Aharon Gladstein, M.D.
Pediatric Orthopaedic Surgery Physician · Houston, TX 77094 · NPI 1124324058
54%of Medicare
BCBSTX pays Aharon Gladstein, M.D. $51.98 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 pediatric orthopaedic surgery physicians |
|---|---|---|---|---|
| 99213Office visit, established patient, low complexity | $51.98 | $96.33 | 54% | above 7% of 16 Houston pediatric orthopaedic surgery physicians |
| 99214Office visit, established patient, moderate complexity | $80.13 | $137.41 | 58% | above 7% of 16 Houston pediatric orthopaedic surgery physicians |
Also contracted — outside this specialty’s usual billing
| Service | BCBSTX | Medicare | % | |
|---|---|---|---|---|
| 72148MRI lumbar spine, without contrast | $159.58 | $192.38 | 83% | not typically billed by pediatric 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 Aharon Gladstein, M.D. performs these services, and they are kept out of the benchmark above.