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 & MedicaidKarl Riggle
    Ask Trek AI about this page

    Karl Riggle — Billing Profile & Reimbursement Data

    NPI 1831114511 · Hagerstown, MD · Surgery Physician

    Customize your policy alerts

    Sign up for Karl Riggle — 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.

    Karl Riggle is a surgery physician provider located in Hagerstown, Maryland. This profile covers 23 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
    OrganizationKarl Riggle
    Address1110 Professional Ct
    CityHagerstown
    StateMD
    ZIP21740
    TaxonomySurgery Physician
    NPI EnumeratedJuly 13, 2006

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

    Payer SourceTotal Paid
    Medicare$113K
    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.

    23 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    47563The provider removes the gallbladder through a laparoscope, a tubular instrument with a light source and camera inserted through the abdominal wall, to treat gallbladder disease. She injects dye and…30$580$18.6K
    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…170$70$11.8K
    36830In this procedure, the provider surgically creates an arteriovenous fistula, a connection between an artery and a vein using a nonautogenous graft. This service is done to allow for hemodialysis…20$530$9K
    36831In this procedure, the provider surgically opens the autogenous or nonautogenous arteriovenous fistula and removes the clot from the connection between the artery and the vein. He does not revise the…20$490$8.8K
    36902The provider introduces a needle and/or catheter under fluoroscopic guidance (live X–rays that can be viewed on a monitor) and injects contrast material into the dialysis access point to visualize…40$170$6.7K
    49505The provider repairs an initial inguinal hernia on a child, five years of age or older. She pushes the hernia back to reduce it.10$420$5.9K
    36561A central venous access catheter is a device that the physician inserts beneath the skin to draw blood or administer medication/nutrients to the patient.  The catheter's tip must terminate in the…20$270$5.8K
    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…60$90$5.7K
    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…70$80$5.6K
    99222The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…40$100$4.5K

    Showing 1–10 of 23

    Medicare: Competitive Analysis & Benchmarks

    How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 23 CPT/HCPCS codes.

    View: State1 / 2

    Full comparison — all codes billed, vs. state median

    23 rows

    CPT/HCPCS CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    3690371020$2,950$73.7K
    36902205030$900$64.1K
    4538534636080$310$35.6K
    4538035337070$220$26.4K
    992147,42910,270150$90$24.1K
    992133,1939,280100$60$12.5K
    49505213020$540$12.5K
    3683031020$530$10.6K
    36561308020$360$8.6K
    4756311020$470$8.5K

    Showing 1–10 of 23

    Related Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Hany ShanoudyPACardiovascular Disease Physician$571.3K$108.8K
    William TyndallPAOrthopaedic Surgery Physician$182.6K$77.5K
    Richard LatuskaPAGastroenterology Physician$126.2K$42.6K
    Craig AronchickCAGastroenterology Physician$111.5K$0
    Erin DonoghueMDPhysician Assistant$47.7K$0
    James GerardoPACardiovascular Disease Physician$33.1K$2.2K
    Danny ForsytheSCAnesthesiology Physician$28.4K$0

    Nearby Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Dr. David M. Vieth 2, P.C.MDGeneral Practice Dentistry$0$77.8M
    Potomac Case Management Services, Inc.MDCase Management Agency$0$28M
    Phoenix Health Center LLCMDMethadone Clinic$507.7K$21.4M
    Awakenings Recovery Center, LLCMDSubstance Abuse Rehabilitation Facility$0$19.8M
    Qualitycare Internet, LLPMDMental Health Counselor$0$19.4M
    Walnut Street Community Health Center, Inc.MDFederally Qualified Health Center (FQHC)$0$19.3M
    Board Of Education Of Washington CountyMDLocal Education Agency (LEA)$0$19.1M
    Center For Pain Management, LLCMDInterventional Pain Medicine Physician$0$18.9M
    Metro Treatment Of Maryland LPMDCommunity/Behavioral Health Agency$361K$16.6M
    The Western Maryland Counseling CenterMDCommunity/Behavioral Health Agency$0$16.5M

    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. Maryland Distribution
    Karl Riggle — 1 of 23 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Maryland