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    OpenPayerNPI Medicare & MedicaidRoscoe Nelson
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    Roscoe Nelson — Billing Profile & Reimbursement Data

    NPI 1962487462 · American Fork, UT · Urology Physician

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    Roscoe Nelson is a urology physician provider located in American Fork, Utah. This profile covers 24 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
    OrganizationRoscoe Nelson
    Address1159 E 200 N Ste 300
    CityAmerican Fork
    StateUT
    ZIP84003
    TaxonomyUrology Physician
    NPI EnumeratedDecember 7, 2005

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

    Payer SourceTotal Paid
    Medicare$193.9K
    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.

    24 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…770$80$64.3K
    51728In this procedure, the provider performs a complex cystometrogram along with voiding pressure studies to diagnose certain urinary disorders like an overactive bladder, stress incontinence, or urinary…140$260$35.8K
    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…290$60$16.7K
    0421TN/A30$530$13.7K
    52000In 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…190$70$13.6K
    76770A retroperitoneal ultrasound is a noninvasive procedure used to assess the body parts within the abdomen (i.e.Kidneys, urinary bladder, and aorta). This particular code is used when the ultrasound is…150$80$11K
    50590Extracorporeal shock wave lithotripsy (ESWL) is a procedure used to destroy calculus (kidney stones) in the kidneys and ureters.20$440$7.4K
    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…70$100$7.3K
    52224The provider inspects the urethra, prostatic urethra (in men), the interior of the bladder, and ureteric openings using a cystoscope passed through the urethra and into the bladder; he destroys…20$150$3.4K
    52234The provider inspects the urethra, prostatic urethra (in men), the interior of the bladder, and ureteric openings using a cystoscope passed through the urethra and into the bladder; he destroys…10$190$2.4K

    Showing 1–10 of 24

    Medicare: Competitive Analysis & Benchmarks

    How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 24 CPT/HCPCS codes.

    View: State1 / 2

    Full comparison — all codes billed, vs. state median

    24 rows

    CPT/HCPCS CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    50590152020$590$14.1K
    0421T11030$530$13.7K
    5200046060$150$12.6K
    99214724,08080$80$11.6K
    5221421020$410$8.1K
    5172811020$240$7.3K
    992133173,68060$50$6.4K
    992042181,79030$100$4.1K
    55700104020$160$3.7K
    5228131020$200$3.6K

    Showing 1–10 of 24

    Related Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Arizona Oncology Associates PCAZSpecialist$0$13.9M
    Ironwood Physicians, PCAZHematology & Oncology Physician$0$7.3M
    Granger Medical Clinic PCUTMulti-Specialty Clinic/Center$0$5.1M
    Rakesh BagaiAZHematology & Oncology Physician$4.6M$0
    Iyad HamarnehAZMedical Oncology Physician$3.5M$0
    Peter MathernAZMedical Oncology Physician$3M$0
    Douglas MehrUTRetina Specialist (Ophthalmology) Physician$2.7M$0
    Alan LangerakAZHematology & Oncology Physician$2.7M$0
    Charles TaylorOKHematology & Oncology Physician$2.3M$0
    Allan Espinosa MorazanAZMedical Oncology Physician$2.2M$0

    Nearby Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Ihc Health Services, Inc.UTGeneral Acute Care Hospital$0$17.2M
    Alpine School DistrictUTLocal Education Agency (LEA)$0$8.4M
    Star KidsUTHome Health Agency$0$5M
    American Fork City CorporationUTLand Ambulance$188.3K$2.8M
    Alliance Youth ServicesUTFoster Care Agency$0$2.5M
    Smith And Macdonald Pediatric DentistryUTPediatric Dentistry$0$2.3M
    North Valley Emergency Physicians LcUTEmergency Medical Services (Emergency Medicine) Physician$0$1.5M
    Michael WhitingUTPediatric Adolescent Medicine Physician$0$827.1K
    Chad GollaherUTPediatric Dentistry$0$759.4K
    David MacdonaldUTPediatric Dentistry$0$729.9K

    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. Utah Distribution
    Roscoe Nelson — 4 of 24 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Utah