Fangyi Zhang, M.D.
Neurological Surgery Physician · Houston, TX 77030 · NPI 1619062254 · 1 payer file
132%of Medicare
Aetna — Texas (office visit and psychotherapy codes only) pays Fangyi Zhang, M.D. $127.21 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. The file lists 70 contract rows for this clinician and code, from $64.34 to $174.41; the median is shown.
Negotiated rates vs Medicare
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston neurological surgery physicians, same plan |
|---|---|---|---|---|---|
| 99213Office visit, established patient, low complexity | Aetna — Texas (office visit and psychotherapy codes only) | $127.21median of 70 rows · $64.34–$174.41 | $96.33 | 132% | above 82% of 124 Houston neurological surgery physicians on this plan |
| 99214Office visit, established patient, moderate complexity | Aetna — Texas (office visit and psychotherapy codes only) | $183.74median of 56 rows · $77.54–$246.79 | $137.41 | 134% | above 82% of 124 Houston neurological surgery physicians on this plan |
Also contracted — outside this specialty’s usual billing
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston neurological surgery physicians, same plan |
|---|---|---|---|---|---|
| 90833Psychotherapy, 30 minutes, add-on to an office visit | Aetna — Texas (office visit and psychotherapy codes only) | $104.36median of 12 rows · $92.08–$122.77 | $82.68 | 126% | not typically billed by neurological surgery physicians |
| 90838Psychotherapy, 60 minutes, add-on to an office visit | Aetna — Texas (office visit and psychotherapy codes only) | $215.24median of 8 rows · $197.78–$232.69 | $138.62 | 155% | not typically billed by neurological 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 Fangyi Zhang, M.D. performs these services, and they are kept out of the benchmark above.