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

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

Tri-state Orthopaedics, LLC (NPI 1871531426)

Tri-state Orthopaedics, LLC is a orthopaedic surgery physician provider located in Memphis, Tennessee. This profile covers 0 Medicare and 43 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	Tri-state Orthopaedics, LLC
Address	1264 Wesley Dr
City	Memphis
State	TN
ZIP	38116
Taxonomy	Orthopaedic Surgery Physician
NPI Enumerated	June 4, 2006

Payer Source	Total Paid
Medicaid	$6.9M
Medicare	$0

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

43 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J3300	Injection, triamcinolone acetonide, preservative free, 1 mg	7,600	$140	$1M
20611	In this procedure, the provider inserts a needle through the skin of a patient and into a major joint or bursa, typically the shoulder, hip, knee, or subacromial bursa, and then uses the syringe…	23,570	$40	$895.7K
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	7,800	$100	$771.9K
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…	18,710	$30	$636.1K
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…	9,780	$50	$508.4K
93970	The provider performs an ultrasound scanning procedure called a duplex scan to characterize the pattern and direction of blood flow in extremity veins (arms or legs). This is a complete, bilateral…	3,780	$100	$366.7K
L0650	Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid…	690	$460	$316.5K
93925	The provider performs a duplex ultrasound scan of the lower extremity arteries or bypass grafts on both sides. Providers perform noninvasive arterial diagnostic procedures to examine the rate of…	2,920	$110	$315K
L1833	Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated, off-the shelf	1,330	$210	$272.2K
J7325	Hyaluronan or derivative, synvisc or synvisc-one, for intra-articular injection, 1 mg	2,730	$90	$234.9K

Showing 1–10 of 43

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Tennessee Distribution

Tri-state Orthopaedics, LLC — 12 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Tennessee

Full comparison — all codes billed, vs. Tennessee median

43 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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…	335	3,760	610	$40	$202.3K
J7323	Hyaluronan or derivative, euflexxa, for intra-articular injection, per dose	1	10	3,790	$50	$198.7K
J3300	Injection, triamcinolone acetonide, preservative free, 1 mg	1	30	1,120	$110	$187.2K
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…	221	4,050	620	$30	$183.9K
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	56	350	1,060	$30	$173.8K
L0650	Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid…	3	30	120	$480	$132.6K
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…	74	1,080	120	$80	$90.7K
J7325	Hyaluronan or derivative, synvisc or synvisc-one, for intra-articular injection, 1 mg	1	10	100	$90	$90.1K
L1833	Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated, off-the shelf	1	10	160	$190	$72.3K
97140	Manual therapy is a form of physical therapy which uses the controlled movement and pressure of hands to treat various disorders of soft tissues and joints, eg, chronic back pain. Manual therapy…	125	170	530	$10	$67.8K

Showing 1–10 of 43

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Memphis Children's Clinic, PLLC	TN	Pediatrics Physician	$0	$27.7M
Memphis & Shelby County Ped. Group	TN	Pediatrics Physician	$0	$9.2M
Satellite Healthcare Of Pace Road LLC	TN	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$4M
Ob Gyn Centers Of Memphis,mpllc	TN	Obstetrics & Gynecology Physician	$0	$3M
Center For Oral And Facial Surgery	TN	Oral and Maxillofacial Surgery (Dentist)	$0	$2.9M
Isd Renal Inc	TN	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$2.5M
Ricky Robinson	TN	Podiatrist	$162.3K	$322.4K
Perisco Wofford	TN	Internal Medicine Physician	$117.8K	$75.5K
Ahsan Kathawala	TN	Internal Medicine Physician	$104.8K	$0
Dwight Dishmon	TN	Interventional Cardiology Physician	$92.2K	$0

Tri-state Orthopaedics, LLC — Billing Profile & Reimbursement Data

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Tri-state Orthopaedics, LLC — 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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