Upstate Orthopedics, LLP

Upstate Orthopedics, LLP was paid $5.94M by Medicaid between Jan 2018 and Dec 2024, across 50 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 45% of everything it billed.

33Billing provider infoUPSTATE ORTHOPEDICS, LLP
EAST SYRACUSE, NY 13057

33aNPI1740228311assigned 06/03/2006

33bProvider typeDurable Medical Equipment & Medical Supplies

28Total paid$5.94M

24GClaims78,727

24DCodes billed50

24AFirst – last monthJan 2018 – Dec 2024

Compared with peers

Next to other Durable Medical Equipment & Medical Supplies providers in New York

Rank by total paid#29 of 479

Median peer was paid$138K

This provider vs. median43×

Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.

Box 24A · Dates of service

Paid by month

Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider

By year, as a table

Year	Claims	Paid
2018	5,447	$389K
2019	8,056	$551K
2020	9,290	$663K
2021	13,803	$1.14M
2022	15,370	$1.20M
2023	15,940	$1.20M
2024incomplete	10,821	$792K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
99213	Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity	45%	33,871	32,637	$2.70M
99203	Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity	20%	11,025	11,015	$1.17M
99214	Doctor's office visit, returning patient (more involved)Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity	13%	6,894	6,670	$786K
99204	Doctor's office visit, new patient (more involved)Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity	3.6%	1,357	1,357	$215K
72082		2.2%	2,036	1,908	$133K
99202	Office or other outpatient visit for the evaluation and management of a new patient, straightforward	2.0%	1,617	1,615	$117K
73630		1.7%	3,085	2,866	$101K
72110		1.1%	1,504	1,466	$68K
73600		1.0%	1,877	1,729	$60K
72081		<1%	1,326	1,321	$53K
73030		<1%	1,537	1,436	$47K
73110		<1%	1,233	1,057	$46K

38 more codes

72148	Magnetic resonance imaging, lumbar spine; without contrast material	<1%	241	$45K
73721	Magnetic resonance imaging, any joint of lower extremity; without contrast material	<1%	200	$43K
99212	Office or other outpatient visit for the evaluation and management of an established patient, straightforward	<1%	804	$41K
73562		<1%	736	$33K
73564		<1%	663	$32K
73590		<1%	812	$31K
99050		<1%	3,274	$29K
99215	Doctor's office visit, returning patient (complex)	<1%	181	$27K
72170		<1%	585	$16K
73610		<1%	436	$15K
25600		<1%	43	$14K
99223	Prolong inpt eval add15 m	<1%	79	$13K
72050		<1%	276	$13K
73100		<1%	359	$12K
99221		<1%	117	$11K
73080		<1%	297	$9K
73560		<1%	221	$7K
20610		<1%	95	$6K
73130		<1%	176	$6K
73140		<1%	161	$5K
73551		<1%	108	$5K
J1030	Injection, methylprednisolone acetate, 40 mg	<1%	366	$5K
73502		<1%	101	$4K
99070		<1%	514	$4K
73070		<1%	108	$3K
73565		<1%	86	$3K
99205	Prolong outpt/office vis	<1%	13	$3K
72141		<1%	14	$3K
L1902	Ankle orthosis, ankle gauntlet or similar, with or without joints, prefabricated, off-the-shelf	<1%	26	$2K
73090		<1%	75	$2K
73521		<1%	54	$2K
72190		<1%	41	$2K
L1812	Knee orthosis, elastic with joints, prefabricated, off-the-shelf	<1%	14	$1K
73620		<1%	26	$775.26
73552		<1%	24	$771.47
99201		<1%	15	$667.13
73522		<1%	12	$640.94
L3040	Foot, arch support, removable, premolded, longitudinal, each	<1%	12	$555.51

Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.

From NPPES

Who's on the registration

Authorized officialALBANESE, STEPHEN (ORTHOPEDIC DEPARTMENT CHAIRMAN)