Active NPI 1932303682 Individual Practitioner Male Practitioner

Dr. Benjamin Lee Hensley , DO

Surgery • Summersville, WV

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. Benjamin Hensley, DO is a certified Surgery practicing in Summersville, WV. With approximately 22 years of clinical experience since graduating from West Virginia School Of Osteopathic Medicine in 2004, Dr. Hensley delivers high-quality medical care to the local community at 400 FAIRVIEW HEIGHTS RD.

Dr. Hensley is affiliated with West Virginia Health Care Cooperative Inc and accepts Medicare assignment.

Frequently performed procedures and clinical services include established patient outpatient office visit, new patient outpatient office visit, initial hospital care with straightforward or low-level medical decision making, if using time, at least. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

400 Fairview Heights Rd

Summersville, WV 266519308

Telephone 3048725124

Fax 3048720409

Associated Practice Facility / Clinic

🏢 Summersville Regional Medical Center Facility NPI 1104813740

Medicare Profile & Education

Medical School

West Virginia School Of Osteopathic Medicine

Graduation Year

2004

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Surgery in Summersville, WV

Senior Veteran Specialist (>20 Yrs)

Practitioner Clinical Experience

22 Yrs +3.0 yrs vs City Avg

City Avg: 19.0 Yrs

State Avg: 29.4 Yrs

Regional Practice Density

3 Specialists

Practicing in Summersville, WV (221 Statewide)

Telehealth Adoption Rate

0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

32.8% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Hensley (22 Years) 22 Yrs

Summersville Specialty Average (19.0 Years) 19.0 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
99213 Established patient office or other outpatient visit, typically 15 minutes	32	28	$89.50	$78.98
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	24	24	$176.00	$103.34
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	17	17	$52.00	$47.82
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	14	13	$138.43	$122.29
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	11	11	$260.36	$129.18

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	97	88	$99.74	$83.71
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	88	88	$184.14	$104.14
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	64	60	$57.61	$49.05
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	33	31	$133.45	$116.76
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	29	29	$225.10	$147.69
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	23	23	$242.70	$127.83

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	133	110	$101.32	$86.19
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	93	93	$155.08	$104.22
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	47	47	$57.00	$53.20
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	40	40	$243.00	$161.69
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	37	35	$144.89	$122.09
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	13	11	$248.00	$131.92

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	140	119	$97.00	$85.10
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	106	106	$148.00	$105.62
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	48	41	$139.00	$122.20
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	34	34	$232.00	$158.13
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	33	18	$123.00	$69.75
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	30	28	$54.93	$52.86
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	22	22	$236.00	$132.18

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	116	88	$93.78	$68.53
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	75	66	$135.45	$100.68
99202 New patient office or other outpatient visit, typically 20 minutes	43	43	$95.02	$69.55
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	38	38	$225.00	$152.91
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	32	19	$123.00	$68.37
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	32	32	$137.19	$97.11
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	24	24	$347.00	$194.03
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	19	18	$52.00	$41.18

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	39	34	$90.00	$63.86
99231 Follow-up hospital inpatient care per day, typically 15 minutes	35	13	$64.00	$37.46
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	23	23	$130.00	$99.74
99221 Initial hospital inpatient care per day, typically 30 minutes	21	19	$167.00	$96.35
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	20	20	$128.00	$94.57
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	15	13	$50.00	$35.67
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	13	13	$214.00	$142.16
43239 Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope	13	13	$575.00	$100.92
45380 Biopsy of large bowel using an endoscope	11	11	$1206.00	$147.12

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	116	96	$50.00	$37.98
99213 Established patient office or other outpatient visit, typically 15 minutes	100	91	$90.00	$63.17
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	80	77	$128.00	$94.33
43239 Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope	65	64	$575.00	$96.87
99202 New patient office or other outpatient visit, typically 20 minutes	59	59	$90.00	$64.64
45380 Biopsy of large bowel using an endoscope	49	48	$1206.00	$146.11
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	39	39	$130.00	$92.50
45385 Removal of polyps or growths of large bowel using an endoscope with mechanical snare	39	39	$1566.92	$240.35
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	32	32	$214.00	$148.21
99231 Follow-up hospital inpatient care per day, typically 15 minutes	31	20	$64.00	$36.37
45378 Diagnostic exam of large bowel using a flexible endoscope	25	25	$1070.00	$174.67
43450 Dilation of esophagus	24	24	$300.00	$39.24
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	20	16	$117.00	$67.08
G0121 Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk	15	15	$1070.00	$177.11
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	13	13	$225.00	$126.58
99221 Initial hospital inpatient care per day, typically 30 minutes	12	11	$167.00	$93.94
99225 Subsequent observation care, typically 25 minutes per day	12	12	$118.00	$67.35

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	132	121	$128.00	$93.00
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	106	87	$50.00	$37.67
99213 Established patient office or other outpatient visit, typically 15 minutes	90	86	$90.00	$63.03
43239 Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope	59	59	$575.00	$101.99
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	54	54	$214.00	$138.53
45380 Biopsy of large bowel using an endoscope	54	53	$1206.00	$149.60
99231 Follow-up hospital inpatient care per day, typically 15 minutes	51	27	$64.00	$36.36
99202 New patient office or other outpatient visit, typically 20 minutes	50	50	$90.00	$65.32
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	43	43	$130.00	$95.81
43450 Dilation of esophagus	28	27	$300.00	$35.61
45385 Removal of polyps or growths of large bowel using an endoscope with mechanical snare	25	24	$1536.00	$245.23
99221 Initial hospital inpatient care per day, typically 30 minutes	24	23	$167.00	$94.29
45378 Diagnostic exam of large bowel using a flexible endoscope	23	23	$1070.00	$168.69
47562 Removal of gallbladder using an endoscope	20	20	$2784.00	$631.52
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	16	13	$117.00	$66.48
G0121 Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk	12	12	$1070.00	$177.67
G0105 Colorectal cancer screening; colonoscopy on individual at high risk	12	12	$1070.00	$176.81

Medical Specialties & State Licenses

CMS Verified: 2022-04-21

Surgery Primary Specialty

NUCC Taxonomy Code: 208600000X

State License WV 2403

A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.

Hospital & Practice Group Affiliations

West Virginia Health Care Cooperative Inc

400 Fairview Heighs Rd, Summersville, WV 266519308

Phone: 3048728402

Practice Associates & Co-Workers

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

3 Associated Practitioners

Dr. Bandy Mullins , MD

Surgery

NPI 1033249057

Doctor of Medicine (M.D.)

Dr. Marvin Wurth , MD

Internal Medicine

NPI 1841287422

Doctor of Medicine (M.D.)

Elmer Nagye , PA-C

Physician Assistant - Medical

NPI 1881673192

Physician Assistant (Certified)

Career & Practice History Timeline

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

6 Historical Events

✅

NPI Profile Active August 27, 2013

NPI status registered as active in NPPES database

📍

Updated Practice Location August 27, 2013

Registered at 400 FAIRVIEW HEIGHTS RD, SUMMERSVILLE, WV 266519308 (Tel: 3048725124)

📍

Updated Business Mailing Address August 27, 2013

Registered at 400 FAIRVIEW HEIGHTS RD, SUMMERSVILLE, WV 266519308 (Tel: 3048725124)

👤

Provider Name / Credentials Updated August 27, 2013

Recorded as BENJAMIN HENSLEY, D.O.

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) August 27, 2013

Surgery (License #2403 in WV)

🟢

Initial NPI Registration & Enumeration June 14, 2007

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

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NPI Administrative Meta

NPI Number: 1932303682

Entity Type:

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

Enumeration Date: June 14, 2007

Last Update: April 21, 2022

Sole Proprietor: No

Update or Correct Profile

Mailing Address

400 Fairview Heights Rd

Summersville, WV 266519308

Phone: 3048725124

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.