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

Why is the Medicaid comparison limited to New Mexico 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. New Mexico (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.

Orthopedic Associates PA (NPI 1750356820)

Orthopedic Associates PA is a orthopaedic surgery physician provider located in Farmington, New Mexico. This profile covers 0 Medicare and 37 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	Orthopedic Associates PA
Address	2300 E 30th St Ste 101
City	Farmington
State	NM
ZIP	87401
Taxonomy	Orthopaedic Surgery Physician
NPI Enumerated	February 21, 2006

Payer Source	Total Paid
Medicaid	$4.4M
Medicare	$0

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

37 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…	12,420	$90	$1.1M
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…	14,290	$60	$843.1K
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…	6,300	$90	$547.7K
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…	3,550	$140	$511.8K
20610	In this procedure, the provider inserts a needle through the skin of a patient and into a major joint or bursa and then uses the syringe attachment to the needle to remove fluid or he may inject a…	5,270	$50	$237.2K
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.	4,260	$50	$204.2K
73562	In 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.	6,650	$30	$166.3K
97112	Neuromuscular reeducation is a therapeutic treatment (exercise) performed by a physician in an attempt to reduce impairments and restore function through the application of clinical skills and/or…	4,140	$40	$153.1K
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…	4,600	$30	$147.3K
73721	In this diagnostic procedure, the provider performs magnetic resonance imaging of a lower extremity joint without using contrast material.	520	$200	$105.6K

Showing 1–10 of 37

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. New Mexico Distribution

Orthopedic Associates PA — 2 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — New Mexico

Full comparison — all codes billed, vs. New Mexico median

37 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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…	84	930	910	$80	$521.6K
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…	79	960	1,010	$90	$490K
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.	62	220	1,570	$70	$340.6K
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…	115	290	2,790	$50	$325.7K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	78	380	220	$160	$273.9K
L1820	Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific…	8	10	100	$100	$175.2K
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…	78	150	1,710	$30	$149.9K
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…	24	360	220	$90	$134.7K
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…	22	380	150	$130	$132.8K
97112	Neuromuscular reeducation is a therapeutic treatment (exercise) performed by a physician in an attempt to reduce impairments and restore function through the application of clinical skills and/or…	29	150	520	$40	$119.4K

Showing 1–10 of 37

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
San Juan Regional Medical Center, Inc.	NM	General Acute Care Hospital	$0	$141.5M
San Juan Regional Medical Center Inc	NM	Emergency Medicine Physician	$0	$23.8M
San Juan Regional Medical Center Inc	NM	Pediatrics Physician	$0	$15.7M
San Juan Regional Medical Center Inc	NM	Family Medicine Physician	$0	$7.9M
San Juan Regional Medical Center Inc	NM	Hospitalist Physician	$0	$3.6M
San Juan Regional Medical Center Inc	NM	Neurology Physician	$0	$2.5M
San Juan Regional Medical Center Inc	NM	Internal Medicine Physician	$0	$1.5M
Clayton Labaume	CO	Surgical Physician Assistant	$1.4M	$0
San Juan Regional Medical Center Inc	NM	Psychiatry Physician	$0	$1.4M
Graeme Fisher	IL	Therapeutic Radiology Physician	$658K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Basin Coordinated Healthcare,inc	NM	Personal Care Attendant	$0	$79.7M
Presbyterian Medical Services	NM	Federally Qualified Health Center (FQHC)	$0	$41.2M
Links Ii Inc	NM	In Home Supportive Care Agency	$0	$38.9M
Generations Personal Care, Inc	NM	Personal Care Attendant	$0	$33.9M
Southwestern Private Services, Inc.	NM	Home Health Agency	$0	$30.4M
San Juan Center For Independence	NM	Home Health Agency	$0	$22.5M
Cottonwood Clinical Services, Inc.	NM	Community/Behavioral Health Agency	$0	$18.1M
Better Together Home And Community Services, LLC	NM	Child Intellectual and/or Developmental Disabilities Respite Care	$0	$14.5M
Southwestern Private Services, Inc	NM	Home Health Agency	$0	$7.3M
Pms Dba Roundtree Childrens' Development Services	NM	Developmental Disabilities Clinic/Center	$0	$6.9M

Orthopedic Associates PA — Billing Profile & Reimbursement Data

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Orthopedic Associates PA — 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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