Robert Kress, D.O.
Colon & Rectal Surgery Physician · Houston, TX 77030 · NPI 1083068803 · 1 payer file
120%of Medicare
Aetna — Texas (office visit and psychotherapy codes only) pays Robert Kress, D.O. $115.95 for a 99213 — Office visit, established patient, low complexity. Medicare pays $96.33 for the same service in this locality. Commercial insurance is widely assumed to pay above Medicare. The file lists 36 contract rows for this clinician and code, from $85.43 to $157.32; the median is shown.
Negotiated rates vs Medicare
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston colon & rectal surgery physicians, same plan |
|---|---|---|---|---|---|
| 99213Office visit, established patient, low complexity | Aetna — Texas (office visit and psychotherapy codes only) | $115.95median of 36 rows · $85.43–$157.32 | $96.33 | 120% | above 88% of 33 Houston colon & rectal surgery physicians on this plan |
| 99214Office visit, established patient, moderate complexity | Aetna — Texas (office visit and psychotherapy codes only) | $166.99median of 24 rows · $125.78–$221.70 | $137.41 | 122% | above 88% of 33 Houston colon & rectal surgery physicians on this plan |
Also contracted — outside this specialty’s usual billing
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston colon & rectal surgery physicians, same plan |
|---|---|---|---|---|---|
| 90833Psychotherapy, 30 minutes, add-on to an office visit | Aetna — Texas (office visit and psychotherapy codes only) | $117.66median of 24 rows · $97.71–$146.55 | $82.68 | 142% | not typically billed by colon & rectal surgery 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 Robert Kress, D.O. performs these services, and they are kept out of the benchmark above.