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

Why is the Medicaid comparison limited to Montana 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. Montana (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.

Zachary Scheer (NPI 1841388832)

Field	Value
Entity Type	Individual
Organization	Zachary Scheer
Address	2900 12th Ave N Ste 140w
City	Billings
State	MT
ZIP	59101
Taxonomy	Orthopaedic Surgery Physician
NPI Enumerated	October 11, 2006

Payer Source	Total Paid
Medicare	$379.2K
Medicaid	$0

Key Findings

Specialty and service mix indicate a high-volume arthroplasty practice focused on major joint replacement and related procedures: the top surgical codes are 27447 (total knee arthroplasty), 27130 (total hip arthroplasty), and 27487 (knee revision), and the provider also reports frequent use of computer-assisted navigation (20985). This code mix — dominated by primary and revision joint replacement plus procedural navigation support — is consistent with an orthopaedic surgeon whose revenue is driven largely by operative care rather than outpatient medical management alone.

Revenue is highly concentrated in a few procedures: the top 3 Medicare codes by revenue account for 76.9% of the provider's total Medicare revenue, with 27447 representing $174.4K (46.0%), 27130 representing $89K (23.4%), and 99214 representing $28.3K (7.5%). This concentration means most of the provider’s $379.2K in Medicare revenue is tied to a small set of high-revenue surgical and visit codes.

Payer mix is effectively single-payer Medicare: the provider reports $379.2K in total Medicare revenue and no Medicaid billing on file, so operational and reimbursement risk is concentrated on Medicare payment policies and volumes rather than a mixed Medicare/Medicaid strategy. For payers and network planners, this profile should be treated as a Medicare-centric surgical practice with no recorded Medicaid activity.

The provider is a national outlier for knee replacement volume: 27447 appears as an “extreme outlier,” with 170 claims, a $1026 avg paid/claim, $174.4K revenue and a national rank of #173 of 12089 providers (99th percentile). That standing indicates the provider is a materially above-typical contributor to national knee arthroplasty volume and competes at a high level for this procedure.

Hip replacement volume is also well above typical: 27130 reports 86 claims, a $1035 avg paid/claim, $89K revenue and a national rank of #373 of 8062 providers (95th percentile), described as “notably above typical national volume for this code.” This supports the interpretation that the practice is a regional to national-level source of primary joint replacement cases for hips as well as knees.

Use of technology is notable: 20985 (computer assisted navigation) appears with 161 claims, a $116 avg paid/claim, $18.7K revenue and a rank of #61 of 1390 providers (96th percentile), labeled “notably above typical national volume for this code.” High use of CANS suggests the surgeon adopts navigation-assisted techniques for joint replacement, which may influence case complexity, implant choices, and contractual discussions around device and technology reimbursement.

Outpatient and imaging activity is present but not the primary revenue driver: 99214 shows 289 claims, a $98 avg paid/claim, and $28.3K revenue (78th percentile, described as typical), while knee and hip radiography codes such as 73562 (261 claims, $31 avg, $8.1K) and 73502 (211 claims, $35 avg, $7.4K) appear at volumes characterized as typical or unremarkable for those codes. These data indicate routine pre- and post-operative clinic and imaging workflows supporting the surgical practice rather than indicating a separate high-volume non-surgical clinic.

Tenure and likely referral position are established: the provider’s NPI was enumerated 2006-10-11 (~20 years ago), indicating long-standing registration in Medicare. Combined with the high concentration in major arthroplasty codes, this suggests an experienced, surgery-focused practice that is likely integrated into referral networks for complex joint replacement cases rather than a newly established outpatient-only practice.

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…	170	$1,030	$174.4K
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…	90	$1,040	$89K
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…	290	$100	$28.3K
27487	In this procedure, the provider performs revision arthroplasty of the knee joint. She revises both the femoral and tibial components. She may or may not use an allograft to perform this procedure.…	20	$1,410	$21.1K
20985	A provider using a computer assisted navigation system, or CANS, performs musculoskeletal procedures, such as a joint replacement surgery, with the aid of a computer screen that provides a…	160	$120	$18.7K
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…	160	$70	$10.9K
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…	80	$130	$9.4K
73562	In this procedure, the provider takes three X–ray images of a patient’s knee joint to check for any fracture, swelling, or reason for pain in the knee area.	260	$30	$8.1K
73502	In this diagnostic procedure, the provider takes X–ray images of one hip, either left or right, from two or three projections (directions or angles) to check for any fracture, swelling, or other…	210	$40	$7.4K
73564	In this procedure, the provider takes four or more X–ray views of the knee joint to check for any fracture, swelling, or reason for pain in the knee area.	150	$40	$5.1K

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. Montana Distribution

Zachary Scheer — 2 of 13 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Montana

Full comparison — all codes billed, vs. state median

13 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
27447	3	80	40	$1,080	$60.6K
27130	6	50	40	$1,150	$54.1K
27487	4	10	20	$820	$14.8K
99214	328	1,810	100	$70	$12.4K
99213	472	1,730	90	$50	$7.2K
20985	2	10	30	$90	$6.6K
99204	121	780	30	$100	$4.8K
20610	83	210	40	$40	$3.3K
99203	295	700	30	$70	$3.1K
73564	19	120	60	$20	$1.8K

Showing 1–10 of 13

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Riverside Radiology And Interventional Associates Inc	OH	Diagnostic Radiology Physician	$0	$30.3M
Scl Health Medical Group-butte LLC	MT	Family Medicine Physician	$0	$9.9M
Nathan Steinle	CA	Retina Specialist (Ophthalmology) Physician	$9.5M	$0
Prema Abraham	SD	Retina Specialist (Ophthalmology) Physician	$7.1M	$0
Kyle Thompson	ID	Retina Specialist (Ophthalmology) Physician	$4.5M	$0
Douglas Holmes	WY	Retina Specialist (Ophthalmology) Physician	$4.1M	$0
Mitchell Goff	UT	Retina Specialist (Ophthalmology) Physician	$3.8M	$0
Richard Kinsey	TN	Anatomic Pathology & Clinical Pathology Physician	$3.3M	$147.3K
Brendan Girschek	AZ	Ophthalmology Physician	$3.2M	$0
John Bormes	SD	Ophthalmology Physician	$2.6M	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Billings Clinic	MT	General Practice Physician	$0	$53.8M
Rimrock Foundation	MT	Substance Use Disorder Rehabilitation Clinic/Center	$0	$44.9M
Scl Health Medical Group - Billings LLC	MT	Clinic/Center	$0	$32.2M
Residential Support Services	MT	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$30.6M
Billings Public School District 2	MT	Local Education Agency (LEA)	$0	$19.2M
South Central Montana Regional Mental Health Center	MT	Clinic/Center	$0	$16.6M
Billings Clinic	MT	Emergency Care Clinic/Center	$0	$15.7M
Community Solutions Incorporated	MT	Clinical Medical Laboratory	$0	$14.1M
Scl Health Montana	MT	General Acute Care Hospital	$0	$13.5M
Benefis Community Care, Inc.	MT	Case Management Agency	$0	$10.8M

Zachary Scheer — Billing Profile & Reimbursement Data

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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