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    v1.0.28
    OpenPayerNPI Medicare & MedicaidMickey Plymale
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    Mickey Plymale — Billing Profile & Reimbursement Data

    NPI 1972809192 · Lexington, SC · Sports Medicine (Orthopaedic Surgery) Physician

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    Mickey Plymale is a sports medicine (orthopaedic surgery) physician provider located in Lexington, South Carolina. This profile covers 18 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
    OrganizationMickey Plymale
    Address104 Saluda Pointe Dr
    CityLexington
    StateSC
    ZIP29072
    TaxonomySports Medicine (Orthopaedic Surgery) Physician
    NPI EnumeratedFebruary 4, 2011

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

    Payer SourceTotal Paid
    Medicare$123.4K
    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.

    18 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    27245In this procedure, the provider performs an open treatment of a femoral fracture between, around, or below the trochanters. He fixes the fracture using an intramedullary implant, or an implant the…30$930$23.3K
    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…240$90$20.6K
    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…330$60$19.5K
    20610In this procedure, the provider inserts a needle through the skin of a patient and into a major joint or bursa and then uses the syringe attachment to the needle to remove fluid or he may inject a…240$50$11.3K
    27236In this procedure, the provider performs an open treatment of a femur neck fracture, or a fracture in the upper end of the femur. He uses internal fixation implants such as pins, wires, or screws to…10$900$9.9K
    99203The 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…130$70$9.8K
    J7326Hyaluronan or derivative, gel-one, for intra-articular injection, per dose20$400$7.6K
    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$130$5K
    73564In this procedure, the provider takes four or more X–ray views of the knee joint to check for any fracture, swelling, or reason for pain in the knee area.150$30$4.6K
    73030This particular procedure is for a minimum of 2 X–ray views of the complete shoulder.140$20$3.2K

    Showing 1–10 of 18

    Medicare: Competitive Analysis & Benchmarks

    How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 18 CPT/HCPCS codes.

    View: State1 / 2

    Full comparison — all codes billed, vs. state median

    18 rows

    CPT/HCPCS CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    J7326445070$400$31.2K
    992142,9967,860160$80$23.2K
    2724575020$790$15.8K
    27236334010$810$14.5K
    992131,2197,690100$60$10.8K
    992231,0242,08040$130$8.3K
    2061016181070$50$7.3K
    992032922,97030$70$3.9K
    735646344040$30$2.1K
    7356223047050$20$1.9K

    Showing 1–10 of 18

    Related Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Prisma Health University Medical GroupSCFamily Medicine Physician$0$171.7M
    Prisma Health Medical Group-midlandsSCMulti-Specialty Clinic/Center$0$77.6M
    Prisma Health-midlandsSCGeneral Acute Care Hospital$0$74.6M
    Prisma Health-midlandsSCGeneral Acute Care Hospital$0$68.3M
    Centra Medical Group, LLCVAFamily Medicine Physician$0$60.1M
    Prisma Health-midlandsSCGeneral Acute Care Hospital$0$28.1M
    The Regional Medical Center Of Orangeburg And Calhoun CountiesSCGeneral Acute Care Hospital$0$25.7M
    Prisma Health-midlandsSCGeneral Acute Care Hospital$0$11.8M
    Medical University Hospital AuthoritySCGeneral Acute Care Hospital$0$8.7M
    Prisma Health Medical Group-midlandsSCOrthopaedic Surgery Physician$0$8.7M

    Nearby Providers

    Other providers in the same ZIP code as Mickey Plymale, 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
    Mickey Plymale — 0 of 18 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — South Carolina