Active NPI 1760460570 Individual Practitioner Male Practitioner

Dr. Michael E Higgins , MD

Orthopaedic Surgery • Hampton, VA

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. Michael Higgins, MD is a certified Orthopaedic Surgery practicing in Hampton, VA. With approximately 26 years of clinical experience since completing medical education in 2000, Dr. Higgins delivers high-quality medical care to the local community at 901 ENTERPRISE PKWY STE 900.

Dr. Higgins is affiliated with Tidewater Orthopaedic Associates Inc. and accepts Medicare assignment.

Frequently performed procedures and clinical services include injection, methylprednisolone acetate, 1 mg, established patient outpatient office visit, x-ray of hip, 2-3 views. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

901 Enterprise Pkwy Ste 900

Hampton, VA 236666250

Telephone 7578272480

Fax 7578272566

Associated Practice Facility / Clinic

🏢 Tidewater Orthopaedic Associates Inc Facility NPI 1225058548

Medicare Profile & Education

Medical School

Other

Graduation Year

2000

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Orthopaedic Surgery in Hampton, VA

Senior Veteran Specialist (>20 Yrs)

Practitioner Clinical Experience

26 Yrs +4.7 yrs vs City Avg

City Avg: 21.3 Yrs

State Avg: 26.3 Yrs

Regional Practice Density

14 Specialists

Practicing in Hampton, VA (618 Statewide)

Telehealth Adoption Rate

7.1% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

71.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Higgins (26 Years) 26 Yrs

Hampton Specialty Average (21.3 Years) 21.3 Yrs

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
J1010 Injection, methylprednisolone acetate, 1 mg	11,401	156	$0.40	$0.13
99213 Established patient office or other outpatient visit, typically 15 minutes	681	541	$225.93	$86.96
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	529	426	$328.94	$122.31
73502 X-ray of hip, 2-3 views	368	338	$136.00	$45.21
73564 X-ray of knee, 4 or more views	313	298	$152.98	$45.07
20610 Aspiration and/or injection of fluid from large joint	190	158	$215.22	$64.93
73562 X-ray of knee, 3 views	160	142	$124.64	$39.55
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	154	154	$497.00	$160.88
27447 Replacement of knee joint, both sides of knee	104	102	$4284.78	$1164.93
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	96	96	$324.95	$107.49
J1030 Injection, methylprednisolone acetate, 40 mg	87	49	$15.26	$6.33
27130 Replacement of thigh bone and hip joint with prosthesis	74	70	$4230.95	$1194.38
73721 Mri scan of leg joint without contrast	69	65	$792.17	$144.63
73521 X-ray of both hips, 2 views	64	64	$120.00	$39.39
20553 Injection of trigger points, 3 or more muscles	49	47	$195.00	$57.79
29880 Removal of both knee cartilages using an endoscope	34	32	$1729.65	$538.55

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J7318 Hyaluronan or derivative, durolane, for intra-articular injection, 1 mg	1,863	29	$18.16	$6.75
99213 Established patient office or other outpatient visit, typically 15 minutes	721	552	$225.93	$87.78
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	617	482	$329.00	$123.92
73502 X-ray of hip, 2-3 views	389	367	$136.00	$45.87
73564 X-ray of knee, 4 or more views	364	345	$151.22	$46.26
J1030 Injection, methylprednisolone acetate, 40 mg	300	192	$25.83	$7.55
20610 Aspiration and/or injection of fluid from large joint	244	207	$218.81	$68.47
73562 X-ray of knee, 3 views	170	150	$133.27	$39.63
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	162	161	$496.96	$162.47
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	153	153	$324.97	$108.48
27447 Replacement of knee joint, both sides of knee	110	109	$4170.70	$1251.12
27130 Replacement of thigh bone and hip joint with prosthesis	97	88	$4218.23	$1220.98
73721 Mri scan of leg joint without contrast	93	87	$798.84	$154.96
73521 X-ray of both hips, 2 views	54	53	$120.00	$40.92
29880 Removal of both knee cartilages using an endoscope	32	32	$1729.56	$529.42
20611 Aspiration and/or injection of fluid large joint using ultrasound guidance	20	19	$351.45	$87.87
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	16	16	$610.06	$169.09

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J7318 Hyaluronan or derivative, durolane, for intra-articular injection, 1 mg	5,763	75	$17.60	$14.78
99213 Established patient office or other outpatient visit, typically 15 minutes	728	575	$225.81	$90.05
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	674	511	$328.77	$125.77
73502 X-ray of hip, 2-3 views	478	417	$136.57	$47.31
73564 X-ray of knee, 4 or more views	392	356	$154.90	$46.40
J1030 Injection, methylprednisolone acetate, 40 mg	285	202	$54.90	$6.33
20610 Aspiration and/or injection of fluid from large joint	228	182	$223.38	$68.80
73562 X-ray of knee, 3 views	197	158	$128.18	$41.22
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	159	159	$324.97	$112.11
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	145	145	$496.95	$166.93
27447 Replacement of knee joint, both sides of knee	110	105	$4114.27	$1272.86
20611 Aspiration and/or injection of fluid large joint using ultrasound guidance	106	101	$347.94	$111.00
27130 Replacement of thigh bone and hip joint with prosthesis	84	82	$4157.40	$1274.19
73721 Mri scan of leg joint without contrast	61	60	$787.61	$146.34
73521 X-ray of both hips, 2 views	59	58	$120.00	$41.89
29880 Removal of both knee cartilages using an endoscope	37	37	$1773.11	$427.15
29879 Repair of knee joint using an endoscope	12	12	$2041.00	$667.75

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J7318 Hyaluronan or derivative, durolane, for intra-articular injection, 1 mg	3,841	53	$17.60	$17.23
99213 Established patient office or other outpatient visit, typically 15 minutes	810	561	$227.00	$91.45
73502 X-ray of hip, 2-3 views	441	323	$135.94	$47.08
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	423	359	$330.17	$128.78
73564 X-ray of knee, 4 or more views	332	321	$150.28	$46.07
73562 X-ray of knee, 3 views	276	167	$121.42	$40.78
J1030 Injection, methylprednisolone acetate, 40 mg	246	167	$47.50	$5.64
20611 Aspiration and/or injection of fluid large joint using ultrasound guidance	197	162	$332.16	$109.02
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	172	172	$325.00	$112.36
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	119	119	$497.00	$167.64
73721 Mri scan of leg joint without contrast	85	82	$693.27	$155.36
27447 Replacement of knee joint, both sides of knee	80	76	$4235.29	$1301.09
27130 Replacement of thigh bone and hip joint with prosthesis	68	67	$4188.00	$1305.92
20610 Aspiration and/or injection of fluid from large joint	64	61	$231.00	$68.27
29880 Removal of both knee cartilages using an endoscope	37	36	$1731.00	$421.76
73521 X-ray of both hips, 2 views	36	34	$120.00	$41.63
73552 X-ray of thigh bone, minimum 2 views	25	11	$104.00	$35.72
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	15	15	$614.00	$199.00
29879 Repair of knee joint using an endoscope	12	11	$2041.00	$624.36
72100 X-ray of lower and sacral spine, 2-3 views	11	11	$115.00	$40.24

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J7318 Hyaluronan or derivative, durolane, for intra-articular injection, 1 mg	5,295	85	$18.14	$17.18
99213 Established patient office or other outpatient visit, typically 15 minutes	1,046	584	$227.23	$75.34
73502 X-ray of hip, 2-3 views	450	319	$133.76	$45.11
J1030 Injection, methylprednisolone acetate, 40 mg	315	208	$53.14	$5.97
20611 Aspiration and/or injection of fluid large joint using ultrasound guidance	314	233	$336.86	$103.78
73564 X-ray of knee, 4 or more views	307	286	$148.46	$43.55
73562 X-ray of knee, 3 views	220	148	$121.69	$39.12
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	211	194	$331.71	$108.25
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	185	185	$324.43	$107.75
20610 Aspiration and/or injection of fluid from large joint	81	70	$220.00	$66.81
73721 Mri scan of leg joint without contrast	74	73	$710.16	$161.96
72100 X-ray of lower and sacral spine, 2-3 views	60	57	$117.63	$37.83
27447 Replacement of knee joint, both sides of knee	59	57	$4149.64	$1360.94
27130 Replacement of thigh bone and hip joint with prosthesis	59	59	$4169.24	$1380.32
29880 Removal of both knee cartilages using an endoscope	52	52	$1743.37	$484.38
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	51	51	$497.67	$160.97
73521 X-ray of both hips, 2 views	40	38	$121.78	$40.04
73552 X-ray of thigh bone, minimum 2 views	23	11	$102.13	$34.75
73030 X-ray of shoulder, minimum of 2 views	23	18	$121.74	$32.25
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	22	21	$611.55	$197.14
G0180 Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and	15	15	$60.00	$54.02
J7323 Hyaluronan or derivative, euflexxa, for intra-articular injection, per dose	14	12	$603.21	$141.83
27236 Treatment of upper end of broken thigh bone with placement of stabilizing device or prosthetic replacement	12	12	$3660.50	$1183.75
29879 Repair of knee joint using an endoscope	11	11	$2037.27	$679.13

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	1,238	700	$214.82	$72.96
J1030 Injection, methylprednisolone acetate, 40 mg	515	306	$21.26	$6.19
73502 X-ray of hip, 2-3 views	505	349	$123.00	$41.91
73564 X-ray of knee, 4 or more views	316	294	$103.34	$40.65
73562 X-ray of knee, 3 views	280	189	$83.68	$36.75
20611 Aspiration and/or injection of fluid large joint using ultrasound guidance	268	214	$321.42	$97.83
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	258	236	$318.39	$107.12
20610 Aspiration and/or injection of fluid from large joint	224	184	$208.93	$64.14
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	185	185	$319.45	$107.34
27447 Replacement of knee joint, both sides of knee	69	64	$4117.39	$1360.15
27130 Replacement of thigh bone and hip joint with prosthesis	65	64	$4065.00	$1367.62
J7323 Hyaluronan or derivative, euflexxa, for intra-articular injection, per dose	65	46	$388.38	$141.87
73721 Mri scan of leg joint without contrast	62	60	$800.00	$160.81
72100 X-ray of lower and sacral spine, 2-3 views	44	44	$110.11	$36.12
73521 X-ray of both hips, 2 views	43	41	$131.16	$37.15
29880 Removal of both knee cartilages using an endoscope	43	42	$1973.14	$418.24
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	36	36	$605.50	$200.69
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	27	27	$490.00	$162.98
73552 X-ray of thigh bone, minimum 2 views	25	13	$95.00	$32.07
G0180 Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and	23	23	$60.00	$52.70
29879 Repair of knee joint using an endoscope	14	14	$2000.00	$637.75
73030 X-ray of shoulder, minimum of 2 views	12	12	$65.00	$29.84
27245 Treatment of broken neck of thigh bone with bone implant	12	12	$3680.00	$1241.53
76882 Limited ultrasound scan of joint or other extremity structure except blood vessels	12	11	$119.17	$56.85
27236 Treatment of upper end of broken thigh bone with placement of stabilizing device or prosthetic replacement	11	11	$3585.36	$1206.51

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	1,215	707	$214.88	$71.57
J1030 Injection, methylprednisolone acetate, 40 mg	673	385	$17.05	$6.56
20610 Aspiration and/or injection of fluid from large joint	519	362	$205.43	$62.90
73502 X-ray of hip, 2-3 views	517	334	$123.00	$40.26
73564 X-ray of knee, 4 or more views	350	323	$105.17	$38.70
73562 X-ray of knee, 3 views	289	181	$83.04	$35.15
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	181	168	$320.00	$105.40
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	174	174	$319.40	$105.56
27130 Replacement of thigh bone and hip joint with prosthesis	71	71	$4065.00	$1351.86
20611 Aspiration and/or injection of fluid large joint using ultrasound guidance	62	51	$288.31	$91.42
27447 Replacement of knee joint, both sides of knee	59	59	$4060.00	$1365.52
73521 X-ray of both hips, 2 views	56	45	$141.43	$36.53
73721 Mri scan of leg joint without contrast	53	48	$800.00	$167.38
J7323 Hyaluronan or derivative, euflexxa, for intra-articular injection, per dose	44	32	$365.11	$145.47
72100 X-ray of lower and sacral spine, 2-3 views	35	35	$110.00	$33.66
29880 Removal of both knee cartilages using an endoscope	29	28	$1969.83	$310.85
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	28	28	$490.00	$163.67
73560 X-ray of knee, 1-2 views	26	12	$65.00	$28.20
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	25	25	$605.00	$201.60
76882 Limited ultrasound scan of joint or other extremity structure except blood vessels	20	19	$115.00	$57.42
29879 Repair of knee joint using an endoscope	18	18	$2000.00	$666.39
27245 Treatment of broken neck of thigh bone with bone implant	15	15	$3680.00	$1239.48
27236 Treatment of upper end of broken thigh bone with placement of stabilizing device or prosthetic replacement	12	12	$3575.00	$1204.21

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	1,099	647	$214.87	$71.70
J1030 Injection, methylprednisolone acetate, 40 mg	701	361	$15.43	$5.64
20610 Aspiration and/or injection of fluid from large joint	484	332	$194.92	$59.42
73502 X-ray of hip, 2-3 views	448	316	$123.00	$40.11
73564 X-ray of knee, 4 or more views	303	272	$97.76	$38.58
73562 X-ray of knee, 3 views	302	189	$81.85	$34.94
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	203	187	$319.41	$104.23
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	165	165	$320.00	$105.92
27447 Replacement of knee joint, both sides of knee	69	66	$4118.84	$1338.25
73721 Mri scan of leg joint without contrast	63	63	$800.00	$165.09
20611 Aspiration and/or injection of fluid large joint using ultrasound guidance	59	53	$284.32	$90.37
72100 X-ray of lower and sacral spine, 2-3 views	58	56	$110.00	$34.52
27130 Replacement of thigh bone and hip joint with prosthesis	51	50	$4065.00	$1354.50
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	48	46	$605.00	$200.21
J7323 Hyaluronan or derivative, euflexxa, for intra-articular injection, per dose	45	26	$336.00	$152.40
73521 X-ray of both hips, 2 views	41	33	$122.93	$36.68
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	39	39	$490.00	$154.78
73560 X-ray of knee, 1-2 views	29	11	$65.00	$28.76
29880 Removal of both knee cartilages using an endoscope	27	27	$1903.52	$282.91
10160 Aspiration of abscess, blood accumulation, blister, or cyst	21	18	$385.00	$120.06
27236 Treatment of upper end of broken thigh bone with placement of stabilizing device or prosthetic replacement	21	20	$3575.00	$1194.08
73030 X-ray of shoulder, minimum of 2 views	21	18	$63.26	$28.54
29879 Repair of knee joint using an endoscope	18	18	$2000.00	$627.75
76882 Limited ultrasound scan of joint or other extremity structure except blood vessels	18	17	$110.00	$34.04

Medical Specialties & State Licenses

CMS Verified: 2024-02-05

Orthopaedic Surgery Primary Specialty

NUCC Taxonomy Code: 207X00000X

State License VA 0101237682

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.

Orthopaedic Surgery - Adult Reconstructive Orthopaedic Surgery

NUCC Taxonomy Code: 207XS0114X

State License VA 0101237682

Recognized by several state medical boards as a fellowship subspecialty program of orthopaedic surgery, adult reconstructive orthopaedic surgeons deal with reconstructive procedures such as joint arthroplasty (i.e., hip and knee), osteotomy, arthroscopy, soft-tissue reconstruction, and a variety of other adult reconstructive surgical procedures.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID

010285411 (VA)

Commercial Insurance / Payer ID Anthem

239627 (VA)

Commercial Insurance / Payer ID Optima/sentara

10012033 (VA)

Commercial Insurance / Payer ID Mamsi

2167454 (VA)

Hospital & Practice Group Affiliations

Tidewater Orthopaedic Associates Inc.

901 Enterprise Pkwy, Hampton, VA 236666250

Phone: 7578272480

Practice Associates & Co-Workers

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

39 Associated Practitioners

Michael Burgos , OTR, L

Occupational Therapist

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Occupational Therapist Registered, L

Alex Rodriguez , MOT, OTR, L

Occupational Therapist

NPI 1093603797

Master of Occupational Therapy, Occupational Therapist Registered, L

Davina Gillespie , FNP

Nurse Practitioner - Family

NPI 1104597228

Family Nurse Practitioner

Eva Mcewen , PA

Physician Assistant

NPI 1194357863

Physician Assistant

Dr. Laura Gray , DPT MBA MED CERT MDT

Physical Therapist

NPI 1194786178

DPTMBAMEDCERTMDT

Dr. Arthur Greene , MD

Orthopaedic Surgery

NPI 1205834157

Doctor of Medicine (M.D.)

Career & Practice History Timeline

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

8 Historical Events

📍

Updated Practice Location February 05, 2024

Registered at 901 ENTERPRISE PKWY STE 900, HAMPTON, VA 236666250 (Tel: 7578272480)

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) February 05, 2024

Orthopaedic Surgery (License #0101237682 in VA)

✅

NPI Profile Active July 31, 2008

NPI status registered as active in NPPES database

📍

Updated Practice Location July 31, 2008

Registered at 901 ENTERPRISE PARKWAY, SUITE 900, HAMPTON, VA 23666 (Tel: 7578272480)

📍

Updated Business Mailing Address July 31, 2008

Registered at 901 ENTERPRISE PARKWAY, SUITE 900, HAMPTON, VA 23666 (Tel: 7578272480)

👤

Provider Name / Credentials Updated July 31, 2008

Recorded as MICHAEL HIGGINS, M.D.

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) July 31, 2008

Orthopaedic Surgery (License #0101237682 in VA)

🟢

Initial NPI Registration & Enumeration January 03, 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: 1760460570

Entity Type:

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

Enumeration Date: January 03, 2006

Last Update: February 05, 2024

Sole Proprietor: No

Update or Correct Profile

Mailing Address

901 Enterprise Parkway, Suite 900

Hampton, VA 23666

Phone: 7578272480

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

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.