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 & MedicaidRaymond Wawrowski
    Ask Trek AI about this page

    Raymond Wawrowski — Billing Profile & Reimbursement Data

    NPI 1750343422 · Hudson, OH · Physician Assistant

    Customize your policy alerts

    Sign up for Raymond Wawrowski — 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.

    Raymond Wawrowski is a physician assistant provider located in Hudson, Ohio. This profile covers 9 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.

    Table of contents

    Progress1 / 9

    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 TypeIndividual
    OrganizationRaymond Wawrowski
    Address5700 Darrow Road
    CityHudson
    StateOH
    ZIP44236
    TaxonomyPhysician Assistant
    NPI EnumeratedApril 6, 2006

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

    Payer SourceTotal Paid
    Medicare$4.7M
    Medicaid$0

    Key Findings

    This provider’s commercial billing footprint on public programs is effectively single-payer: lifetime Medicare revenue is $4.7M while there is no Medicaid billing on file. That concentration means analyses of utilization and revenue risk should be judged almost entirely through the Medicare lens rather than a dual-payer comparison.

    Revenue is extremely concentrated in a pair of skin-substitute add-on codes: the precomputed top three Medicare codes account for 99.3% of this provider’s Medicare revenue, with Q4253 contributing 51.1% and Q4262 contributing 47.9%. Those two codes alone generate the vast majority of payment dollars ($2.4M for Q4253 and $2.2M for Q4262), leaving all other codes at immaterial shares.

    The code mix and payment details point to a wound-care / skin-substitute business model: Q4253 (Zenith amniotic membrane) appears in 4.2K claims at $571 avg paid/claim and Q4262 (dual layer impax membrane) appears in 2.4K claims at $926 avg paid/claim. Both codes are per-square-centimeter add-ons, indicating revenue is driven by the volume of biologic/allograft material applied rather than traditional office E/M services.

    Despite very large absolute Medicare dollars, the provider is not a national outlier for these products: Q4253 ranks #17 of 73 providers (78th percentile) and Q4262 ranks #40 of 141 providers (72th percentile), and both are described in the dataset as typical or unremarkable volume. In other words, the practice produces substantial revenue through high unit counts but sits in a modest-to-above-median competitive position rather than as a dominant national leader for these codes.

    Other procedural and E/M activity is present but immaterial to overall revenue: 15271 and 11042 each contribute about 0.3% of Medicare revenue (15271: $15.3K; 11042: $14.1K), and home/nursing-facility visit codes such as 99348, 99342, and 99304 together represent very small dollar amounts. These smaller line items indicate occasional debridement and post-acute or home-based care activity but they do not meaningfully diversify the revenue base away from skin-substitute products.

    Reliance on per-square-centimeter add-on codes implies revenue sensitivity to product utilization and coding of material units: because Q4253 and Q4262 are billed by area, fluctuations in case mix, wound size, or product selection would materially affect monthly billing and payments. Analysts should therefore monitor patterns in claim counts and avg paid/claim for those two codes when assessing revenue trends or anomaly detection.

    The provider has long tenure in Medicare billing — NPI enumerated 2006-04-06 (~20 years ago) — which provides a lengthy claims history for longitudinal analysis and suggests an established practice pattern around wound-care products. That long registration window supports reliable trend analysis but also means any abrupt changes in utilization will stand out against many years of prior behavior.

    Payer-mix and network implications follow from the absence of Medicaid activity: with no Medicaid billing on file, this provider’s referral and patient-access dynamics likely skew toward Medicare and commercially insured populations. For payers and competitors, that single-payer exposure reduces Medicaid-managed care overlap but increases sensitivity to Medicare policy, coverage updates for skin substitutes, and pricing changes for the specific product codes driving revenue.

    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.

    9 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    Q4253Zenith amniotic membrane, per square centimeter (add-on, list separately in addition to primary procedure)4,190$570$2.4M
    Q4262Dual layer impax membrane, per square centimeter (add-on, list separately in addition to primary procedure)2,420$930$2.2M
    15271The provider uses a skin substitute, such as an allograft or xenograft, to cover wounds on the patient’s trunk, arms, and/or legs up to an area of 100 cm2. This code covers up to the first 25 cm2.160$90$15.3K
    11042The provider uses surgical instruments to remove the dead tissue in skin down to the subcutaneous layer and including the epidermis and dermis, up to the first 20 cm2.180$80$14.1K
    99348The provider sees an established patient for a home or residence visit involving evaluation and management (E/M). The visit involves low medical decision making or the provider spends at least 30…170$50$8.3K
    15275The provider uses a skin substitute, such as an allograft or xenograft, to cover wounds on the face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, up to…60$100$6.4K
    99342The provider sees a new patient for a home or residence visit involving evaluation and management (E/M). The visit involves a low level of medical decision making or the provider spends at least 30…40$50$1.9K
    93922Noninvasive physiologic studies of upper or lower extremity arteries, single level, bilateral20$50$870
    99304The provider sees a patient for an initial nursing facility care visit involving evaluation and management (E/M). The visit involves straightforward or low medical decision making or the provider…10$50$620

    Medicare: Competitive Analysis & Benchmarks

    How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 9 CPT/HCPCS codes.

    View: State1 / 2

    Full comparison — all codes billed, vs. state median

    9 rows

    CPT/HCPCS CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    Q4262110740$950$1.1M
    Q4253110860$570$954.5K
    1104211054090$60$7.5K
    1527112070$80$6.3K
    9934810461060$50$5.9K
    1527572050$100$5.3K
    9930415317030$60$3.6K
    99342249030$50$2.1K
    9392219925040$20$1K

    Related Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Ohiohealth CorporationOHFamily Medicine Physician$0$89.1M
    Richard ParkCAInternal Medicine Physician$31.7M$0
    Quick Med Urgent Care LLCOHUrgent Care Clinic/Center$0$21.8M
    Nyrie AustinNJFamily Nurse Practitioner$15.9M$8.8K
    Ohio North East Health Systems, IncOHFederally Qualified Health Center (FQHC)$0$14M
    Patrick BlackCAPhysical Therapist$14M$0
    Owen EllingtonTXHematology & Oncology Physician$11.5M$0
    Ohio North East Health Systems IncOHFederally Qualified Health Center (FQHC)$0$11M
    Joseph PalumboWVEmergency Medicine Physician$7.9M$44.3K
    Shelita JonesTXFamily Nurse Practitioner$6.7M$0

    Nearby Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Edwards Health Care Services, Inc.OHDurable Medical Equipment & Medical Supplies$0$149.9M
    Clinical Specialties Inc.OHHome Infusion Therapy Pharmacy$0$12.6M
    Mark ArmstrongOHDiagnostic Radiology Physician$357.6K$49.6K
    Elizabeth GaaryOHDiagnostic Radiology Physician$153.4K$0
    Emil HayekOHCardiovascular Disease Physician$83.8K$0
    Tejas SamarooOHDiagnostic Radiology Physician$75K$0
    Raul MartinOHDiagnostic Radiology Physician$71.4K$0
    Josef NogaOHDiagnostic Radiology Physician$53.6K$0
    Bryan LazzaraOHDiagnostic Radiology Physician$37K$0
    Ronald BaileyOHDiagnostic Radiology Physician$35.1K$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. Ohio Distribution
    Raymond Wawrowski — 3 of 9 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Ohio