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 & MedicaidDavid Macknet
    Ask Trek AI about this page

    David Macknet — Billing Profile & Reimbursement Data

    NPI 1891149910 · Fort Mill, SC · Orthopaedic Surgery Physician

    Customize your policy alerts

    Sign up for David Macknet — 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.

    David Macknet is a orthopaedic surgery physician provider located in Fort Mill, South Carolina. This profile covers 19 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
    OrganizationDavid Macknet
    Address601 S Sutton Rd
    CityFort Mill
    StateSC
    ZIP29715
    TaxonomyOrthopaedic Surgery Physician
    NPI EnumeratedApril 14, 2016

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

    Payer SourceTotal Paid
    Medicare$86K
    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.

    19 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    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…380$60$23.4K
    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…230$80$18.4K
    99204The 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…100$110$10.1K
    73630In this diagnostic procedure, the provider takes a minimum of three views of the foot to assess injury, fracture, arthritis, tumor, or congenital abnormality.380$20$8.8K
    27829In this procedure, the provider surgically repairs the disrupted ligaments of the tibiofibular joint and secures the tibia and the fibula with plates and screws, wires, or pins.20$290$5.8K
    73610In 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.190$30$4.7K
    99223The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…30$130$3.5K
    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…50$70$3.3K
    20605In this procedure, the provider inserts a needle through the skin of a patient and into an intermediate joint or bursa and then uses the syringe attachment to the needle to remove fluid or he may…40$40$1.7K
    99215The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…10$120$1.5K

    Showing 1–10 of 19

    Medicare: Competitive Analysis & Benchmarks

    How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 19 CPT/HCPCS codes.

    View: State1 / 2

    Full comparison — all codes billed, vs. state median

    19 rows

    CPT/HCPCS CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    992143,1317,860160$80$23.2K
    992131,0297,690100$60$10.8K
    992152,2182,36040$120$9.3K
    992231,3382,08040$130$8.3K
    992048584,52040$110$6.4K
    2782911010$320$4.8K
    992031,1362,97030$70$3.9K
    11055829050$50$3.6K
    2055021523040$40$2.2K
    7600092030$20$1.7K

    Showing 1–10 of 19

    Related Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Charlotte Eye Ear Nose & Throat Associates, P.A.NCOphthalmology Physician$0$20.4M
    OrthocarolinaNCOrthopaedic Surgery Physician$0$12.3M
    Russell GilchristNCInterventional Pain Medicine Physician$665.2K$0
    James MelvinMDOrthopaedic Surgery Physician$518.4K$0
    Mark KurdPAOrthopaedic Surgery Physician$505.1K$0
    Daniel BaluchFLOrthopaedic Surgery of the Spine Physician$456.3K$0
    Ronald SingerNCOrthopaedic Surgery Physician$380.5K$0
    Brian GladnickTXOrthopaedic Surgery Physician$372.8K$0
    Anthony KwonNCOrthopaedic Surgery Physician$371.3K$0
    David HoweNCOrthopaedic Surgery Physician$355.3K$0

    Nearby Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Fort Mill School District #4SCLocal Education Agency (LEA)$0$5.5M
    Carolinas Physicians Network IncSCPediatrics Physician$0$3M
    Therapy WorldSCOccupational Therapist$0$2.2M
    Barrett LittleSCOrthopaedic Surgery Physician$170.5K$3.2K
    Christopher JonesSCOtolaryngology Physician$140.1K$0
    Sunitha SequeiraSCOtolaryngology Physician$113K$0
    Michael RobertsSCPhysician Assistant$82.7K$0
    Benjamin SutkerSCOrthopaedic Hand Surgery Physician$80K$0
    South Carolina Cvs Pharmacy LLCSDPharmacy$76.9K$0
    Kevin McculloughSCPhysician Assistant$35K$0

    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. South Carolina Distribution
    David Macknet — 3 of 19 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — South Carolina