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

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

Northwest Surgical Specialists, P.C. (NPI 1730118803)

Northwest Surgical Specialists, P.C. is a orthopaedic surgery physician provider located in Portland, Oregon. This profile covers 0 Medicare and 34 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	Northwest Surgical Specialists, P.C.
Address	1 N Center Court St Ste 110
City	Portland
State	OR
ZIP	97227
Taxonomy	Orthopaedic Surgery Physician
NPI Enumerated	July 1, 2006

Payer Source	Total Paid
Medicaid	$2.4M
Medicare	$0

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

34 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	21,560	$60	$1.3M
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…	5,280	$70	$374.6K
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…	2,600	$90	$241.6K
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…	1,210	$100	$118.4K
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…	480	$170	$80.1K
73110	The provider takes at least three X–ray images of a patient’s complete wrist to check for any fracture, swelling, or reason of pain in the wrist area.	1,740	$30	$59.1K
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.	1,780	$30	$55.2K
99202	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves straightforward medical decision making, and/or the provider…	260	$70	$18.5K
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.	610	$30	$17.6K
73564	In this procedure, the provider takes four or more X–ray views of the knee joint to check for any fracture, swelling, or reason for pain in the knee area.	440	$40	$15.9K

Showing 1–10 of 34

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Oregon Distribution

Northwest Surgical Specialists, P.C. — 3 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Oregon

Full comparison — all codes billed, vs. Oregon median

34 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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…	411	1,500	650	$70	$312.4K
97530	The provider uses various activities during direct contact with the patient to improve the patient’s functional performance. Use this code for each 15 minutes of activity.	233	290	770	$60	$252K
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…	257	1,590	590	$50	$236.5K
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	91	90	320	$50	$187.6K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	101	100	370	$30	$138.2K
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	9	350	760	$30	$116.5K
95913	In this procedure, the provider performs 13 or more nerve conduction studies, a diagnostic test to evaluate function, especially the electrical conduction ability of the motor and sensory nerves of…	5	10	20	$230	$115.2K
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…	98	600	120	$80	$83.3K
97140	Manual therapy is a form of physical therapy which uses the controlled movement and pressure of hands to treat various disorders of soft tissues and joints, eg, chronic back pain. Manual therapy…	219	350	610	$30	$73.9K
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…	25	40	270	$100	$71.5K

Showing 1–10 of 34

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Stephen Southerland	WA	Orthopaedic Surgery Physician	$178.7K	$0
Todd Borus	WA	Orthopaedic Surgery Physician	$157.3K	$0
Edward Sparling	WA	Orthopaedic Surgery Physician	$127.2K	$0
Brian Ragel	WA	Neurological Surgery Physician	$76.3K	$0
Alan Newman	WA	Orthopaedic Surgery Physician	$64.7K	$0
James Chesnutt	OR	Sports Medicine (Family Medicine) Physician	$51.3K	$0
Edward Olson	WA	Neurology Physician	$48.4K	$0
Kyle Pirtle	WA	Surgical Physician Assistant	$47.5K	$0
Douglas Musgrave	WA	Orthopaedic Hand Surgery Physician	$45.4K	$0
Danielle Ries De Chaffin	WA	Orthopaedic Trauma Physician	$37.8K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Legacy Emanuel Hospital & Health Center	OR	General Acute Care Hospital	$0	$64.2M
Legacy Emanuel Hospital & Health Center	OR	Clinic/Center	$0	$17M
Central City Concern	OR	Substance Abuse Rehabilitation Facility	$0	$6.9M
Pediatric Cardiology Center Of Oregon PC	OR	Pediatric Cardiology Physician	$0	$5.5M
Kaiser Foundation Hospitals	OR	Ambulatory Surgical Clinic/Center	$35.3K	$2.3M
Radiology Consultants, Inc	OR	Diagnostic Radiology Physician	$0	$1.9M
Legacy Emanuel Hospital & Health Center	OR	Clinic/Center	$0	$1.5M
Uplifting Journey LLC	OR	Community/Behavioral Health Agency	$0	$1.3M
Tony Ho	OR	Hematology & Oncology Physician	$796.7K	$0
Gerald Segal	OR	Hematology & Oncology Physician	$583.9K	$0

Northwest Surgical Specialists, P.C. — Billing Profile & Reimbursement Data

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Northwest Surgical Specialists, 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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