Why are Medicare and Medicaid shown separately instead of combined?

They come from two different CMS data sources with no shared claim identifier, so they can't be reconciled into one number without double-counting or guessing. Every table and chart on this page keeps them fully separate.

Why is there no private/commercial revenue figure?

Private and commercial payer data comes from Transparency in Coverage files, which only publish negotiated rates — not claims or utilization volume. Without a volume figure, no revenue number can be computed for any provider from that data.

What does "Rank" mean in the Competitive Analysis & Benchmarks tables?

For a given CPT/HCPCS code, it's this provider's position by claims volume among all providers billing that same code at that geography level (State, National, or Michigan for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Michigan only?

Medicaid is administered per-state with no single national fee schedule, so a state or national comparison the way Medicare has one isn't available. Michigan (this provider's own state) is the only grouping that's conceptually meaningful.

Why are the numbers rounded to the nearest 10?

To avoid implying more precision than the underlying data supports at a single-provider level. Ratios are kept precise since they're a relative comparison, not a volume or dollar figure.

How current is this data?

The Medicare and Medicaid tables are both single current snapshots, not refreshed on a recurring schedule yet.

Orthopaedic Associates Of Muskegon, PC (NPI 1972566594)

Orthopaedic Associates Of Muskegon, PC is a orthopaedic surgery physician provider located in Muskegon, Michigan. This profile covers 0 Medicare and 91 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Medicaid: Complete Services Breakdown

Field	Value
Entity Type	Organization
Organization	Orthopaedic Associates Of Muskegon, PC
Address	1400 Mercy Dr
City	Muskegon
State	MI
ZIP	49444
Taxonomy	Orthopaedic Surgery Physician
NPI Enumerated	April 7, 2006

Payer Source	Total Paid
Medicaid	$7.1M
Medicare	$0

Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.

91 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…	33,360	$40	$1.4M
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…	18,540	$60	$1.1M
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…	10,980	$60	$636.7K
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…	6,750	$90	$580.8K
64483	This procedure is the injection of an anesthetic agent and/or steroid in the form of a transforaminal epidural injection into a single level (either lumbar or sacral).	3,360	$110	$369.2K
L4361	Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf	1,840	$170	$305.6K
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	9,630	$30	$240.8K
L3984	Upper extremity fracture orthosis, wrist, prefabricated, includes fitting and adjustment	950	$200	$194.4K
95886	The provider assesses the electrical activity of a muscle in the extremity and related paraspinal areas. At the same session as a separately reportable nerve conduction study. He studies five or more…	2,890	$60	$161.7K
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,…	6,460	$30	$161.5K

Showing 1–10 of 91

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other Michigan providers billing the same CPT/HCPCS codes.

Claims Volume vs. Michigan Distribution

Orthopaedic Associates Of Muskegon, PC — 9 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Michigan

Full comparison — all codes billed, vs. Michigan median

91 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
27447	In this procedure, the provider replaces the damaged weight bearing surfaces of both the medial and lateral compartments in the knee joint using implants of metal or other strong materials. The…	3	10	30	$1,930	$660.8K
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…	177	4,380	1,000	$70	$289.9K
97530	The provider uses various activities during direct contact with the patient to improve the patient’s functional performance. Use this code for each 15 minutes of activity.	232	390	1,660	$40	$281.8K
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…	139	4,770	1,060	$50	$247.8K
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	131	550	2,350	$30	$240.6K
L3809	Wrist hand finger orthosis, without joint(s), prefabricated, off-the-shelf, any type	15	20	260	$120	$174.4K
97112	Neuromuscular reeducation is a therapeutic treatment (exercise) performed by a physician in an attempt to reduce impairments and restore function through the application of clinical skills and/or…	163	360	1,410	$20	$136.3K
64483	This procedure is the injection of an anesthetic agent and/or steroid in the form of a transforaminal epidural injection into a single level (either lumbar or sacral).	4	70	190	$150	$122.9K
99223	The 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…	485	760	240	$100	$121.4K
L3984	Upper extremity fracture orthosis, wrist, prefabricated, includes fitting and adjustment	2	10	700	$200	$116.8K

Showing 1–10 of 91

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Tyler Voss	MI	Family Medicine Physician	$587.7K	$0
Anthony Bozzio	MI	Orthopaedic Surgery Physician	$297.9K	$0
Joshua Anderson	MI	Adult Reconstructive Orthopaedic Surgery Physician	$273.2K	$0
Lindsay Rudert	MI	Family Medicine Physician	$250.9K	$0
Todd Galdes	MI	Adult Reconstructive Orthopaedic Surgery Physician	$176.8K	$0
Yousif Hamati	MI	Orthopaedic Surgery Physician	$145.1K	$0
Katie Mccausland	MI	Physical Medicine & Rehabilitation Physician	$144.1K	$0
Mark Moulton	MI	Orthopaedic Surgery Physician	$138.9K	$0
Adam Geller	MI	Physician Assistant	$129.4K	$0
Scott Nemec	MI	Orthopaedic Surgery Physician	$123.5K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Moka Corporation	MI	Intellectual and/or Developmental Disabilities Residential Treatment Facility	$0	$126.2M
Mercy Health Partners	MI	General Acute Care Hospital	$0	$98.1M
Senior Resources Of West Michigan	MI	Case Management Agency	$0	$31.5M
Mgh Family Health Center	MI	Federally Qualified Health Center (FQHC)	$0	$24.4M
Hackley Community Care Center Inc	MI	Federally Qualified Health Center (FQHC)	$0	$23.1M
Port City Pediatrics	MI	Pediatrics Physician	$0	$5.9M
Radiology Muskegon PC	MI	Diagnostic Radiology Physician	$0	$5.9M
Mercy Specialty Services	MI	Internal Medicine Physician	$0	$5.3M
Paul Raphaelian	MI	Retina Specialist (Ophthalmology) Physician	$1.5M	$0
Muskegon Sc, LLC	MI	Ambulatory Surgical Clinic/Center	$967.6K	$68.1K

Orthopaedic Associates Of Muskegon, PC — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

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