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

Why is the Medicaid comparison limited to West Virginia 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. West Virginia (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.

West Virginia Orthopedic Trauma Inc (NPI 1871040626)

West Virginia Orthopedic Trauma Inc is a orthopaedic trauma physician provider located in Beckley, West Virginia. This profile covers 0 Medicare and 26 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Medicaid: Complete Services Breakdown

Field	Value
Entity Type	Organization
Organization	West Virginia Orthopedic Trauma Inc
Address	201 Woodcrest Dr
City	Beckley
State	WV
ZIP	25801
Taxonomy	Orthopaedic Trauma Physician
NPI Enumerated	September 8, 2016

Payer Source	Total Paid
Medicaid	$1M
Medicare	$0

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

26 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	5,940	$90	$510.5K
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…	4,460	$40	$196.1K
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…	2,160	$40	$82K
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…	630	$60	$36.4K
J3301	Injection, triamcinolone acetonide, not otherwise specified, 10 mg	2,740	$10	$32.9K
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…	410	$80	$30.4K
73100	In this procedure, the provider takes two X–ray images of a patient’s wrist to check for any fracture, swelling, or reason of pain in the wrist area.	1,390	$20	$26.4K
25600	The provider treats a fracture of the wrist end of the radius, one of the bones in the forearm, in which the fracture fragment displaces upward or downward, in a closed procedure. The growth plate at…	130	$190	$25K
L4360	Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a…	120	$210	$24.9K
73560	In this procedure, the provider takes one or two X–ray images of a patient’s knee joint to check for any fracture, swelling, or reason for pain in the knee area.	900	$20	$20.6K

Showing 1–10 of 26

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. West Virginia Distribution

West Virginia Orthopedic Trauma Inc — 6 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — West Virginia

Full comparison — all codes billed, vs. West Virginia median

26 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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…	361	1,270	1,240	$30	$245K
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…	584	1,030	890	$50	$221K
L4360	Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a…	8	10	350	$190	$133.7K
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…	11	340	140	$90	$97.5K
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…	119	440	110	$60	$57.2K
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…	13	70	230	$40	$51.2K
73610	In this procedure, the provider takes three or more X–ray images of the ankle joint to check for any fracture, swelling, or reason for pain in the ankle area.	26	80	400	$20	$26.3K
L3908	Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf	9	10	360	$40	$25.5K
25600	The provider treats a fracture of the wrist end of the radius, one of the bones in the forearm, in which the fracture fragment displaces upward or downward, in a closed procedure. The growth plate at…	2	10	30	$220	$23.3K
29075	The provider applies a cast encasing the lower arm. A short arm cast treats fractures of the bones in the lower arm and corrects deformities of the hand and wrist.	1	10	100	$90	$21.6K

Showing 1–10 of 26

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
John Tabit	WV	Orthopaedic Trauma Physician	$143.3K	$0
Megan Dincher	WV	Surgical Physician Assistant	$61.3K	$0
Brittany Hamilton	PA	Physician Assistant	$35.4K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Raleigh General Hospital LLC	WV	General Acute Care Hospital	$0	$36.4M
Community Health Systems, Inc.	WV	Federally Qualified Health Center (FQHC)	$0	$35M
Fmrs Health Systems Inc	WV	Community/Behavioral Health Agency	$0	$27M
Health Care Alliance, Inc.	WV	Emergency Medicine Physician	$0	$25M
Jan-care Ambulance Of Raleigh County Inc	WV	Land Ambulance	$1.9M	$20.8M
Appalachian Regional Healthcare, Inc	WV	General Acute Care Hospital	$0	$18.3M
Raleigh County Commission On Aging, Inc.	WV	Home Health Agency	$0	$16.7M
Mountain State Home Health Care Inc	WV	Nursing Care Agency	$0	$16.5M
Family Options Providers, LLC.	WV	Community/Behavioral Health Agency	$0	$16.1M
Raleigh County Commission On Aging, Inc.	WV	Home Health Agency	$0	$13.8M

West Virginia Orthopedic Trauma Inc — Billing Profile & Reimbursement Data

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West Virginia Orthopedic Trauma Inc — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

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