostic Radiology Physician$92.2K$107.5K

    Nearby Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Familia Dental Racine LLCWIDental Clinic/Center$0$17.9M
    Idental LLCWIDentist$0$11.7M
    Developmental Disabilities Information Service, Inc.WICase Management Agency$0$10.9M
    Beta Diagnostic Labs LLCWIClinical Medical Laboratory$1.7M$8.4M
    Mynt Dental Racine LLCWIGeneral Practice Dentistry$0$4.2M
    Covid Care Zone IncWIClinical Medical Laboratory$71.4K$3.6M
    Sweet Smiles Mt. Pleasant LLCWIGeneral Practice Dentistry$0$3.6M
    Chad Novasic Pt LtdWIPhysical Therapist$0$2.6M
    Paramount Pediatric Dentistry Of RacineWIPediatric Dentistry$0$2.3M
    Sasan MolaviWIDentist$0$2.1M

    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. Wisconsin Distribution
    Thomas Bormes — 3 of 14 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Wisconsin