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    OpenPayerNPI Medicare & MedicaidJames Jackson
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    James Jackson — Billing Profile & Reimbursement Data

    NPI 1912165234 · Lexington, SC · Orthopaedic Surgery Physician

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    James Jackson is a orthopaedic surgery physician provider located in Lexington, South Carolina. This profile covers 14 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.

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    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeIndividual
    OrganizationJames Jackson
    Address104 Saluda Pointe Dr
    CityLexington
    StateSC
    ZIP29072
    TaxonomyOrthopaedic Surgery Physician
    NPI EnumeratedMay 23, 2008

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

    Payer SourceTotal Paid
    Medicare$64.7K
    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.

    14 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    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…200$90$18.9K
    28011In this procedure, the provider performs a percutaneous tenotomy in which he incises or divides multiple tendons in a toe through a small incision in the skin to correct deformity like hammer toe.120$130$15.2K
    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…110$60$6.7K
    73630In this diagnostic procedure, the provider takes a minimum of three views of the foot to assess injury, fracture, arthritis, tumor, or congenital abnormality.250$20$5.5K
    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…40$120$4.8K
    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.160$30$3.9K
    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…30$100$2.5K
    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…20$140$2.2K
    20604In this procedure, the provider inserts a needle through the skin of a patient and into a small joint or bursa, typically the fingers or toes, and then uses the syringe attachment to the needle to…30$60$1.6K
    29405The provider applies a cast to the lower leg to treat a fracture of one or both bones of the lower leg, the tibia and fibula, or a severe ankle sprain. The short leg cast extends from just below the…20$60$1.1K

    Showing 1–10 of 14

    Medicare: Competitive Analysis & Benchmarks

    How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 14 CPT/HCPCS codes.

    View: State1 / 2

    Full comparison — all codes billed, vs. state median

    14 rows

    CPT/HCPCS CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    992143,3967,860160$80$23.2K
    992133,4747,690100$60$10.8K
    992151,9732,36040$120$9.3K
    992231,0242,08040$130$8.3K
    2801111020$150$7.8K
    992043,0224,52040$110$6.4K
    992032,8532,97030$70$3.9K
    20604102030$60$3.4K
    736303759040$20$1.3K
    29405102020$60$1.3K

    Showing 1–10 of 14

    Related Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    The Regional Medical Center Of Orangeburg And Calhoun CountiesSCGeneral Acute Care Hospital$0$25.7M
    Medical University Hospital AuthoritySCGeneral Acute Care Hospital$0$8.7M
    Andrew McgownSCSports Medicine (Family Medicine) Physician$758K$0
    Gregory GrabowskiSCOrthopaedic Surgery of the Spine Physician$239K$0
    Matthew PollackSCSports Medicine (Family Medicine) Physician$186K$0
    William WesterkamSCPhysical Medicine & Rehabilitation Physician$182.1K$0
    David KoonSCOrthopaedic Surgery Physician$152.8K$0
    Vann Beth ShulerSCFamily Medicine Physician$135.9K$0
    Ali-reza GolshayanNCHematology (Internal Medicine) Physician$128.4K$0
    Mickey PlymaleSCSports Medicine (Orthopaedic Surgery) Physician$123.4K$0

    Nearby Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Southern Medical Management, LLCSCPediatrics Physician$0$43.9M
    Allcaregivers, Inc.SCNursing Care Agency$0$33.3M
    South Carolina Dept Of Mental Health Accounting OfficeSCMental Health Clinic/Center (Including Community Mental Health Center)$0$32M
    Lexington County EmsSCAmbulance$2.9M$6.9M
    Lexington Health IncSCUrgent Care Clinic/Center$0$8.7M
    Key Care Health Services, LLCSCHome Health Agency$0$8.5M
    Capital City Therapy Group, LLCSCSpecialist$0$7.3M
    Health Promotion SpecialistsSCDental Hygienist$0$6.5M
    Lexington School District OneSCLocal Education Agency (LEA)$0$5.7M
    Lexington Health IncSCPediatric Adolescent Medicine Physician$0$5.7M

    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
    James Jackson — 2 of 14 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — South Carolina