Dr. James Mcfadden , MD
Moderate MarkupHigher 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.
- 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.
Balanced Practice
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.
Appointment Length & Visit Style
Clinical appointment coding analysis across standard patient evaluations
Dr. Mcfadden primarily performs clinical procedures, imaging, or laboratory services rather than routine timed office consultations.
Pricing Transparency & Fee Comparison
How this provider bills compared to standard insurance benchmarks
Dr. Mcfadden 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 & Code | Annual Services | Doctor Charge | Peer Norm | Standard Baseline | vs. Peer Norm |
|---|---|---|---|---|---|
HCPCS Q9967 | 2,801 | $2.26 | $1.00 | $0.15 | 2.26x |
CPT 74177 | 531 | $309.46 | $447.44 | $89.88 | 0.69x |
CPT 71275 | 331 | $295.07 | $366.92 | $87.94 | 0.8x |
CPT 70450 | 308 | $141.49 | $198.00 | $41.38 | 0.71x |
CPT 74176 | 177 | $296.95 | $387.00 | $86.42 | 0.77x |
CPT 71260 | 124 | $226.32 | $276.00 | $54.36 | 0.82x |
CPT 71250 | 104 | $195.85 | $254.00 | $52.20 | 0.77x |
CPT 71045 | 104 | $38.84 | $37.00 | $9.13 | 1.05x |
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👨⚕️ 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:
Estimated appointment time calculation: N/A. Indicates the proportion of high-complexity (99205/99215) vs. moderate-complexity (99204/99214) documentation relative to national specialty peers.
Gross charge multiplier: 3.79x. 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. Mcfadden 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.