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    OpenPayerNPI Medicare & MedicaidMark Nishiya
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    Mark Nishiya — Billing Profile & Reimbursement Data

    NPI 1760411995 · Grand Junction, CO · Urology Physician

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    Mark Nishiya is a urology physician provider located in Grand Junction, Colorado. This profile covers 28 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.

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    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeIndividual
    OrganizationMark Nishiya
    Address2373 G Rd
    CityGrand Junction
    StateCO
    ZIP81505
    TaxonomyUrology Physician
    NPI EnumeratedJuly 1, 2006

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

    Payer SourceTotal Paid
    Medicare$114.6K
    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.

    28 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    57425The provider uses a laparoscopic approach to suspend the top of the vagina to a strong structure to treat vaginal vault prolapse using sutures or mesh.30$790$20.4K
    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…170$90$15.6K
    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…90$110$9.8K
    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…50$190$9.1K
    51728In this procedure, the provider performs a complex cystometrogram along with voiding pressure studies to diagnose certain urinary disorders like an overactive bladder, stress incontinence, or urinary…30$300$8K
    57267The provider inserts a prosthetic graft over the anterior and or posterior vaginal wall because of the lack of reasonable tissue strength. This is a vaginal approach procedure. This is an add–on…40$180$7.5K
    57288The provider places a sling made of fascia or synthetic material under the urethra to support it in the correct position to treat urinary stress incontinence. The procedure can be performed…30$300$7.5K
    64561The provider, under imaging guidance, implants electrodes around nerves in the sacral region to reduce the pain along the path of the nerve.20$300$7.1K
    57260The provider repairs the vaginal tissues over the weakened spots to support the area and return the bladder and rectum to their correct positions.  This is a vaginal approach procedure. The provider…20$280$6K
    87798The lab analyst performs a test for an infectious agent not specified in another code using an amplified nucleic acid probe technique. Use this code if you know the laboratory technique is amplified…140$30$4.9K

    Showing 1–10 of 28

    Medicare: Competitive Analysis & Benchmarks

    How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 28 CPT/HCPCS codes.

    View: State1 / 2

    Full comparison — all codes billed, vs. state median

    28 rows

    CPT/HCPCS CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    877985250350$30$112.5K
    64590152020$6,130$110.4K
    87801222070$70$79.2K
    64561132030$2,090$69.1K
    874814650120$30$25K
    5200011415070$150$15.6K
    5742541020$530$12.3K
    992142,2858,16080$80$11.3K
    87653475030$30$8.4K
    5171511010$570$8K

    Showing 1–10 of 28

    Related Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Delta County Memorial HospitalCORural Acute Care Hospital$0$4.9M
    Delta County Memorial HospitalCORural Acute Care Hospital$0$4M
    Dane StewartCOOphthalmology Physician$641.7K$0
    Shad SaundersCOOphthalmology Physician$401.7K$0
    Bennett ObergDCOphthalmology Physician$374.2K$0
    Daniel WardMAOrthopaedic Surgery Physician$343K$0
    John SielatyckiCOOrthopaedic Surgery of the Spine Physician$300.2K$0
    Nicholas NeubaumCOOphthalmology Physician$298.2K$0
    William HowarthCOOrthopaedic Surgery Physician$296.3K$0
    John KnutsonCOOrthopaedic Surgery Physician$239.5K$0

    Nearby Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Grand Junction Regional CenterCODevelopmentally Disabled Services Day Training Agency$0$42.3M
    Colorado West Healthcare SystemCOGeneral Acute Care Hospital$0$12.8M
    Senior Care Service LLCCODurable Medical Equipment & Medical Supplies$0$9M
    Pediatric Dental Specialists Of Western CoCOPediatric Dentistry$0$6.7M
    K2taxi, LLCCOTaxi$0$4.6M
    Gj West Dental Prof LLCCOGeneral Practice Dentistry$0$4.3M
    Endoscopy Center Of Western Colorado IncCOAmbulatory Surgical Clinic/Center$549.2K$261.6K
    Canyon View Asc, LLCCOAmbulatory Surgical Clinic/Center$438.3K$14.9K
    William WaterhouseCOOphthalmology Physician$357.3K$24.4K
    Kristin SperleCONurse Practitioner$364.2K$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. Colorado Distribution
    Mark Nishiya — 2 of 25 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Colorado