Homer Macapinlac, M.D.
Nuclear Radiology Physician · Houston, TX 77030 · NPI 1467546101
42%of Medicare
BCBSTX pays Homer Macapinlac, M.D. $134.59 for a 70553 — MRI brain, with and without contrast. Medicare pays $317.92 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 nuclear radiology physicians |
|---|---|---|---|---|
| 70553MRI brain, with and without contrast | $134.59 | $317.92 | 42% | above 38% of 17,053 all Houston clinicians |
| 74177CT abdomen and pelvis, with contrast | $125.18 | $300.72 | 42% | above 67% of 18,157 all Houston clinicians |
| 77067Screening mammography, bilateral | $44.86 | $126.38 | 35% | above 66% of 18,167 all Houston clinicians |
Also contracted — outside this specialty’s usual billing
| Service | BCBSTX | Medicare | % | |
|---|---|---|---|---|
| 99214Office visit, established patient, moderate complexity | $110.52 | $137.41 | 80% | not typically billed by nuclear radiology 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 Homer Macapinlac, M.D. performs these services, and they are kept out of the benchmark above.