Loading...

    Explore
    • Policy Monitoring
    • Live Policy Feed
    • Billing Codes
    • NPI Medicare & Medicaid
    • Healthcare Providers
    • Health Insurance Payers
    • States
    • Service Lines
    • Taxonomy Codes
    Lookup tools
    • Billing Code Lookup
    • CPT Modifier Lookup
    • Provider Taxonomy Code Lookup
    • Healthcare Provider & Facility Lookup
    • Health Insurance Payer Lookup
    • Payer Contact Directory

    Policy & Benchmark Tools

    • Prior Authorization Lookup
    • Coverage Criteria Lookup
    • Timely Filing Lookup
    • Billing Code Reimbursement Rates
    • Payer Comparison Dashboard
    • Facility Comparison Dashboard
    • All tools

    Company

    • About OpenPayer
    • Data Sources
    • Trek Health
    OpenPayerby Trek Health
    LinkedInYouTube

    © 2026 Trek Health. All rights reserved.

    OpenPayer is built and maintained by Trek Health.

    v1.0.28
    OpenPayerNPI Medicare & MedicaidMainehealth
    Ask Trek AI about this page

    Mainehealth — Billing Profile & Reimbursement Data

    NPI 1710297494 · South Portland, ME · Urology Physician

    Customize your policy alerts

    Sign up for Mainehealth — Billing Profile & Reimbursement Data policy alerts

    Get alerted when relevant policies change without checking for updates manually.

    Monitor payer policy activity

    Receive email alerts as soon as relevant payer policies are published or updated.

    Mainehealth is a urology physician provider located in South Portland, Maine. This profile covers 0 Medicare and 15 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

    Table of contents

    Progress1 / 8

    Explore openpayer tools

    • Billing CodesCPT, HCPCS, DRG & more
    • Reimbursement RatesCommercial vs. Medicare rate reports
    • ProvidersHospitals & facilities
    • PayersPlans & market footprint
    • Taxonomy CodesNUCC specialty codes
    • ModifiersCPT modifiers & usage
    • Prior AuthorizationPA policies by payer & drug
    • Timely FilingFiling deadlines by payer
    • Coverage CriteriaMedical necessity by payer
    • Payer ContactsClaims, PA & appeals contacts
    View all tools

    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeOrganization
    OrganizationMainehealth
    Address100 Brickhill Ave
    CitySouth Portland
    StateME
    ZIP04106
    TaxonomyUrology Physician
    NPI EnumeratedOctober 15, 2010

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

    Payer SourceTotal Paid
    Medicaid$1.2M
    Medicare$0

    Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

    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

    Medicaid: Complete Services Breakdown

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

    15 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    G0463Hospital outpatient clinic visit for assessment and management of a patient14,090$70$972K
    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…730$220$163.5K
    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…40$960$36.3K
    51705In this procedure, the provider performs a simple removal of a tube that he previously places into a patient’s bladder and replaces it with a new tube through the same incision.240$60$14.9K
    76775A retroperitoneal ultrasound is a noninvasive procedure used to assess the body parts within the abdomen (i.e. Kidneys, urinary bladder, and aorta). This particular CPT code is used when the…450$20$7.6K
    51798Providers perform this ultrasound to measure the volume of residual urine in the bladder.2,570$1$5.1K
    Q3014Telehealth originating site facility fee180$10$2.5K
    87086Culture, bacterial; quantitative, colony count, urine.2,200$1$2.2K
    87077The lab analyst performs additional tests on a presumptively identified aerobic isolate to definitively, which means more specifically, identify the organism, such as to the level of species.520$1$520
    87186The lab analyst performs the technical steps to evaluate a culture isolate’s susceptibility, or sensitivity, to multiple antimicrobial agents, commonly called antibiotics, by observing growth of the…510$1$510

    Showing 1–10 of 15

    Medicaid: Competitive Analysis & Benchmarks

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

    Full comparison — all codes billed, vs. Maine median

    15 rows

    CPT/HCPCS CodeDescriptionRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    G0463Hospital outpatient clinic visit for assessment and management of a patient306018,740$60$4.6M
    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…410160$160$88.7K
    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…21040$770$31.5K
    Q3014Telehealth originating site facility fee3560360$10$31.2K
    51705In this procedure, the provider performs a simple removal of a tube that he previously places into a patient’s bladder and replaces it with a new tube through the same incision.310240$60$24.5K
    87086Culture, bacterial; quantitative, colony count, urine.25405,770$1$12K
    88112Selective cellular enhancement for cytopathology, such as the method of using a liquid–based slide preparation, uses a liquid–based medium to collect samples and preserve cells which can aid in…51070$10$10.5K
    51702The bladder catheter CPT® codes provide options for reporting the procedures that best reflect the exact anatomic location of a catheter insertion, the type of catheter inserted, and, in some cases,…71030$20$6.9K
    87186The lab analyst performs the technical steps to evaluate a culture isolate’s susceptibility, or sensitivity, to multiple antimicrobial agents, commonly called antibiotics, by observing growth of the…32402,340$1$4.7K
    87077The lab analyst performs additional tests on a presumptively identified aerobic isolate to definitively, which means more specifically, identify the organism, such as to the level of species.32402,640$1$3.5K

    Showing 1–10 of 15

    Related Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    MainehealthMEGeneral Acute Care Hospital$0$142.6M
    MainehealthMECommunity/Behavioral Health Agency$0$115M
    MainehealthMEGeneral Acute Care Hospital$0$70.7M
    MainehealthMEGeneral Acute Care Hospital$0$40M
    MainehealthMEGeneral Acute Care Hospital$0$31.5M
    MainehealthMEGeneral Acute Care Hospital$0$22.7M
    MainehealthMERural Health Clinic/Center$0$16.7M
    MainehealthMEMulti-Specialty Clinic/Center$0$10.9M
    MainehealthMERural Health Clinic/Center$0$10M
    MainehealthMERural Health Clinic/Center$0$9.8M

    Nearby Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Alpha OneMECase Management Agency$0$121.3M
    Port ResourcesMEIntellectual and/or Developmental Disabilities Residential Treatment Facility$0$82.9M
    The Opportunity AllianceMEMental Illness Community Based Residential Treatment Facility$0$50.6M
    Community Home Health CareMEIn Home Supportive Care Agency$0$40.3M
    Serenity Residential Care, LLCMEIn Home Supportive Care Agency$0$34.4M
    Noreast Home Care, LLCMEIn Home Supportive Care Agency$0$24.7M
    Center For Behavioral Health Me, Inc.MESubstance Use Disorder Rehabilitation Clinic/Center$536.2K$20.1M
    Connections For KidsMESocial Worker$0$13.8M
    Vna Home Health & HospiceMEHome Health Agency$227.2K$10.4M
    Standard Care, LLCMEIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility$0$10.2M

    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.

    Medicaid Revenue by Year vs. Maine Providers
    0 of 6 years billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Claims Volume vs. Maine Distribution
    Mainehealth — 0 of 11 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Maine