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    v1.0.28
    OpenPayerNPI Medicare & MedicaidMatthew Simons
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    Matthew Simons — Billing Profile & Reimbursement Data

    NPI 1689816266 · Fresno, CA · Orthopaedic Surgery Physician

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    Matthew Simons is a orthopaedic surgery physician provider located in Fresno, California. This profile covers 23 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
    OrganizationMatthew Simons
    Address1630 E Herndon Ave
    CityFresno
    StateCA
    ZIP93720
    TaxonomyOrthopaedic Surgery Physician
    NPI EnumeratedMarch 30, 2009

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

    Payer SourceTotal Paid
    Medicare$466K
    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.

    23 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    27447In this procedure, the provider replaces the damaged weight bearing surfaces of both the medial and lateral compartments in the knee joint using implants of metal or other strong materials. The…170$1,030$176.5K
    27335In this procedure, the provider performs arthrotomy of the knee joint along with anterior and posterior synovectomy that includes the popliteal area to relieve pain and improve gait.180$310$55.7K
    27130In this procedure, the provider surgically replaces the hip joint by prosthesis, or artificial hip joint. He replaces both the femoral and acetabular components with or without using an autograft or…50$1,030$54.7K
    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…410$90$37.3K
    27487In this procedure, the provider performs revision arthroplasty of the knee joint. She revises both the femoral and tibial components. She may or may not use an allograft to perform this procedure.…20$1,340$20.1K
    20985A provider using a computer assisted navigation system, or CANS, performs musculoskeletal procedures, such as a joint replacement surgery, with the aid of a computer screen that provides a…170$120$19.9K
    73562In this procedure, the provider takes three X–ray images of a patient’s knee joint to check for any fracture, swelling, or reason for pain in the knee area.600$30$19.2K
    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…290$60$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…140$120$16.4K
    27054In this procedure, the provider makes an incision to open the hip joint. He then explores the joint and removes the inflamed synovial membrane lining the joint.50$290$12.8K

    Showing 1–10 of 23

    Medicare: Competitive Analysis & Benchmarks

    How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 23 CPT/HCPCS codes.

    View: State1 / 2

    Full comparison — all codes billed, vs. state median

    23 rows

    CPT/HCPCS CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    274471782030$1,110$48.9K
    2713010554030$1,070$40.8K
    992146,56237,970120$90$23.2K
    27487133010$1,240$19.8K
    1312132243030$270$14.3K
    992136,30534,66080$70$13.2K
    2733512060$190$12.3K
    721489801,35060$110$11.5K
    7372141693050$120$11.1K
    2705431040$170$7.8K

    Showing 1–10 of 23

    Related Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Columbus Radiology CorpOHDiagnostic Radiology Physician$0$49.9M
    Daniel WatrousCARheumatology Physician$4M$5M
    Ravi RaoCAHematology & Oncology Physician$6.6M$0
    Dexter EstradaCAHematology & Oncology Physician$5.6M$0
    Sachin GuptaCAHematology & Oncology Physician$5.3M$0
    Humberto VillalvazoORFamily Medicine Physician$4.3M$0
    Abdul HaseebCAHematology & Oncology Physician$4M$0
    Hanumandla ReddyCASpecialist$3.8M$8.8K
    Steven HagerCAHematology & Oncology Physician$3.6M$0
    Amardeep AulakhCAInternal Medicine Physician$3.5M$0

    Nearby Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Sierra Pacific Surgery Center LLCCAAmbulatory Surgical Clinic/Center$4.3M$0
    George BertolucciCAOphthalmology Physician$3.5M$0
    Leonard HackettCAHematology & Oncology Physician$3.3M$0
    Daniel PrescottCAOphthalmology Physician$3.3M$0
    Joseph PascuzzoCAHematology & Oncology Physician$3.2M$0
    William JawienCAHematology & Oncology Physician$3.2M$0
    Sumeer ThindaCAOphthalmology Physician$2.7M$0
    Dalpinder SandhuCACardiovascular Disease Physician$2.7M$0
    Michael KruegerCACardiovascular Disease Physician$2.7M$0
    Himmat GillCARheumatology Physician$2.5M$0

    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. California Distribution
    Matthew Simons — 4 of 23 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — California