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NPI 1891800033 · Durham, NC · Urology Physician
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Neil Grafstein is a urology physician provider located in Durham, North Carolina. This profile covers 17 Medicare and 4 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.
Provider details (source: NPPES NPI Registry)
| Field | Value |
|---|---|
| Entity Type | Individual |
| Organization | Neil Grafstein |
| Address | 4101 N Roxboro St |
| City | Durham |
| State | NC |
| ZIP | 27704 |
| Taxonomy | Urology Physician |
| NPI Enumerated | August 20, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $145.3K |
| Medicaid | $8.6K |
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
17 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 51729 | In this procedure, the provider performs a complex cystometrogram along with voiding pressure studies and urethral pressure profile studies to diagnose certain urinary disorders like an overactive… | 70 | $360 | $25.8K |
| 52000 | In this procedure, the provider performs an examination of the interior of the bladder, the urethra, and the ureteric openings by means of a cystourethroscope, a thin flexible or rigid tube with a… | 110 | $210 | $24.1K |
| 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… | 300 | $80 | $24K |
| 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… | 170 | $110 | $18.5K |
| 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… | 130 | $140 | $17.4K |
| 51797 | Voiding pressure (sometimes referred to as leak point pressure) measures contractions of the detrusor muscle and can detect a pressure obstruction if the patient is able to void, or express, urine. | 70 | $190 | $13.1K |
| 51705 | In this procedure, the provider performs a simple removal of a tube that he previously places into a patient’s bladder and replaces it with a new tube through the same incision. | 70 | $90 | $6K |
| 51702 | The bladder catheter CPT® codes provide options for reporting the procedures that best reflect the exact anatomic location of a catheter insertion, the type of catheter inserted, and, in some cases,… | 70 | $60 | $4K |
| 51701 | In this procedure, the provider places a non–indwelling catheter into the bladder via the urethra for the purpose of intermittent catheterization or catheterization to obtain residual urine left… | 70 | $40 | $2.9K |
| 51784 | This test measures the electrical activity in the anal or urethral sphincter muscles. | 80 | $30 | $2.4K |
Showing 1–10 of 17
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 17 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
17 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| 99214 | 6,742 | 18,060 | 110 | $80 | $15.1K |
| 52000 | 60 | 280 | 70 | $150 | $12.1K |
| 51729 | 6 | 30 | 30 | $240 | $10.1K |
| 99213 | 1,648 | 16,320 | 70 | $50 | $7.1K |
| 36415 | 2,302 | 3,490 | 90 | $10 | $6.4K |
| 99204 | 469 | 8,430 | 30 | $110 | $4.8K |
| 51797 | 6 | 70 | 20 | $120 | $4K |
| 99203 | 3,873 | 5,450 | 30 | $70 | $3.1K |
| 51705 | 9 | 50 | 30 | $60 | $2.6K |
| 99212 | 1,582 | 2,890 | 30 | $30 | $2.1K |
Showing 1–10 of 17
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
View: By Year1 / 3
Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
4 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | 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… | 320 | $20 | $6.5K |
| 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… | 60 | $40 | $2.2K |
| 1036F | N/A | 620 | $0 | $0 |
| 99072 | The provider uses items, supplies materials, or requires clinical staff time in excess of what is normally used or provided for an office visit or other nonfacility encounter. These additional items… | 30 | $0 | $0 |
How this provider's Medicaid billing volume and revenue compare to other North Carolina providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. North Carolina median
4 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… | 3,794 | 4,400 | 960 | $60 | $271.3K |
| 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… | 2,516 | 4,130 | 670 | $50 | $219.9K |
| 99072 | The provider uses items, supplies materials, or requires clinical staff time in excess of what is normally used or provided for an office visit or other nonfacility encounter. These additional items… | 148 | 180 | 180 | $1 | $400 |
| 1036F | N/A | 138 | 390 | 250 | $1 | $1 |
Other providers in the same ZIP code as Neil Grafstein, ranked by combined Medicare and Medicaid revenue.
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