FDFairDoctor.org

Dr. Baher Yanni , M.D.

Extreme Outlier
Practice Location: East Windsor,New Jersey 08520
National Provider Identifier (NPI): 1053409219
26 mins
Average Visit Time
17.36x
Markup Level
7,016
Annual Services
Financial Protection Alert

Higher Out-of-Pocket Billing Risk

This practice submits charges that average 17.4 times customary allowable rates. If you have not met your annual health insurance deductible, or if this doctor is out-of-network with your health plan, you may face significant balance billing.

3 Steps to Protect Your Wallet:
  • Confirm network status: Call your insurer to confirm this specific physician and office address are in-network.
  • Request in-network labs: Before blood draws or biopsies, ask the nurse to send samples exclusively to an in-network commercial laboratory.
  • Ask for a written estimate: Under the No Surprises Act, you are legally entitled to a Good Faith Estimate if you are self-pay or out-of-network.
The Rushed Visit Index

Balanced Practice

~26 min face-time

Maintains a steady clinical rhythm balancing focused physical examination with patient discussion.

How is appointment length calculated?

Visit durations reflect official documentation standards for Evaluation and Management (E/M) office billing codes (CPT 99202 through 99215).

Physicians who bill higher-level comprehensive visits (such as 99214 and 99215) consistently spend 30 to 45 minutes reviewing complex records and discussing care plans, whereas routine refill clinics predominantly bill briefer level 2 and 3 codes.

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Appointment Length & Visit Style

Clinical appointment coding analysis across standard patient evaluations

Consultation Classification
Standard (20-30 mins)

Dr. Yanni provides standard-duration consultations averaging approximately 26 minutes per visit, aligned with typical medical practice guidelines.

What visit duration tells you:
•Thorough evaluations: Longer appointments mean more opportunity to ask questions, review medical histories, and explain treatment options.
•Complex medical care: Patients managing multiple chronic conditions or seeking second opinions often benefit from physicians with extended visit styles.
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Pricing Transparency & Fee Comparison

How this provider bills compared to standard insurance benchmarks

Pricing Markup Ratio
17.36x
National Specialty Average: 2.56x
Total Annual Charges Billed
$8,461,900
Gross billed amount on claims
Standard Benchmark Value
$487,488
Customary fee baseline
Practical Guide for Patients and Families:

⚠️ Price Outlier Warning: Dr. Yanni's submitted charges are significantly higher than peer medians (over 17.36x the baseline standard). If you receive treatment out-of-network or without insurance, you could face substantial bills. Confirm in-network participation with your health plan prior to booking.

Verified Clinical Procedures & Surgical Focus

Official annual procedure volumes, customary fee comparisons, and clinical focus areas.

Clinical Procedure & CodeAnnual ServicesDoctor ChargePeer NormStandard Baselinevs. Peer Norm
HCPCS J3301
3,603$30.06$6.00$1.075.01x
CPT 99213
529$170.00$168.44$98.581.01x
HCPCS Q9966
500$50.00$3.00$0.4416.67x
HCPCS J0665
454$63.15$2.05$0.0230.8x
CPT 99203
121$267.56$234.50$122.181.14x
CPT 64494
118$1850.85$452.00$138.744.09x
CPT 64493
118$2776.27$985.00$272.652.82x
CPT 76000
115$760.87$112.16$16.956.78x
👨‍⚕️ Physician & Medical Billing Intelligence (Click to view professional coding data)Expand ↓

This section provides clinical practice analytics for healthcare administrators, billing coders, and peer physicians evaluating practice benchmarks:

Evaluation & Management Mix

Estimated appointment time calculation: 26 minutes. Indicates the proportion of high-complexity (99205/99215) vs. moderate-complexity (99204/99214) documentation relative to national specialty peers.

Charge-to-Payment Ratio

Gross charge multiplier: 17.36x. Useful for fee schedule alignment, out-of-network charge master analysis, and payer contract negotiations.

Patient Guidance: What to Ask Before Your Appointment

  • In-Network Confirmation: Confirm directly with your insurance plan that Dr. Yanni participates in your specific network tier.
  • Surgical Facility Fees: If having surgery, verify whether it will be in a hospital or an outpatient surgery center. Facility charges are billed separately from physician fees.
  • Written Estimates: If you are paying out of pocket or have a high deductible, request a written good-faith estimate before major treatments.