Dr. Kevin Heaton , DO
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. Heaton provides standard-duration consultations averaging approximately 27 minutes per visit, aligned with typical medical practice guidelines.
Pricing Transparency & Fee Comparison
How this provider bills compared to standard insurance benchmarks
Dr. Heaton 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 J7325 | 1,008 | $23.95 | $28.00 | $8.87 | 0.86x |
CPT 99213 | 206 | $248.00 | $168.44 | $82.71 | 1.47x |
HCPCS J3301 | 192 | $2.06 | $6.00 | $1.03 | 0.34x |
CPT 73564 | 150 | $45.00 | $99.00 | $10.33 | 0.45x |
CPT 73502 | 72 | $39.81 | $76.63 | $10.03 | 0.52x |
CPT 20610 | 66 | $239.17 | $221.85 | $64.19 | 1.08x |
CPT 99203 | 60 | $367.00 | $234.50 | $102.10 | 1.57x |
CPT 27447 | 56 | $4655.00 | $4196.91 | $1132.59 | 1.11x |
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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: 27 minutes. 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. Heaton 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.