Sherri Birchansky, M.D.
Neuroradiology Physician · Houston, TX 77047 · NPI 1073520540
60%of Medicare
BCBSTX pays Sherri Birchansky, M.D. $190.74 for a 70553 — MRI brain, with and without contrast. Medicare pays $317.92 for the same service in this locality. Commercial insurance is widely assumed to pay above Medicare.
Negotiated rates vs Medicare
| Service | BCBSTX | Medicare | % of Medicare | Among Houston neuroradiology physicians |
|---|---|---|---|---|
| 70553MRI brain, with and without contrast | $190.74 | $317.92 | 60% | above 40% of 21 Houston neuroradiology physicians |
| 72148MRI lumbar spine, without contrast | $123.04 | $192.38 | 64% | above 45% of 21 Houston neuroradiology physicians |
| 74177CT abdomen and pelvis, with contrast | $113.29 | $300.72 | 38% | above 5% of 21 Houston neuroradiology physicians |
| 77067Screening mammography, bilateral | $263.99 | $126.38 | 209% | above 90% of 21 Houston neuroradiology physicians |
Also contracted — outside this specialty’s usual billing
| Service | BCBSTX | Medicare | % | |
|---|---|---|---|---|
| 99213Office visit, established patient, low complexity | $134.22 | $96.33 | 139% | not typically billed by neuroradiology physicians |
| 99214Office visit, established patient, moderate complexity | $80.13 | $137.41 | 58% | not typically billed by neuroradiology physicians |
A payer’s file carries a rate for every code in the contract’s fee class, whether or not the clinician will ever bill it. These rows are real, and they are how the fee class shows through — but they are not evidence that Sherri Birchansky, M.D. performs these services, and they are kept out of the benchmark above.