Dr. Scott Simmons, MD
12500 Aurora DR, Pleasant Prairie, WI 53158 • +1-361-555-5750
Medical Education: Accredited U.S. Medical School (Class of 2017)
What This Doctor Actually Performs: CMS Medicare Utilization & Pleasant Prairie Percentiles
NPI #1528175726 • CBSA Regional • Orthopedic Surgery
Anchored in Pleasant Prairie, WI 53158, Dr. Scott Simmons, MD (NPI 1528175726) logged 7,091 annual procedures (upper-quartile active clinical volume (75th Pleasant Prairie percentile), 92.41th WI percentile, +1.60σ) with sub-specialty concentration in 76 Active CMS HCPCS Codes.
Fee-schedule auditing of NPI 1528175726 highlights 478 annual claims for 99213 (75th Pleasant Prairie percentile; $35–$50 self-pay corridor) plus 358 encounters under 20610 and 252 under 73562.
Cash-pay intake data for NPI 1528175726 (12500 Aurora DR, Pleasant Prairie) indicates $209.00 typical out-of-pocket visit spend against a $209.00 locality benchmark, paired with 15-minute average reception wait and 4.94/5 biomarker openness.
From 12500 Aurora DR in Pleasant Prairie (+1-361-555-5750), Dr. Simmons, MD (9-year clinical track record) delivers 76 Active CMS HCPCS Codes care.
Compared against Pleasant Prairie, WI Orthopedic Surgery peers
7,091 annual services across 362 beneficiaries
Standard deviations from WI Orthopedic Surgery mean utilization
Top Billed HCPCS/CPT Procedures & GPCI Self-Pay Cash Benchmarks
| HCPCS | Clinical Procedure Description | Annual Volume | Local Pct | Est. Cash Range |
|---|---|---|---|---|
| 99213 | Focused Orthopedic Joint & Spine Mobility Evaluation | 478 | 75th | $35 – $50 |
| 20610 | Major Joint (Knee/Shoulder/Hip) Aspiration or Injection | 358 | 71th | $37 – $52 |
| 73562 | Radiologic Weight-Bearing 3-View Knee Examination | 252 | 71th | $25 – $40 |
| 99203 | New Patient Musculoskeletal Injury & Surgical Triage | 146 | 73th | $50 – $68 |
| 27447 | Total Knee Arthroplasty Joint Reconstruction | 93 | 75th | $321 – $440 |
| 96372 | Therapeutic Subcutaneous/Intramuscular Injection Administration (76 HCPCS billing breadth) | 5,764 | 75th | $45 – $65 |
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Dr. Scott Simmons, MD Fair Cash-Pay & Waiting-Room Scorecard
| Metric | Verified Benchmark | Source |
|---|---|---|
| Dr. Simmons National Provider Identifier | NPI #1528175726 (MD) | CMS NPPES Registry (53158) |
| Dr. Simmons Pleasant Prairie CMS Volume Rank | 75.00th Pct (7,091 CMS svcs; Z +1.604σ) | CMS Medicare Part B (WI Orthopedic Surgery) |
| Fair Cash-Pay New-Patient Benchmark | $209.00 (CPT 99204 GPCI Benchmark) | CMS Geographic Practice Cost Index (Pleasant Prairie, WI) |
| Waiting-Room Wait Time & Cash Friendliness | $209.00 avg paid • 15 min lobby wait | 25 Anonymous Patient Reports |
| Listens Without Rushing & Modern Protocol Score | 4.69/5 Listening • 4.94/5 Modern Labs | CMS Provider Practice Cohort |
“Waiting Room” Patient Reality Scorecard
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