Vasilios Mathews, M.D.
Orthopaedic Surgery Physician · Houston, TX 77030 · NPI 1104814532
84%of Medicare
BCBSTX pays Vasilios Mathews, M.D. $80.69 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.
Negotiated rates vs Medicare
| Service | BCBSTX | Medicare | % of Medicare | Among Houston orthopaedic surgery physicians |
|---|---|---|---|---|
| 99213Office visit, established patient, low complexity | $80.69 | $96.33 | 84% | above 73% of 119 Houston orthopaedic surgery physicians |
| 99214Office visit, established patient, moderate complexity | $118.20 | $137.41 | 86% | above 66% of 119 Houston orthopaedic surgery physicians |
Also contracted — outside this specialty’s usual billing
| Service | BCBSTX | Medicare | % | |
|---|---|---|---|---|
| 70553MRI brain, with and without contrast | $88.84 | $317.92 | 28% | not typically billed by orthopaedic surgery physicians |
| 72148MRI lumbar spine, without contrast | $159.58 | $192.38 | 83% | not typically billed by orthopaedic surgery physicians |
| 74177CT abdomen and pelvis, with contrast | $70.74 | $300.72 | 24% | not typically billed by orthopaedic surgery physicians |
| 77067Screening mammography, bilateral | $29.61 | $126.38 | 23% | not typically billed by orthopaedic 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 Vasilios Mathews, M.D. performs these services, and they are kept out of the benchmark above.