Rafi Bidros, M.D.
Plastic and Reconstructive Surgery Physician · Houston, TX 77024 · NPI 1932373073 · 1 payer file
71%of Medicare
Aetna — Texas (office visit and psychotherapy codes only) pays Rafi Bidros, M.D. $68.42 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 34 contract rows for this clinician and code, from $53.95 to $80.50; the median is shown.
Negotiated rates vs Medicare
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston plastic and reconstructive surgery physicians, same plan |
|---|---|---|---|---|---|
| 99213Office visit, established patient, low complexity | Aetna — Texas (office visit and psychotherapy codes only) | $68.42median of 34 rows · $53.95–$80.50 | $96.33 | 71% | above 3% of 66 Houston plastic and reconstructive surgery physicians on this plan |
| 99214Office visit, established patient, moderate complexity | Aetna — Texas (office visit and psychotherapy codes only) | $99.31median of 38 rows · $79.48–$116.82 | $137.41 | 72% | above 3% of 66 Houston plastic and reconstructive surgery physicians on this plan |
Also contracted — outside this specialty’s usual billing
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston plastic and reconstructive surgery physicians, same plan |
|---|---|---|---|---|---|
| 90833Psychotherapy, 30 minutes, add-on to an office visit | Aetna — Texas (office visit and psychotherapy codes only) | $65.67median of 18 rows · $57.93–$77.26 | $82.68 | 79% | not typically billed by plastic and reconstructive surgery physicians |
| 90838Psychotherapy, 60 minutes, add-on to an office visit | Aetna — Texas (office visit and psychotherapy codes only) | $115.60median of 12 rows · $102.01–$136.02 | $138.62 | 83% | not typically billed by plastic and reconstructive 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 Rafi Bidros, M.D. performs these services, and they are kept out of the benchmark above.