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Dr. Gary Breitbart , M.D.

Moderate Markup
Practice Location: South Plainfield,New Jersey 07080
National Provider Identifier (NPI): 1073553400
34 mins
Average Visit Time
3.82x
Markup Level
3,531
Annual Services
Financial Protection Alert

Higher Out-of-Pocket Billing Risk

This practice submits charges that average 3.8 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

Thorough Listener

~34 min face-time

Consistently devotes longer face-to-face evaluations. Ideal for complex medical concerns, multiple symptoms, or patients who value comprehensive discussion without feeling rushed.

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
In-Depth (30-40 mins)

Dr. Breitbart provides standard-duration consultations averaging approximately 34 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
3.82x
National Specialty Average: 2.56x
Total Annual Charges Billed
$1,074,608
Gross billed amount on claims
Standard Benchmark Value
$281,513
Customary fee baseline
Practical Guide for Patients and Families:

Dr. Breitbart bills moderately higher than baseline insurance benchmarks. If you are in-network, your co-pay or coinsurance will be determined by your plan's contracted rate. If paying out of pocket, request an upfront written fee estimate.

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
CPT 93970
990$115.11$225.00$35.830.51x
CPT 99213
401$308.70$168.44$100.091.83x
CPT 93971
217$74.08$136.00$23.010.54x
CPT 29580
174$313.10$137.54$39.082.28x
CPT 99212
168$195.00$104.00$38.621.88x
CPT 99214
142$433.77$245.00$142.571.77x
CPT 99223
116$632.07$496.25$188.561.27x
CPT 93923
110$75.00$250.00$23.290.3x
👨‍⚕️ 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: 34 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: 3.82x. 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. Breitbart 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.