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 & MedicaidAndrea Tooley
    Ask Trek AI about this page

    Andrea Tooley — Billing Profile & Reimbursement Data

    NPI 1750797213 · Paducah, KY · Ophthalmic Plastic and Reconstructive Surgery Physician

    Customize your policy alerts

    Sign up for Andrea Tooley — 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.

    Andrea Tooley is a ophthalmic plastic and reconstructive surgery physician provider located in Paducah, Kentucky. This profile covers 10 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 / 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 TypeIndividual
    OrganizationAndrea Tooley
    Address1130 Lone Oak Rd
    CityPaducah
    StateKY
    ZIP42003
    TaxonomyOphthalmic Plastic and Reconstructive Surgery Physician
    NPI EnumeratedJuly 5, 2014

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

    Payer SourceTotal Paid
    Medicare$68.2K
    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.

    10 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    67904The provider repairs a drooping eyelid by tightening the levator muscle that controls eyelid movement to improve cosmetic appearance or remove the obstruction to a patient’s vision. He accesses the…40$660$23.2K
    15823In this procedure, the provider surgically trims excessive skin that weighs down the upper eyelid, typically to improve the cosmetic appearance of the face and due to the interference of the tissue…20$600$11.5K
    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…90$90$8.4K
    67908The provider performs a procedure such as the Fasanella–Servat procedure, which involves resection and plication of the levator/Muller muscles along with the tarsus and the conjunctiva to treat…20$400$6K
    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…50$110$5.3K
    67900The provider repairs a drooping eyebrow due to muscle weakness or paralysis, to improve cosmetic appearance or remove the obstruction to a patient’s vision. He makes an incision immediately above the…10$340$3.8K
    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…60$70$3.8K
    68840This procedure is the probing of the lacrimal canaliculi with or without irrigation.20$130$2.2K
    92081The provider may use one or more methods to determine the extent of a patient's visual field of one or both eyes; he interprets the results and prepares a report. Report this code for a limited…90$20$2.1K
    99203The 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…20$80$2K

    Medicare: Competitive Analysis & Benchmarks

    How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 10 CPT/HCPCS codes.

    View: State1 / 2

    Full comparison — all codes billed, vs. state median

    10 rows

    CPT/HCPCS CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    67904101040$690$38.5K
    15823332030$550$21.6K
    992143,9027,230110$70$14.1K
    67900221020$490$8.7K
    992133,8757,25080$50$7.7K
    992046123,20030$100$4.8K
    992031,2312,38030$70$2.9K
    6884071020$110$2.7K
    9208171030$20$1.2K
    6790890N/A$N/A$N/A

    Related Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Innovative Eye Surgery Center, PLLCKYAmbulatory Surgical Clinic/Center$356.2K$82.4K
    Timothy HobbsKYOptometrist$233.8K$4.8K
    Barbara BowersKYOphthalmology Physician$196.9K$0
    Daniel SmileyKYCertified Registered Nurse Anesthetist$12.6K$0

    Nearby Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Baptist Healthcare System, IncKYGeneral Acute Care Hospital$0$72.6M
    Mercy Health-lourdes Hospital LLCKYGeneral Acute Care Hospital$0$61.9M
    Baptist Health Medical Group IncKYFamily Medicine Physician$0$21.9M
    Mercy Health Physicians Kentucky LLCKYFamily Medicine Physician$0$11.9M
    Ambulatory Surgery Center LLCKYAmbulatory Surgical Clinic/Center$771.4K$8.7M
    Joseph BlackmonKYMOHS-Micrographic Surgery Physician$6.9M$0
    John Colgan Jr.KYPediatric Dentistry$0$5.6M
    Mercy Health Physicians Kentucky Specialty Care LLCKYSurgery Physician$0$4.7M
    Justin ColganKYPediatric Dentistry$0$4.6M
    Paducah Ophthalmology Asc LLCKYAmbulatory Surgical Clinic/Center$1.3M$467.8K

    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. Kentucky Distribution
    Andrea Tooley — 0 of 9 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Kentucky