Paige Wheaton, PA-C, ATC
Surgical Physician Assistant · Houston, TX 77030 · NPI 1952996852
54%of Medicare
BCBSTX pays Paige Wheaton, PA-C, ATC $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 surgical physician assistants |
|---|---|---|---|---|
| 99213Office visit, established patient, low complexity | $51.98 | $96.33 | 54% | above 89% of 159 Houston surgical physician assistants |
| 99214Office visit, established patient, moderate complexity | $80.13 | $137.41 | 58% | above 4% of 159 Houston surgical physician assistants |
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 surgical physician assistants |
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 Paige Wheaton, PA-C, ATC performs these services, and they are kept out of the benchmark above.