Active NPI 1356383582 Individual Practitioner Male Practitioner

Dr. Thomas J Fox , MD

Orthopaedic Surgery • Saint Louis, MO

Professional Overview & Biography Verified Profile Summary

Dr. Thomas Fox, MD is a registered healthcare professional specializing in Orthopaedic Surgery in Saint Louis, MO. Practice services are available at 1031 BELLEVUE AVE under active NPI credentials.

Frequently performed procedures and clinical services include injection, triamcinolone acetonide, not otherwise specified, 10 mg, aspiration and/or injection of fluid from large joint, established patient outpatient office visit. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

1031 Bellevue Ave

Saint Louis, MO 631171818

Telephone 3149834700

Associated Practice Facility / Clinic

🏢 St Louis University Facility NPI 1295708527

Specialty Benchmarks & Practice Insights

Comparative analytics for Orthopaedic Surgery in Saint Louis, MO

Active Practitioner

Practitioner Clinical Experience

Active

City Avg: 20.1 Yrs

State Avg: 25.7 Yrs

Regional Practice Density

172 Specialists

Practicing in Saint Louis, MO (550 Statewide)

Telehealth Adoption Rate

3.5% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

66.1% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	862	71	$40.00	$1.02
20610 Aspiration and/or injection of fluid from large joint	88	69	$436.57	$73.38
99213 Established patient office or other outpatient visit, typically 15 minutes	37	34	$190.00	$89.15
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	23	20	$140.00	$55.26
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	17	14	$295.00	$126.24
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	11	11	$239.00	$109.16

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	1,784	110	$6.67	$1.07
20610 Aspiration and/or injection of fluid from large joint	190	113	$186.21	$71.78
99213 Established patient office or other outpatient visit, typically 15 minutes	89	72	$153.66	$88.59
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	57	49	$76.00	$55.40
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	43	43	$210.81	$110.00
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	25	24	$171.60	$125.43
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	15	15	$230.00	$153.68
99202 New patient office or other outpatient visit, typically 20 minutes	11	11	$100.00	$70.93

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	1,888	131	$7.00	$1.14
20610 Aspiration and/or injection of fluid from large joint	196	131	$182.73	$73.36
99213 Established patient office or other outpatient visit, typically 15 minutes	80	70	$124.00	$90.82
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	61	59	$150.00	$128.27
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	59	52	$76.00	$56.23
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	46	46	$230.00	$165.20
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	41	41	$155.00	$112.07

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	2,022	133	$6.84	$1.26
20610 Aspiration and/or injection of fluid from large joint	222	138	$180.27	$72.10
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	93	83	$153.87	$127.59
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	79	66	$72.89	$56.29
99213 Established patient office or other outpatient visit, typically 15 minutes	69	61	$112.07	$91.55
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	57	57	$225.26	$166.09
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	44	44	$148.86	$112.54
99221 Initial hospital inpatient care per day, typically 30 minutes	17	16	$140.00	$100.41
27447 Replacement of knee joint, both sides of knee	14	14	$3030.00	$1302.01

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	1,942	132	$6.00	$1.46
20610 Aspiration and/or injection of fluid from large joint	214	136	$176.85	$69.15
99213 Established patient office or other outpatient visit, typically 15 minutes	84	78	$93.00	$75.43
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	83	75	$140.00	$109.32
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	48	48	$145.00	$108.16
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	39	39	$66.00	$44.23
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	37	37	$215.00	$159.29
99221 Initial hospital inpatient care per day, typically 30 minutes	22	22	$140.00	$103.50
27447 Replacement of knee joint, both sides of knee	22	21	$3030.00	$1399.15
27130 Replacement of thigh bone and hip joint with prosthesis	13	12	$2835.00	$1405.47

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	2,580	186	$6.32	$1.59
20610 Aspiration and/or injection of fluid from large joint	297	189	$213.56	$66.60
99213 Established patient office or other outpatient visit, typically 15 minutes	174	144	$96.16	$72.22
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	129	116	$140.94	$107.20
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	76	63	$75.87	$44.26
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	66	66	$155.91	$107.58
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	56	56	$223.93	$161.03
27447 Replacement of knee joint, both sides of knee	27	27	$3630.33	$1349.99
73564 X-ray of knee, 4 or more views	24	21	$173.00	$40.67
73562 X-ray of knee, 3 views	20	16	$154.00	$35.12
73502 X-ray of hip, 2-3 views	14	14	$164.00	$39.75

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	3,844	269	$12.01	$1.77
20610 Aspiration and/or injection of fluid from large joint	532	266	$314.00	$52.90
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	330	219	$81.00	$42.62
99213 Established patient office or other outpatient visit, typically 15 minutes	247	199	$104.00	$71.16
73562 X-ray of knee, 3 views	154	108	$154.00	$33.27
73564 X-ray of knee, 4 or more views	153	135	$173.00	$37.79
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	101	101	$185.00	$104.91
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	88	84	$152.30	$102.73
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	70	70	$265.00	$160.56
73502 X-ray of hip, 2-3 views	57	49	$164.00	$39.65
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	43	42	$241.00	$137.32
73560 X-ray of knee, 1-2 views	36	20	$131.00	$26.59
72170 X-ray of pelvis, 1-2 views	32	31	$178.00	$29.54
27447 Replacement of knee joint, both sides of knee	27	27	$8433.00	$1359.34
73030 X-ray of shoulder, minimum of 2 views	27	23	$185.00	$28.56
72100 X-ray of lower and sacral spine, 2-3 views	25	25	$169.00	$32.90
73630 X-ray of foot, minimum of 3 views	22	12	$138.00	$28.51
73610 X-ray of ankle, minimum of 3 views	21	14	$138.00	$27.45
27130 Replacement of thigh bone and hip joint with prosthesis	16	16	$18763.00	$1373.72
73501 X-ray of hip with pelvis, 1 view	15	15	$119.00	$29.27
99202 New patient office or other outpatient visit, typically 20 minutes	13	13	$142.00	$73.81
99211 Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional	12	12	$57.00	$20.60

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	4,222	293	$12.01	$1.77
J7325 Hyaluronan or derivative, synvisc or synvisc-one, for intra-articular injection, 1 mg	816	14	$32.20	$12.38
20610 Aspiration and/or injection of fluid from large joint	614	295	$314.00	$53.44
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	319	213	$81.00	$41.87
99213 Established patient office or other outpatient visit, typically 15 minutes	288	222	$108.86	$70.81
73564 X-ray of knee, 4 or more views	156	133	$173.00	$37.81
73562 X-ray of knee, 3 views	139	96	$154.00	$34.01
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	94	86	$151.00	$105.16
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	87	87	$185.00	$105.94
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	83	83	$265.00	$161.06
73502 X-ray of hip, 2-3 views	51	44	$164.00	$39.43
73030 X-ray of shoulder, minimum of 2 views	45	31	$185.00	$27.50
72170 X-ray of pelvis, 1-2 views	39	38	$178.00	$30.78
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	34	32	$241.00	$141.64
27447 Replacement of knee joint, both sides of knee	33	33	$8433.00	$1364.35
72100 X-ray of lower and sacral spine, 2-3 views	27	27	$169.00	$33.89
73560 X-ray of knee, 1-2 views	24	14	$131.00	$29.71
99205 New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more	17	17	$358.00	$203.39
20550 Injection into tendon or ligament	17	15	$281.00	$44.48

Medical Specialties & State Licenses

CMS Verified: 2021-02-24

Orthopaedic Surgery Primary Specialty

NUCC Taxonomy Code: 207X00000X

State License MO R9D70

An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID

202456109 (MO)

Commercial Insurance / Payer ID Aetna

4643680 (MO)

Commercial Insurance / Payer ID Cigna

3099607001 (MO)

Commercial Insurance / Payer ID Blue Cross Blue Shield

25711 (MO)

Commercial Insurance / Payer ID Group Health Plan

83396V3223 (MO)

Commercial Insurance / Payer ID Healthlink

100343 (MO)

Commercial Insurance / Payer ID United Health Care

0900153 (MO)

Commercial Insurance / Payer ID Railroad Medicare

200042025 (MO)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

14 Associated Practitioners

Dr. John Sheridan , MD

Orthopaedic Surgery

NPI 1083657423

Doctor of Medicine (M.D.)

Dr. Scott Zehnder , MD

Orthopaedic Surgery - Sports Medicine

NPI 1104020957

Doctor of Medicine (M.D.)

Dr. David Anderson , MD

Orthopaedic Surgery - Pediatric Orthopaedic Surgery

NPI 1306802343

Doctor of Medicine (M.D.)

Dr. Howard Setzer , DO

Physical Medicine & Rehabilitation

NPI 1336431857

Doctor of Osteopathic Medicine (D.O.)

Elizabeth Erker

Dietitian, Registered

NPI 1346400561

Dr. Mark Sucher , MD

Orthopaedic Surgery

NPI 1417278649

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

13 Historical Events

📍

Updated Practice Location February 24, 2021

Registered at 1031 BELLEVUE AVE, SAINT LOUIS, MO 631171818 (Tel: 3149834700)

📍

Updated Business Mailing Address February 24, 2021

Registered at 1031 BELLEVUE AVE, SAINT LOUIS, MO 631171818

✅

NPI Profile Active September 13, 2017

NPI status registered as active in NPPES database

📍

Updated Practice Location September 13, 2017

Registered at 845 N NEW BALLAS CT STE 200, SAINT LOUIS, MO 631417169 (Tel: 3149834700)

📍

Updated Business Mailing Address September 13, 2017

Registered at 12639 OLD TESSON RD, SUITE 115, SAINT LOUIS, MO 631282786 (Tel: (314) 849-0311)

👤

Provider Name / Credentials Updated September 13, 2017

Recorded as THOMAS FOX, M.D.

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) September 13, 2017

Orthopaedic Surgery (License #R9D70 in MO)

✅

NPI Profile Active August 28, 2013

NPI status registered as active in NPPES database

📍

Updated Practice Location August 28, 2013

Registered at 1027 BELLEVUE AVE, SUITE 25, SAINT LOUIS, MO 631171851 (Tel: 3149834700)

📍

Updated Business Mailing Address August 28, 2013

Registered at 12639 OLD TESSON RD, SUITE 115, SAINT LOUIS, MO 631282786 (Tel: 3148490311)

👤

Provider Name / Credentials Updated August 28, 2013

Recorded as THOMAS FOX, M.D.

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) August 28, 2013

Orthopaedic Surgery (License #R9D70 in MO)

🟢

Initial NPI Registration & Enumeration June 12, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1356383582

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: June 12, 2006

Last Update: February 24, 2021

Sole Proprietor: No

Update or Correct Profile

Mailing Address

1031 Bellevue Ave

Saint Louis, MO 631171818

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

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