Loading...
NPI 1962400879 · New York, NY · Urology Physician
Customize your policy alerts
Get alerted when relevant policies change without checking for updates manually.
Monitor payer policy activity
Robert Valenzuela is a urology physician provider located in New York, New York. This profile covers 7 Medicare and 10 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 | Robert Valenzuela |
| Address | 286 Fort Washington Ave |
| City | New York |
| State | NY |
| ZIP | 10032 |
| Taxonomy | Urology Physician |
| NPI Enumerated | July 13, 2005 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $45.5K |
| Medicare | $31.7K |
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
7 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 54405 | The provider inserts inflatable synthetic material for a multicomponent, inflatable penile prosthesis into the penis of the patient. The provider also places a pump, the cylinders, and a reservoir… | 20 | $710 | $12.7K |
| 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… | 70 | $110 | $7K |
| 54360 | The provider surgically repairs the angulation, or abnormal curvature, of the penis of the patient. | 10 | $340 | $4.4K |
| 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… | 60 | $70 | $4.1K |
| 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… | 20 | $110 | $2.5K |
| 54235 | The provider injects pharmacologic agents such as papaverine, phentolamine, or prostaglandin E1 into the corpora cavernosa of the penis. He performs this procedure to treat patients with erectile… | 20 | $30 | $630 |
| 36415 | In this procedure, the provider inserts a needle into a vein to collect a blood sample. | 40 | $10 | $350 |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 7 CPT/HCPCS codes.
View: State1 / 2
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.
10 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… | 1,330 | $20 | $29.3K |
| 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… | 300 | $30 | $9.6K |
| 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… | 50 | $70 | $3.5K |
| 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… | 50 | $30 | $1.6K |
| 99490 | The clinical staff provides services directed by the provider to support and coordinate a patient’s care across multiple disciplines. The patient has two or more chronic conditions that place the… | 110 | $10 | $1.3K |
| 99212 | The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,… | 70 | $10 | $740 |
| 76857 | A pelvic ultrasound is a noninvasive procedure used to assess one or more pelvic structures, such as bladder, ovaries, uterus, cervix, and fallopian tubes in females and the bladder, prostate gland,… | 20 | $20 | $340 |
| 1036F | N/A | 580 | $0 | $0 |
| 36415 | In this procedure, the provider inserts a needle into a vein to collect a blood sample. | 160 | $0 | $0 |
| G8427 | Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications | 10 | $0 | $0 |
How this provider's Medicaid billing volume and revenue compare to other New York providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. New York median
10 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… | 5,863 | 19,110 | 360 | $70 | $321K |
| 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… | 7,381 | 16,550 | 220 | $90 | $186.8K |
| 99212 | The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,… | 3,595 | 5,420 | 210 | $70 | $154.3K |
| 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… | 3,105 | 4,700 | 130 | $100 | $136.6K |
| 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… | 2,367 | 3,820 | 100 | $130 | $99.7K |
| 36415 | In this procedure, the provider inserts a needle into a vein to collect a blood sample. | 3,266 | 5,090 | 450 | $10 | $35.9K |
| 76857 | A pelvic ultrasound is a noninvasive procedure used to assess one or more pelvic structures, such as bladder, ovaries, uterus, cervix, and fallopian tubes in females and the bladder, prostate gland,… | 156 | 200 | 80 | $40 | $25.7K |
| 99490 | The clinical staff provides services directed by the provider to support and coordinate a patient’s care across multiple disciplines. The patient has two or more chronic conditions that place the… | 726 | 1,110 | 230 | $10 | $12.1K |
| G8427 | Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications | 1,864 | 2,000 | 210 | $1 | $90 |
| 1036F | N/A | 488 | 1,770 | 150 | $1 | $50 |
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.