Marc Stock, DPM
Podiatrist · Houston, TX 77030 · NPI 1215954714
54%of Medicare
BCBSTX pays Marc Stock, DPM $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 podiatrists |
|---|---|---|---|---|
| 99213Office visit, established patient, low complexity | $51.98 | $96.33 | 54% | above 12% of 52 Houston podiatrists |
| 99214Office visit, established patient, moderate complexity | $80.13 | $137.41 | 58% | above 2% of 52 Houston podiatrists |
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 podiatrists |
| 77067Screening mammography, bilateral | $29.61 | $126.38 | 23% | not typically billed by podiatrists |
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 Marc Stock, DPM performs these services, and they are kept out of the benchmark above.