Jessica Mcgraw-heinrich, M.D.
Pediatric Orthopaedic Surgery Physician · Houston, TX 77030 · NPI 1275988586
121%of Medicare
BCBSTX pays Jessica Mcgraw-heinrich, M.D. $116.53 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 | $116.53 | $96.33 | 121% | above 40% of 16 Houston pediatric orthopaedic surgery physicians |
| 99214Office visit, established patient, moderate complexity | $123.69 | $137.41 | 90% | above 27% of 16 Houston pediatric orthopaedic surgery physicians |
Also contracted — outside this specialty’s usual billing
| Service | BCBSTX | Medicare | % | |
|---|---|---|---|---|
| 74177CT abdomen and pelvis, with contrast | $70.74 | $300.72 | 24% | 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 Jessica Mcgraw-heinrich, M.D. performs these services, and they are kept out of the benchmark above.