DAVID A GUTHRIE M.D.
NPI 1154302321
Surgery in Chambersburg, PA

Medicare Participation & PECOS Enrollment Status

David Guthrie is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

David Guthrie is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

• Is the provider registered in PECOS? Yes

• PECOS PAC ID: 2961479373

  What is the PECOS Associate Control ID?
  A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

• PECOS Enrollment ID: I20070531000063

  What is the Provider Enrollment ID?
  The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

• Accepts Medicare Assignment? Yes

  What does it mean "accepts medicare assignment"?
  When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
  A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

• Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

• Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

• Eligible to Order or Refer a Home Health Agency (HHA): Yes

• Eligible to Order or Refer Power Mobility Devices: Yes

Provider Referred Orders for Durable Medical Equipment, Devices & Supplies

The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.

Durable Medical Equipment

• DME-Medical/Surgical Supplies (DA000N)

  Tape, non-waterproof, per 18 square inches (HCPCS:A4450)

  2 DME suppliers used 20 Medicare Claims 1320 Services Paid

• DME-Medical/Surgical Supplies (DA000N)

  Tape, waterproof, per 18 square inches (HCPCS:A4452)

  5 DME suppliers used 69 Medicare Claims 6800 Services Paid

• DME-Medical/Surgical Supplies (DA023N)

  Foam dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing (HCPCS:A6210)

  3 DME suppliers used 38 Medicare Claims 713 Services Paid

• DME-Medical/Surgical Supplies (DA023N)

  Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing (HCPCS:A6212)

  4 DME suppliers used 13 Medicare Claims 216 Services Paid

• DME-Medical/Surgical Supplies (DA023N)

  Specialty absorptive dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing (HCPCS:A6251)

  3 DME suppliers used 20 Medicare Claims 831 Services Paid

• DME-Medical/Surgical Supplies (DA023N)

  Specialty absorptive dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing (HCPCS:A6252)

  3 DME suppliers used 15 Medicare Claims 483 Services Paid

• DME-Medical/Surgical Supplies (DA023N)

  Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing (HCPCS:A6402)

  4 DME suppliers used 87 Medicare Claims 6516 Services Paid

• DME-Medical/Surgical Supplies (DA023N)

  Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard (HCPCS:A6446)

  2 DME suppliers used 31 Medicare Claims 2185 Services Paid

• DME-Medical/Surgical Supplies (DA023N)

  Tubular dressing with or without elastic, any width, per linear yard (HCPCS:A6457)

  2 DME suppliers used 11 Medicare Claims 40 Services Paid

• DME-Medical/Surgical Supplies (DA000N)

  Gradient compression stocking, below knee, 30-40 mmhg, each (HCPCS:A6531)

  2 DME suppliers used 13 Medicare Claims 33 Services Paid

• DME-Other DME (DE000N)

  Wound care set, for negative pressure wound therapy electrical pump, includes all supplies and accessories (HCPCS:A6550)

  2 DME suppliers used 31 Medicare Claims 315 Services Paid

• DME-Other DME (DE000N)

  Canister, disposable, used with suction pump, each (HCPCS:A7000)

  2 DME suppliers used 25 Medicare Claims 225 Services Paid

• DME-Other DME (DE000N)

  Negative pressure wound therapy electrical pump, stationary or portable (HCPCS:E2402)

  2 DME suppliers used 30 Medicare Claims 30 Services Paid

• DME-Wheelchairs (DD000N)

  Lightweight wheelchair (HCPCS:K0003)

  1 DME suppliers used 13 Medicare Claims 13 Services Paid

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Complete ultrasound study of arm and leg arteries

This procedure involves using sound waves to produce images of your arm and leg arteries. It helps identify blockages or abnormalities that could lead to conditions like stroke or peripheral artery disease. It's non-invasive and painless.

This service was performed 42 times for 39 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

This service was performed 118 times for 103 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

This service was performed 61 times for 53 patients

Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

This service was performed 1,081 times for 251 patients

Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

This service was performed 334 times for 222 patients

Initial hospital care with straightforward or low level of medical decision making, per day, if using time, at least 40 minutes

Initial hospital inpatient care refers to the first day of your stay in the hospital. This service typically includes a 30-minute check-up with a healthcare professional. They'll assess your health, discuss your condition, and plan your treatment. It's part of ensuring you receive the best possible care.

This service was performed 78 times for 69 patients

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

This service was performed 25 times for 24 patients

Insertion of stent in arteries of leg

A stent insertion in the leg arteries is a procedure to improve blood flow. A tiny mesh tube called a stent is placed in your artery to keep it open. This helps prevent blockages, alleviating pain and aiding in better mobility.

This service was performed 25 times for 23 patients

Insertion of stent in artery of leg, initial vessel

A stent insertion in the leg artery is a procedure to open narrowed or blocked arteries, improving blood flow. A tiny tube (stent) is placed in the initial vessel of your leg to keep the artery open. This helps prevent leg pain and other complications.

This service was performed 11 times for 11 patients

Management of oxygen chamber therapy

Oxygen chamber therapy involves breathing pure oxygen in a pressurized room or tube. It's used to treat various conditions like wounds that won't heal due to diabetes or radiation injury. In this therapy, your body's tissues get more oxygen to promote healing and fight infection.

This service was performed 321 times for 12 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

This service was performed 85 times for 85 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

This service was performed 47 times for 47 patients

Removal of bone, 20.0 sq cm or less

The procedure involves the surgical removal of a section of bone, up to 20.0 square cm in size. This may be necessary due to various reasons such as injury, infection, or to treat a disease. The process aims to alleviate pain, enhance mobility, or prevent the spread of disease.

This service was performed 19 times for 14 patients

Removal of bone, each additional 20.0 sq cm or less

This procedure involves the surgical removal of a specified amount of bone, typically due to disease or injury. Each additional 20.0 square cm or less refers to the size of the bone area being removed. It's a precise operation performed by skilled surgeons.

This service was performed 104 times for 11 patients

Removal of muscle and/or tissue, 20.0 sq cm or less

This procedure involves the surgical removal of a specified area (20.0 sq cm or less) of muscle and/or tissue. It's typically done to treat conditions like tumors, infections, or injuries. Local or general anesthesia ensures comfort. Recovery time varies.

This service was performed 38 times for 24 patients

Removal of muscle and/or tissue, each additional 20.0 sq cm or less

This procedure involves the removal of muscle and/or tissue, typically to treat disease or injury. An additional 20.0 square cm or less of tissue may be removed if necessary. The process is performed by a skilled medical professional to ensure your safety and recovery.

This service was performed 98 times for 15 patients

Removal of skin and tissue, 20.0 sq cm or less

This procedure involves the surgical removal of skin and tissue, up to 20.0 square cm in size. It's often performed to treat conditions like skin cancer or to remove moles, warts, and other skin lesions. The area is numbed and the unwanted tissue is carefully cut out.

This service was performed 71 times for 53 patients

Removal of skin and tissue, each additional 20.0 sq cm or less

This procedure involves the removal of skin and tissue, typically due to disease, injury, or abnormal growth. Each session removes an area of 20.0 square cm or less. It's performed by a trained professional and may require multiple sessions for larger areas.

This service was performed 40 times for 11 patients

Removal of tissue from wound, 20.0 sq cm or less

This procedure involves the careful removal of damaged or infected tissue from a wound that's 20.0 square cm or less. It's done to promote healing and prevent further infection. The process is carried out under local anesthesia, ensuring minimal discomfort.

This service was performed 132 times for 78 patients

Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes

Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.

This service was performed 536 times for 123 patients

Ultrasound study of arm and leg arteries

An ultrasound study of arm and leg arteries is a non-invasive procedure that uses sound waves to create images of your arteries. It helps in checking blood flow, identifying blockages, or detecting other abnormalities in your arteries.

This service was performed 290 times for 243 patients

Physician Visit Costs

The typical physician office visit costs for Medicare beneficiaries in this area are: $21.22 for a new patient copayment and $17.09 for an established patient copayment.

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 17201 ZIP code area.

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Find Provider Hospital Affiliations - Privileges

Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.

Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. David Guthrie is affiliated with the following medical facilities:

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