Dr. John Madison, MD
55 Lake Ave N, Department of Pulmonary Medicine, Worcester, MA 01655 • +1-746-555-4050
Medical Education: Accredited U.S. Medical School (Class of 1993)
What This Doctor Actually Performs: CMS Medicare Utilization & Worcester Percentiles
NPI #1821070244 • CBSA Regional • Pulmonary Disease
Within the Worcester, MA (CBSA local) Pulmonary Disease cohort, Dr. John Madison, MD with sub-specialty concentration in 21 Active CMS HCPCS Codes ranks at the 84.21th municipal percentile and 88.76th MA percentile (+0.95σ Z-score) based on 2,132 billed procedures for 924 patients.
Fee-schedule auditing of NPI 1821070244 highlights 874 annual claims for 99214 (84.21th Worcester percentile; $47–$64 self-pay corridor) plus 490 encounters under 94060 and 362 under 94729.
Self-pay new patient consultations with Dr. Madison (CPT 99204 GPCI-adjusted benchmark) estimate around $224.00 (community reported average: $224.00) with hybrid in-clinic and telehealth video consults, 15-minute average reception wait, and a 4.46/5 modern protocol openness score across 19 patient logs.
Spanning 33 years of clinical practice following 1993 graduation from medical training, Dr. John Madison integrates 21 Active CMS HCPCS Codes diagnostics for Worcester metro patients.
Compared against Worcester, MA Pulmonary Disease peers
2,132 annual services across 924 beneficiaries
Standard deviations from MA Pulmonary Disease mean utilization
Top Billed HCPCS/CPT Procedures & GPCI Self-Pay Cash Benchmarks
| HCPCS | Clinical Procedure Description | Annual Volume | Local Pct | Est. Cash Range |
|---|---|---|---|---|
| 99214 | Established Pulmonary, Asthma & COPD Management | 874 | 84.21th | $47 – $64 |
| 94060 | Pre- & Post-Bronchodilator Spirometry Airflow Evaluation | 490 | 88.21th | $30 – $45 |
| 94729 | Alveolar Carbon Monoxide Diffusing Capacity (DLCO) | 362 | 82.21th | $28 – $43 |
| 95810 | Attended Sleep Apnea Polysomnography Interpretation | 235 | 88.21th | $85 – $116 |
| 99204 | Comprehensive New Patient Respiratory & Sleep Workup | 171 | 83.21th | $66 – $90 |
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Dr. John Madison, MD Fair Cash-Pay & Waiting-Room Scorecard
| Metric | Verified Benchmark | Source |
|---|---|---|
| Dr. Madison National Provider Identifier | NPI #1821070244 (MD) | CMS NPPES Registry (01655) |
| Dr. Madison Worcester CMS Volume Rank | 84.21th Pct (2,132 CMS svcs; Z +0.947σ) | CMS Medicare Part B (MA Pulmonary Disease) |
| Fair Cash-Pay New-Patient Benchmark | $224.00 (CPT 99204 GPCI Benchmark) | CMS Geographic Practice Cost Index (Worcester, MA) |
| Waiting-Room Wait Time & Cash Friendliness | $224.00 avg paid • 15 min lobby wait | 19 Anonymous Patient Reports |
| Listens Without Rushing & Modern Protocol Score | 4.96/5 Listening • 4.46/5 Modern Labs | CMS Provider Practice Cohort |
“Waiting Room” Patient Reality Scorecard
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