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

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

Nebraska Orthopaedic Center PC (NPI 1659349330)

Nebraska Orthopaedic Center PC is a orthopaedic surgery physician provider located in Lincoln, Nebraska. This profile covers 0 Medicare and 22 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	Nebraska Orthopaedic Center PC
Address	6900 A St Ste 100
City	Lincoln
State	NE
ZIP	68510
Taxonomy	Orthopaedic Surgery Physician
NPI Enumerated	March 9, 2006

Payer Source	Total Paid
Medicaid	$377.3K
Medicare	$0

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

22 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…	5,140	$30	$174.6K
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…	780	$90	$72.8K
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…	860	$60	$50.1K
95911	In this procedure, the provider performs nine or ten nerve conduction studies, a diagnostic test to evaluate function, especially the electrical conduction ability of the motor and sensory nerves of…	300	$110	$32.3K
95912	In this procedure, the provider performs eleven or twelve nerve conduction studies, a diagnostic test to evaluate function, especially the electrical conduction ability of the motor and sensory…	110	$140	$15.9K
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…	110	$80	$8.7K
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…	140	$50	$6.3K
73100	In this procedure, the provider takes two X–ray images of a patient’s wrist to check for any fracture, swelling, or reason of pain in the wrist area.	170	$20	$3.6K
73030	This particular procedure is for a minimum of 2 X–ray views of the complete shoulder.	130	$20	$2.4K
73140	In this diagnostic procedure, the provider performs a radiological study of one or more fingers. He performs two or more views.	90	$20	$1.9K

Showing 1–10 of 22

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Nebraska Distribution

Nebraska Orthopaedic Center PC — 3 of 21 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Nebraska

Full comparison — all codes billed, vs. Nebraska median

22 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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…	128	700	660	$70	$305.1K
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…	435	600	610	$70	$251.4K
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…	36	190	130	$70	$48.5K
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…	72	130	130	$90	$43.8K
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…	10	20	70	$70	$36.7K
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,…	232	250	140	$60	$29.7K
73100	In this procedure, the provider takes two X–ray images of a patient’s wrist to check for any fracture, swelling, or reason of pain in the wrist area.	3	10	100	$70	$27.2K
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…	4	20	120	$70	$26.6K
73610	In this procedure, the provider takes three or more X–ray images of the ankle joint to check for any fracture, swelling, or reason for pain in the ankle area.	36	40	180	$20	$14.8K
73630	In this diagnostic procedure, the provider takes a minimum of three views of the foot to assess injury, fracture, arthritis, tumor, or congenital abnormality.	41	50	120	$20	$13.1K

Showing 1–10 of 22

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
James Gallentine	NE	Orthopaedic Foot and Ankle Surgery Physician	$443.3K	$0
Sukchan Lee	NE	Orthopaedic Surgery Physician	$297.8K	$0
Douglas Koch	NE	Orthopaedic Surgery Physician	$271K	$0
Nicholas Gove	NE	Orthopaedic Hand Surgery Physician	$269.4K	$0
Brad Webb	NE	Orthopaedic Surgery of the Spine Physician	$254.4K	$0
Justin Harris	NE	Sports Medicine (Orthopaedic Surgery) Physician	$245K	$0
David Clare	NE	Sports Medicine (Orthopaedic Surgery) Physician	$228.9K	$0
Benjamin Woodhead	NE	Orthopaedic Surgery Physician	$224.4K	$0
Daniel Cullan	NE	Orthopaedic Hand Surgery Physician	$180.8K	$0
Douglas Tewes	NE	Orthopaedic Surgery Physician	$144.7K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Saint Elizabeth Regional Medical Center	NE	General Acute Care Hospital	$0	$14.9M
St. Monica's	NE	Substance Abuse Rehabilitation Facility	$0	$7.1M
Hopespoke	NE	Community/Behavioral Health Agency	$0	$3.9M
Centerpointe, Inc.	NE	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$3.7M
Bluestem Health	NE	Federally Qualified Health Center (FQHC)	$0	$3.6M
Lincoln Medical Education Partnership	NE	Family Medicine Physician	$0	$3.2M
Hopespoke	NE	Community/Behavioral Health Agency	$0	$2.9M
Lincoln-lancaster County Health Department	NE	Public Health or Welfare Agency	$0	$2.7M
Chi Health Clinic Specialty, LLC	NE	Hospitalist Physician	$0	$2.6M
Eyes On Lincoln	NE	Optometrist	$0	$2.6M

Nebraska Orthopaedic Center PC — Billing Profile & Reimbursement Data

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Nebraska Orthopaedic Center 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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