Public Medicare billing profile
Gregory Montalbano, MD
Orthopedic Surgery · Staten Island, NY · NPI 1487654273
Medicare allowed
$854,682
Services
19,947
Top 5 codes are
51%
51% of your Medicare revenue sits in five codes
That concentration is the useful part. It means a few percent of variance on a handful of codes moves real money, and it means checking whether you are being paid correctly is a small job rather than an audit of everything you bill.
| Code | Service | Volume | You charge | Medicare allows |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more | 1,029 | $460.63 | $138.33 |
| 20611 | Aspiration and/or injection of fluid large joint using ultrasound guidance | 846 | $1,774.11 | $119.53 |
| 97112 | Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes | 1,965 | $123.22 | $35.74 |
| J7321 | Hyaluronan or derivative, hyalgan, supartz or visco-3, for intra-articular injection, per dose | 884 | $201.98 | $69.19 |
| 97110 | Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes | 2,582 | $135.92 | $23.30 |
| 97140 | Therapy procedure using manual technique, each 15 minutes | 2,091 | $143.11 | $21.73 |
| 99213 | Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | 419 | $398.40 | $98.69 |
| 27447facility | Replacement of knee joint, both sides of knee | 24 | $19,475.06 | $1,351.49 |
Ranked by total Medicare allowed. Allowed amounts are already adjusted by CMS for your locality.
Here is what this does not tell you
CMS publishes what Medicare allowed you. It publishes nothing about what Aetna, Cigna, United or your Blues plan allowed for the same codes. Commercial contracts are conventionally written as a percentage of Medicare and normally sit above it, so the numbers in that table are a floor your commercial payers should clear.
Most practices have never checked. A claim paid at 70% of the allowable does not show up as a denial or land in anyone's work queue. It shows up as paid.
The report is free, needs no signup, and the file never leaves your browser. Open your network tab before you drop it and you will see no request.
Where these numbers come from
Medicare Physician & Other Practitioners, by Provider and Service, published by the Centers for Medicare & Medicaid Services. It is public data covering Part B fee-for-service claims. Service descriptions are CMS's own.
Nothing here is modelled and nothing is an estimate of what you could recover. The totals are sums of what CMS published for NPI 1487654273. Beneficiary counts overlap across codes, so we do not add them up.
If something is wrong or you would rather this page not exist, tell us and we will correct or remove it.