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NPI 1679663447 · Las Vegas, NV · Diagnostic Radiology Physician
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Southwest Medical Associates, Inc is a diagnostic radiology physician provider located in Las Vegas, Nevada. This profile covers 60 Medicare and 161 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.
Provider details (source: NPPES NPI Registry)
| Field | Value |
|---|---|
| Entity Type | Organization |
| Organization | Southwest Medical Associates, Inc |
| Address | 888 S Rancho Drive |
| City | Las Vegas |
| State | NV |
| ZIP | 89106 |
| Taxonomy | Diagnostic Radiology Physician |
| NPI Enumerated | October 13, 2006 |
| NPI Deactivated | March 4, 2019 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $15.8M |
| Medicare | $418.3K |
SOUTHWEST MEDICAL ASSOCIATES, INC is a long-tenured diagnostic radiology practice in Las Vegas, NV, with NPI enumeration dated 2006-10-13 (~20 years ago), indicating an established presence in the market and continuity of billing operations across Medicare and Medicaid. The longevity supports interpretation of volume patterns as sustained operational behavior rather than a short-term aberration.
The provider’s payer mix is heavily weighted toward Medicaid in absolute scale: total Medicaid revenue is $15.8M versus total Medicare revenue of $418.3K, indicating Medicaid is the dominant source of reimbursed activity for this entity. This imbalance suggests the practice’s patient base or contracting footprint is oriented toward Medicaid populations or state-contracted imaging services.
Medicare revenue is modest at $418.3K and shows concentration: the precomputed top three Medicare codes account for 53.0% of Medicare revenue, with 77067 (screening mammography) alone representing $133.8K (36.0% of Medicare revenue). This concentration implies that breast imaging is the primary Medicare service line for this provider rather than a broad mix of advanced CT or cardiac procedures.
Medicaid revenue is highly concentrated in office/outpatient E/M and imaging: the precomputed top three Medicaid codes account for 46.0% of Medicaid revenue, driven by 99214 and 99213 office visits plus 77067 screening mammography. Notably, 99214 (67.7K claims, $2.8M revenue) and 99213 (62.8K claims, $1.8M revenue) are extreme outliers in-state, indicating the provider reports massive volumes of outpatient E/M services under Medicaid compared with peers and that E/M is a major Medicaid revenue driver.
Competitive standing differs by payer and code: for Medicare, many top codes (for example 77067 at the 91st percentile nationally and 76642 at the 98th percentile) show typical-to-notably-above-typical national volumes, so the practice is not a national dominant radiology center but does perform above-typical volumes for specific breast-imaging codes. For Medicaid, the provider is often a statewide leader or extreme outlier — for example 77067 ranks #1 of 72 providers in-state and 99214 ranks #8 of 2254 providers in-state (100th percentile descriptors applied), establishing Southwest Medical as a major in-state provider for mammography and E/M services.
The procedural mix and code descriptions indicate the practice operates a high-volume imaging center with emphasis on breast imaging (77067, 77066, 77065, 76642) and general diagnostic ultrasound and CT (74177, 74178, 76700, 71250). High counts for 99214/99213 under Medicaid imply integrated outpatient evaluation-and-management activity or large numbers of billed office encounters co-located with imaging services, which is unusual for a purely interpretive radiology-only practice and suggests either on-site clinic services or bundled encounters.
State-level outlier signals are strong in Medicaid across multiple imaging and E/M codes: several codes are labeled extreme outlier or 100th percentile in-state (e.g., 77067, 76642, 76856, 71250, 72100), indicating Southwest Medical is a dominant in-state supplier for those services and a focal point for payer network management or utilization review in Nevada. These labels warrant attention from analysts assessing network concentration and reimbursement risk.
Despite high Medicaid volumes, Medicare activity appears limited and more procedure-specific: Medicare top codes and their national rank distribution (many in mid-to-high percentiles but not top ranks) suggest the provider participates in Medicare at typical volumes for a community radiology practice, with breast imaging and outpatient radiographs comprising most Medicare revenue rather than complex advanced imaging.
The mix of high-volume, low-unit-price E/M claims on Medicaid (99214/99213) combined with large mammography volumes (77067) creates a revenue structure reliant on scale rather than high per-procedure reimbursement. Analysts should consider the operational implications for capacity, staffing, and payer negotiations, since small changes in Medicaid policy or referral flows could materially affect the provider’s $15.8M Medicaid revenue base.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
60 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 77067 | The provider takes two X–ray views of each breast for routine screening and may use specially designed computer software to help identify any potential abnormalities within the images; the software… | 1,050 | $130 | $133.8K |
| 77063 | The provider captures three dimensional images of the breast using X–rays at various angles for routine checkup. He checks for the presence of any abnormality within the breasts. Tomosynthesis… | 640 | $50 | $34K |
| 74177 | The provider performs computed tomography of the abdomen and pelvis with contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs. | 130 | $230 | $29.3K |
| 71046 | In this diagnostic procedure, the provider performs a minimum of two radiological views of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and… | 1,010 | $20 | $22.1K |
| 76642 | In this procedure, the provider performs a focused ultrasound of one breast on a limited area. The procedure includes documentation of the images. | 260 | $70 | $17.3K |
| 74176 | The provider performs computed tomography of the abdomen and pelvis without contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs. | 120 | $130 | $14.5K |
| 77066 | The provider performs X–ray imaging on both breasts in a patient with a lump or suspected cancer and may use specially designed computer software to help identify or diagnose potential abnormalities… | 120 | $120 | $13.6K |
| 77065 | The provider performs X–ray imaging on one breast in a patient with a known lump or suspected cancer and may use specially designed computer software to help identify or diagnose potential… | 130 | $90 | $12.3K |
| 76536 | The provider performs real–time ultrasound examination of the soft tissues of the head and neck and records and saves the images for later review. | 120 | $90 | $10.4K |
| 70450 | The provider performed computed tomography, or CT scanning, of the head or brain, without contrast. He performs the procedure to diagnose any brain or intracranial abnormalities. | 120 | $60 | $7.7K |
Showing 1–10 of 60
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 60 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
View: By Year1 / 3
Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
161 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | 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… | 67,690 | $40 | $2.8M |
| 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… | 62,810 | $30 | $1.8M |
| 77067 | The provider takes two X–ray views of each breast for routine screening and may use specially designed computer software to help identify any potential abnormalities within the images; the software… | 25,750 | $60 | $1.4M |
| 74177 | The provider performs computed tomography of the abdomen and pelvis with contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs. | 5,150 | $140 | $726.4K |
| 74178 | The provider performs computed tomography of the abdomen and pelvis without contrast material in one or both body regions followed by contrast material in one or both body regions and additional… | 2,830 | $210 | $591.3K |
| 93306 | The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent… | 5,320 | $110 | $574.2K |
| 76700 | An abdominal ultrasound is a noninvasive procedure used to assess the body parts within the abdomen (i.e. liver, gallbladder, pancreas, bile ducts, spleen, and abdominal aorta). This particular code… | 4,940 | $100 | $493.7K |
| 76830 | The provider performs a transvaginal ultrasound to assess the reproductive organs, that is, the uterus, fallopian tubes, ovaries, cervix, and vagina in a female patient. | 8,190 | $60 | $475.1K |
| 76856 | A pelvic ultrasound is a noninvasive procedure used to assess body parts such as the bladder, ovaries, uterus, cervix, and fallopian tubes in females and the bladder, prostate gland, and seminal… | 8,050 | $60 | $450.7K |
| 74176 | The provider performs computed tomography of the abdomen and pelvis without contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs. | 4,100 | $100 | $405.4K |
Showing 1–10 of 161
How this provider's Medicaid billing volume and revenue compare to other Nevada providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Nevada median
161 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 74177 | The provider performs computed tomography of the abdomen and pelvis with contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs. | 20 | 140 | 210 | $140 | $421K |
| 71275 | In this procedure, the provider performs a computed tomographic angiography, or CTA imaging of the chest to get detailed images of the blood vessels but not the heart. He performs this study using a… | 56 | 60 | 330 | $150 | $250.4K |
| 74178 | The provider performs computed tomography of the abdomen and pelvis without contrast material in one or both body regions followed by contrast material in one or both body regions and additional… | 1 | 10 | 580 | $220 | $221.3K |
| 74176 | The provider performs computed tomography of the abdomen and pelvis without contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs. | 14 | 100 | 120 | $110 | $195.8K |
| 96374 | The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition. | 65 | 80 | 2,150 | $20 | $183.5K |
| 70450 | The provider performed computed tomography, or CT scanning, of the head or brain, without contrast. He performs the procedure to diagnose any brain or intracranial abnormalities. | 29 | 160 | 190 | $50 | $174.9K |
| 76816 | The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound. | 44 | 50 | 230 | $110 | $144.9K |
| 64483 | This procedure is the injection of an anesthetic agent and/or steroid in the form of a transforaminal epidural injection into a single level (either lumbar or sacral). | 28 | 40 | 250 | $140 | $144.9K |
| 45380 | The provider examines the rectum and colon using a flexible colonoscope, a tubular instrument with a light source and camera, to look for the cause of a patient's symptoms, which may include… | 25 | 40 | 130 | $200 | $139.6K |
| 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… | 8 | 2,250 | 290 | $60 | $138K |
Showing 1–10 of 161
Other providers in the same ZIP code as Southwest Medical Associates, Inc, ranked by combined Medicare and Medicaid revenue.
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