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NPI 1992953749 · Washington, DC · Surgery Physician
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Jonathan Johnson is a surgery physician provider located in Washington, District of Columbia. This profile covers 16 Medicare and 5 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 | Jonathan Johnson |
| Address | 2112 F St Nw Ste 804 |
| City | Washington |
| State | DC |
| ZIP | 20037 |
| Taxonomy | Surgery Physician |
| NPI Enumerated | September 5, 2008 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $825K |
| Medicaid | $16.5K |
Provider is overwhelmingly Medicare-focused by revenue: total Medicare revenue is $825K versus total Medicaid revenue of $16.5K, so Medicare represents virtually all billed revenue in this profile and the provider should be treated as effectively single-payer driven for scale and risk analysis. This payer concentration magnifies the importance of the Medicare code mix when assessing business risk and network value.
Medicare revenue is highly concentrated in a small set of wound-care and skin-graft codes: the top 3 Medicare codes by revenue account for 85.2% of the provider's Medicare revenue. The three codes driving that share are Q4210 (44.1% of Medicare revenue), Q4173 (27.5%), and 97610 (13.6%), indicating a narrow revenue base dependent on a few procedural services.
Medicaid revenue is even more concentrated: the top 3 Medicaid codes by revenue account for 92.7% of the provider's Medicaid revenue. Those Medicaid top codes are nursing-facility E/M services (99308 at 62.1%, 99309 at 22.6%, and 99307 at 8.0%), showing that Medicaid billing is almost entirely from SNF/nursing-facility visits rather than procedural wound-care services.
The code mix indicates a core service line focused on advanced wound care and skin-substitute procedures combined with skilled nursing facility follow-up: high Medicare revenue shares for Q4210 (axolotl graft), Q4173 (palingen add-on), and 97610 (low-frequency ultrasound) point to an outpatient or clinic-based wound care program that also bills debridement and skin substitute codes such as 15271 and 11042. At the same time, frequent billing of 99308/99309/99307 under Medicaid and Medicare reflects ongoing nursing-facility follow-up activity.
Competitive standing on Medicare is modest rather than dominant for the major procedures: Q4210 ranks #9 of 14 nationally (38th percentile; typical, unremarkable volume for this code) and Q4173 ranks #14 of 19 nationally (28th percentile; typical, unremarkable volume for this code), while 97610 is comparatively stronger at rank #102 of 320 (68th percentile; typical, unremarkable volume for this code). These ranks suggest the provider operates at typical volumes on these services and is not a leading national provider for the highest-revenue Medicare codes.
State-level Medicaid competitiveness is limited: the top Medicaid code 99308 ranks #25 of 38 in-state (35th percentile; typical, unremarkable volume for this code) and 99309 ranks #28 of 37 (25th percentile; typical, unremarkable volume for this code), indicating modest participation in the in-state nursing-facility E/M market rather than a major Medicaid presence. The provider’s Medicaid volumes and ranks suggest it is a minor-to-moderate player in the state for SNF visits.
Provider tenure is long enough to signal an established practice: the NPI was enumerated on 2008-09-05 (~18 years ago), which supports the interpretation that current patterns reflect sustained clinical focus rather than a brief or new entrant billing spike. This longevity strengthens confidence that the observed concentration in wound-care procedural codes and nursing-facility E/M is persistent.
There are a few low-volume, specialized codes on file but they do not substantially change the business profile: codes such as 0598T (rank #150 of 152 nationally; 1th percentile; typical, unremarkable volume for this code) and 11043 (rank #2002 of 2062 nationally; 2th percentile; typical, unremarkable volume for this code) appear at low revenue levels. Those entries indicate occasional use of niche imaging or deep debridement services, but the provider’s financial picture remains driven by the top wound-care graft and ultrasound codes and by nursing-facility E/M billing.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
16 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| Q4210 | Axolotl graft or axolotl dualgraft, per square centimeter | 560 | $650 | $363.8K |
| Q4173 | Palingen or palingen xplus, per square centimeter (add-on, list separately in addition to primary procedure) | 590 | $380 | $226.7K |
| 97610 | The provider uses a low–frequency ultrasound device to try to improve wound healing. | 260 | $430 | $112.6K |
| 99308 | The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a low level of medical decision making and/or the provider… | 550 | $60 | $34.6K |
| 99309 | The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or the provider… | 270 | $90 | $23.8K |
| 99305 | The provider sees a patient for an initial nursing facility care visit involving evaluation and management (E/M). The visit involves moderate medical decision making or the provider spends at least… | 170 | $110 | $18.3K |
| 15271 | The provider uses a skin substitute, such as an allograft or xenograft, to cover wounds on the patient’s trunk, arms, and/or legs up to an area of 100 cm2. This code covers up to the first 25 cm2. | 90 | $140 | $12.5K |
| 11042 | The provider uses surgical instruments to remove the dead tissue in skin down to the subcutaneous layer and including the epidermis and dermis, up to the first 20 cm2. | 130 | $70 | $9.8K |
| 99307 | The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making or the… | 160 | $30 | $5.4K |
| 99222 | The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or… | 30 | $110 | $3.8K |
Showing 1–10 of 16
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 16 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
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.
5 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 99308 | The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a low level of medical decision making and/or the provider… | 190 | $50 | $10.2K |
| 99309 | The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or the provider… | 70 | $60 | $3.7K |
| 99307 | The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making or the… | 40 | $30 | $1.3K |
| 11042 | The provider uses surgical instruments to remove the dead tissue in skin down to the subcutaneous layer and including the epidermis and dermis, up to the first 20 cm2. | 20 | $50 | $800 |
| 17250 | The provider cauterizes granulation tissue using chemicals like silver nitrate or potassium hydroxide to heal the injured tissue. | 10 | $30 | $400 |
How this provider's Medicaid billing volume and revenue compare to other District of Columbia providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. District of Columbia median
5 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 11042 | The provider uses surgical instruments to remove the dead tissue in skin down to the subcutaneous layer and including the epidermis and dermis, up to the first 20 cm2. | 13 | 10 | 190 | $240 | $205.3K |
| 99309 | The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or the provider… | 28 | 40 | 710 | $30 | $75.8K |
| 99308 | The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a low level of medical decision making and/or the provider… | 25 | 40 | 490 | $20 | $54.6K |
| 99307 | The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making or the… | 12 | 10 | 240 | $10 | $5.4K |
| 17250 | The provider cauterizes granulation tissue using chemicals like silver nitrate or potassium hydroxide to heal the injured tissue. | 2 | 10 | 10 | $90 | $2.1K |
Other providers in the same ZIP code as Jonathan Johnson, ranked by combined Medicare and Medicaid revenue.
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