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

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

Iowa Orthopaedic Center, P.C. (NPI 1669579785)

Iowa Orthopaedic Center, P.C. is a orthopaedic surgery physician provider located in Des Moines, Iowa. This profile covers 0 Medicare and 59 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	Iowa Orthopaedic Center, P.C.
Address	450 Laurel St
City	Des Moines
State	IA
ZIP	50314
Taxonomy	Orthopaedic Surgery Physician
NPI Enumerated	September 20, 2006

Payer Source	Total Paid
Medicaid	$2.5M
Medicare	$0

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

59 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	9,770	$60	$615.4K
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…	17,070	$30	$478K
J0586	Injection, abobotulinumtoxina, 5 units	480	$430	$207K
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…	2,300	$90	$200.3K
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…	4,860	$40	$194.4K
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,…	4,490	$20	$107.7K
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…	2,170	$40	$88.8K
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…	750	$100	$74.8K
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.	3,830	$20	$72.7K
95908	In this procedure, the provider performs three or four nerve conduction studies, a diagnostic test to evaluate the function, especially the ability of electrical conduction of the motor and sensory…	760	$80	$57.1K

Showing 1–10 of 59

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Iowa Distribution

Iowa Orthopaedic Center, P.C. — 11 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Iowa

Full comparison — all codes billed, vs. Iowa median

59 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0586	Injection, abobotulinumtoxina, 5 units	1	10	480	$430	$206.8K
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…	181	1,060	480	$40	$154.5K
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…	104	1,310	760	$20	$153.1K
L4361	Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf	12	10	190	$170	$150.7K
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…	7	40	170	$90	$140.7K
20553	Trigger point injection, or TPI, is a medical procedure in which the provider injects an anesthetic or corticosteroid substance into three or more muscles to relieve painful areas or knots in muscles…	5	10	130	$60	$125K
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…	41	250	110	$80	$47.1K
72148	In this diagnostic procedure, the provider performs magnetic resonance imaging (MRI) of the lumbar spinal canal and contents without using contrast.	15	20	70	$110	$40.6K
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…	3	30	260	$50	$36.4K
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…	3	430	110	$50	$36.1K

Showing 1–10 of 59

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
David Sosnouski	IA	Diagnostic Radiology Physician	$592.7K	$0
Trevor Schmitz	IA	Orthopaedic Surgery of the Spine Physician	$391.9K	$0
Mark Matthes	IA	Orthopaedic Surgery Physician	$376.1K	$0
John Mcgarity	IA	Diagnostic Radiology Physician	$349.5K	$0
Craig Mahoney	IA	Orthopaedic Surgery Physician	$292.1K	$0
Paige Goff	IA	Physician Assistant	$260.4K	$1.3K
Grant Goldsberry	IA	Diagnostic Radiology Physician	$240.9K	$0
Casey Howe	IA	Physician Assistant	$228K	$0
Benjamin Beecher	IA	Adult Reconstructive Orthopaedic Surgery Physician	$205.5K	$0
Thomas Klein	IA	Interventional Pain Medicine Physician	$190.4K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Broadlawns Medical Center	IA	General Acute Care Hospital	$0	$112.9M
Catholic Health Initiatives-iowa Corp	IA	General Acute Care Hospital	$0	$26.4M
Des Moines Independent Community School District	IA	Local Education Agency (LEA)	$0	$22.8M
Primary Health Care, Inc.	IA	Federally Qualified Health Center (FQHC)	$0	$14.1M
Broadlawns Medical Center	IA	Community/Behavioral Health Agency	$0	$13.2M
Mercy Clinics Inc	IA	Pediatric Adolescent Medicine Physician	$0	$10.7M
Des Moines River Physicians, LLC	IA	Emergency Medicine Physician	$0	$8.1M
Catholic Health Initiatives-iowa Corp	IA	Clinical Medical Laboratory	$0	$8M
Primary Health Care, Inc.	IA	Federally Qualified Health Center (FQHC)	$0	$7.9M
Vita Health Services	IA	Intellectual and/or Developmental Disabilities Residential Treatment Facility	$0	$7.5M

Iowa Orthopaedic Center, P.C. — Billing Profile & Reimbursement Data

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Iowa Orthopaedic Center, P.C. — 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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