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.

Howard Berglund (NPI 1831141175)

Field	Value
Entity Type	Individual
Organization	Howard Berglund
Address	1720 University Dr S
City	Fargo
State	ND
ZIP	58103
Taxonomy	Orthopaedic Surgery Physician
NPI Enumerated	May 16, 2006

Payer Source	Total Paid
Medicare	$220K
Medicaid	$0

Key Findings

Howard Berglund is an Orthopaedic Surgery Physician in Fargo, ND whose NPI was enumerated on 2006-05-16 (~20 years ago). The profile shows total Medicare revenue of $220K and no Medicaid billing on file, so the provider’s billed activity in these public payers is effectively single-payer Medicare.

Revenue is highly concentrated in arthroplasty procedures: the precomputed top 3 Medicare codes (27447, 27130, 23472) account for 77.6% of this provider’s total Medicare revenue. Individually those codes are reported as 27447 $69.8K (31.7%), 27130 $56.7K (25.8%), and 23472 $44.2K (20.1%), indicating the bulk of Medicare dollars flow from joint replacement work.

The code mix and descriptions point to a practice oriented toward elective joint replacement and surgical arthroplasty rather than office-based medical management. High-revenue entries are surgical implants (27447 knee, 27130 hip, 23472 shoulder), while office E/M and injection codes such as 99213 ($10.8K revenue, 230 claims, $47 avg paid/claim) and 20610 ($8.1K revenue, 232 claims, $35 avg paid/claim) show routine clinic throughput that contributes materially less to dollars than surgical cases.

From a payer-mix perspective this provider relies on Medicare (Total Medicare revenue: $220K) with no Medicaid revenue reported, creating exposure to Medicare policy and reimbursement shifts and limited diversification into state Medicaid populations. That lack of Medicaid billing also reduces the dataset available for in-state competitive comparisons on the Medicaid side.

National competitive standing for the top arthroplasty codes is not described as dominant: 27447 ranks #2110 of 12089 (82th percentile; typical, unremarkable volume for this code), 27130 ranks #1112 of 8062 (86th percentile; typical, unremarkable volume for this code), and 23472 ranks #550 of 3439 (83th percentile; typical, unremarkable volume for this code). In plain terms, these ranks place the provider above many peers on volume metrics but the supplied labels characterize those volumes as typical/unremarkable rather than outlier or market-leading.

Operationally there is a mismatch between claim frequency and dollar contribution: several codes have high claim counts with low per-claim payment (for example 99213: 230 claims, $47 avg paid/claim, $10.8K revenue; 20610: 232 claims, $35 avg paid/claim, $8.1K revenue), while a smaller number of surgical claims generate the majority of revenue (e.g., 27447: 67 claims producing $69.8K). This suggests the practice combines a steady clinic/injection volume with episodic, higher-revenue surgical procedures.

A few lower-volume surgical/arthroscopic codes appear alongside the primary arthroplasty mix and are labeled as typical in the dataset despite low national ranks—for example 29827 shows 12 claims, $828 avg paid/claim, $9.9K revenue and is listed with a 9th percentile but described as "typical, unremarkable volume for this code." These mixed signals (high-percentile labels for primary joint-replacement codes versus low-ranked but labeled-typical entries for some arthroscopy codes) warrant attention when benchmarking the provider against specialty peers and when projecting procedure-level growth or referral needs.

Medicare: Complete Services Breakdown

The CPT/HCPCS codes generating the most Medicare revenue for this provider.

13 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
27447	In this procedure, the provider replaces the damaged weight bearing surfaces of both the medial and lateral compartments in the knee joint using implants of metal or other strong materials. The…	70	$1,040	$69.8K
27130	In this procedure, the provider surgically replaces the hip joint by prosthesis, or artificial hip joint. He replaces both the femoral and acetabular components with or without using an autograft or…	60	$980	$56.7K
23472	In this procedure, the provider performs a total shoulder arthroplasty in which the provider replaces the damaged head of the humerus and the glenoid cavity with prosthetic implants. The provider…	40	$1,080	$44.2K
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…	230	$50	$10.8K
29827	The provider examines the tissue inside the shoulder joint with an arthroscope. She inserts additional instruments to repair a torn rotator cuff, the grouping of muscles and tendons that surround and…	10	$830	$9.9K
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…	230	$40	$8.1K
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…	100	$70	$6.9K
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,…	150	$30	$4.1K
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…	40	$100	$3.6K
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…	60	$60	$3.2K

Showing 1–10 of 13

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 13 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. North Dakota Distribution

Howard Berglund — 2 of 13 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. state median

13 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
27447	13	60	40	$1,110	$47.9K
27130	5	40	30	$970	$35K
29827	12	10	20	$860	$20.8K
23472	1	20	20	$720	$17.9K
99214	690	1,470	90	$60	$10.4K
99213	215	1,490	80	$50	$5.8K
99204	214	570	30	$100	$4.4K
20610	12	160	50	$40	$3.4K
99203	93	490	30	$60	$2.5K
29826	6	10	20	$80	$1.6K

Showing 1–10 of 13

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Sanford Medical Center Fargo	ND	Family Medicine Physician	$0	$75.9M
Sanford Medical Center	SD	Family Medicine Physician	$0	$68.8M
Sanford Medical Center Fargo	ND	General Acute Care Hospital	$0	$50.2M
Sanford Health Of Northern Minnesota	MN	Internal Medicine Physician	$0	$27.2M
Sanford Medical Center Fargo	ND	Air Ambulance	$0	$12M
Sanford Clinic North	ND	Clinical Medical Laboratory	$1.4M	$7M
Sanford Health Network North	MN	Multi-Specialty Clinic/Center	$0	$5.2M
Sanford Medical Center Fargo	ND	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$3.6M
Max Johnson	ND	Retina Specialist (Ophthalmology) Physician	$2.8M	$0
Gregory Pippin	ND	Otolaryngology Physician	$48.4K	$1.7M

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Community Living Services, Inc	ND	Community/Behavioral Health Agency	$0	$104.6M
Villa Nazareth	ND	Community/Behavioral Health Agency	$0	$84.2M
Psj Acquisition LLC	ND	Psychiatric Hospital	$0	$32.3M
Vocational Training Center, Inc.	ND	Community/Behavioral Health Agency	$0	$28.5M
Fm Ambulance Service, Inc	ND	Land Ambulance	$2M	$23.8M
Innovis Health, LLC	ND	General Acute Care Hospital	$0	$25.5M
Fraser, Ltd.	ND	Community/Behavioral Health Agency	$0	$13.9M
Community Medical Services Montana Private LLC	ND	Methadone Clinic	$214.7K	$8.9M
Southeast Behavioral Health Clinic	ND	Substance Use Disorder Rehabilitation Clinic/Center	$0	$8.8M
Village Family Service Center	ND	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$8.8M

Howard Berglund — Billing Profile & Reimbursement Data

Sign up for Howard Berglund — Billing Profile & Reimbursement Data policy alerts

Howard Berglund — Billing Profile & Reimbursement Data

Sign up for Howard Berglund — Billing Profile & Reimbursement Data policy alerts

Key Findings

Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References