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

Why is the Medicaid comparison limited to North Dakota 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. North Dakota (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.

Valley Oral & Facial Surgery PC (NPI 1801959788)

Field	Value
Entity Type	Organization
Organization	Valley Oral & Facial Surgery PC
Address	1165 S Columbia Rd Ste C
City	Grand Forks
State	ND
ZIP	58201
Taxonomy	Oral and Maxillofacial Surgery Clinic/Center
NPI Enumerated	December 19, 2006

Payer Source	Total Paid
Medicaid	$4.5M
Medicare	$0

Key Findings

VALLEY ORAL & FACIAL SURGERY PC has no Medicare billing on file and is effectively a Medicaid-focused practice, reporting $4.5M in lifetime Medicaid revenue and no Medicare revenue. This payer mix indicates the provider operates almost exclusively within Medicaid rather than a dual Medicare/Medicaid model.

Revenue is highly concentrated: the precomputed top 3 Medicaid codes by revenue account for 80.2% of this provider's total Medicaid revenue, signaling dependence on a narrow set of high-volume service lines for the bulk of billing. Those top three contributors are D7210 (44.4%), D7240 (22.3%), and D9222 (13.5%), together forming the financial core of the practice.

Business/service-line mix aligns with an oral and maxillofacial surgery operation: D7210 (Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth, and including elevation; includes related cutting of gingiva and bone, removal of tooth structure, minor smoothing of socket bone and closure) is the single largest Medicaid revenue driver with 12.3K claims, $160 avg paid/claim, and $2M revenue (44.4% of total Medicaid revenue). The prominence of D7210, alongside other extraction-related codes such as D7140 and D7230, indicates the practice is procedure-oriented with a high volume of operative extractions and related surgical services.

Competitive standing within North Dakota is dominant for multiple high-revenue codes: the provider ranks #1 of 9 for D7210, #1 of 5 for D7240, and #1 of 8 for D9222, each at the 100th percentile and described as notably above typical state volume. These rank/percentile signals identify VALLEY ORAL & FACIAL SURGERY PC as a statewide leader for several core Medicaid procedure codes rather than a modest or mid-tier participant.

Several codes show exceptionally high claim volumes relative to peers or unusual payment patterns: D0140 (7.2K claims, $37 avg paid/claim, $267.8K revenue, 6.0% of total) is a 100th-percentile extreme outlier in state volume, and D1999 (1.9K claims) and D9630 (1.2K claims) both report $0 avg paid/claim and $0 revenue despite high claim counts. These entries suggest substantial reporting activity to Medicaid for limited oral evaluations and miscellaneous/unclassified procedure codes but with either zero-dollar payments or bundling/zero-paid line entries on file.

Operational implications for contracting and utilization management: because nearly half of Medicaid revenue comes from D7210 alone ($2M) and the top-three codes make up 80.2% of Medicaid revenue, any changes to reimbursement, prior authorization, or coverage for these specific codes would disproportionately affect this provider’s Medicaid revenue. Payers and network managers should prioritize monitoring utilization and reimbursement policies for D7210, D7240, and D9222 when assessing cost exposure or network adequacy in the region.

Tenure and stability: the provider’s NPI was enumerated on 2006-12-19 (~20 years ago), indicating long-standing presence in the market. Combined with its concentrated Medicaid footprint and top-state rankings on multiple codes, the practice appears established and consistently focused on surgical oral services within the Medicaid population.

Several mid- and lower-revenue codes show typical volumes and mixed rankings: D7140 (437 claims, $85 avg paid/claim, $37.1K revenue, 0.8% of total) sits at the 55th percentile, while D7230 and D9612 show modest contributions and typical in-state volumes. These figures indicate that beyond its core high-revenue extraction and related codes, the practice bills a range of routine oral/maxillofacial procedures at rates and volumes that are generally unremarkable within the state peer group.

Medicaid: Complete Services Breakdown

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

11 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
D7210	Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth, and including elevation; includes related cutting of gingiva and bone, removal of tooth structure, minor smoothing of…	12,340	$160	$2M
D7240	N/A	3,450	$290	$993.6K
D9222	N/A	5,410	$110	$600.3K
D9223	N/A	4,580	$100	$471.3K
D0140	Limited oral evaluation – problem focused	7,240	$40	$267.8K
D9610	N/A	2,740	$40	$98.7K
D7140	Extraction, erupted tooth or exposed root (elevation and/or forceps removal)	440	$90	$37.1K
D7230	N/A	30	$220	$5.8K
D9612	N/A	70	$40	$2.6K
D1999	N/A	1,930	$0	$0

Showing 1–10 of 11

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. North Dakota Distribution

Valley Oral & Facial Surgery PC — 5 of 9 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — North Dakota

Full comparison — all codes billed, vs. North Dakota median

11 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
D7210	Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth, and including elevation; includes related cutting of gingiva and bone, removal of tooth structure, minor smoothing of…	1	10	100	$150	$280.3K
D7240	N/A	1	10	170	$280	$224.6K
D9610	N/A	1	10	2,740	$40	$98.3K
D9222	N/A	1	10	80	$110	$95.3K
D9223	N/A	1	10	110	$110	$84.5K
D7140	Extraction, erupted tooth or exposed root (elevation and/or forceps removal)	10	20	300	$90	$76.2K
D0140	Limited oral evaluation – problem focused	1	40	100	$70	$44K
D7230	N/A	3	10	80	$200	$18.1K
D9612	N/A	2	10	60	$40	$2.6K
D1999	N/A	1	20	50	$0	$0

Showing 1–10 of 11

Related Providers

Other providers that share a Tax Identification Number (TIN) with Valley Oral & Facial Surgery PC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Troy Petersen	ND	Oral and Maxillofacial Surgery (Dentist)	$2.1K	$0

Nearby Providers

Other providers in the same ZIP code as Valley Oral & Facial Surgery PC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Development Homes Inc	ND	Community/Behavioral Health Agency	$0	$53.9M
Altru Health System	ND	Clinic/Center	$0	$29.7M
Altru Health System	ND	General Acute Care Hospital	$0	$18.7M
L.i.s.t.e.n. Inc	ND	Community/Behavioral Health Agency	$0	$9.4M
Peterson Medical Clinics, LLC	ND	Multi-Specialty Clinic/Center	$0	$8.8M
Edgewood Sartell LLC	ND	Assisted Living Facility	$0	$7.1M
Northeast Behavioral Health Clinic	ND	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$6.7M
Spectra Health	ND	Federally Qualified Health Center (FQHC)	$0	$5.5M
Little Miracles, Inc.	ND	Multi-Specialty Clinic/Center	$0	$5.5M
Anil Potti	ND	Hematology & Oncology Physician	$4.9M	$0

Valley Oral & Facial Surgery PC — Billing Profile & Reimbursement Data

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Valley Oral & Facial Surgery PC — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References