DR. MATTHEW W. JOHNSON MD
NPI 1881685808
Urology in Milwaukee, WI

Medicare Participation & PECOS Enrollment Status

Matthew Johnson 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.

Matthew Johnson 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: 4789658626

  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: I20101103001152

  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.

Orthotic Devices

• DME-Orthotic Devices (DF000N)

  Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each (HCPCS:A4357)

  5 DME suppliers used 30 Medicare Claims 99 Services Paid

• DME-Orthotic Devices (DF010N)

  Ostomy skin barrier, with flange (solid, flexible, or accordion), extended wear, with built-in convexity, 4 x 4 inches or smaller, each (HCPCS:A4407)

  5 DME suppliers used 12 Medicare Claims 400 Services Paid

• DME-Orthotic Devices (DF010N)

  Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each (HCPCS:A4409)

  3 DME suppliers used 28 Medicare Claims 740 Services Paid

• DME-Orthotic Devices (DF010N)

  Ostomy pouch, urinary, with extended wear barrier attached, with faucet-type tap with valve (1 piece), each (HCPCS:A4428)

  2 DME suppliers used 11 Medicare Claims 270 Services Paid

• DME-Orthotic Devices (DF010N)

  Ostomy pouch, urinary; for use on barrier with non-locking flange, with faucet-type tap with valve (2 piece), each (HCPCS:A4432)

  5 DME suppliers used 48 Medicare Claims 1220 Services Paid

• DME-Orthotic Devices (DF010N)

  Skin barrier, wipes or swabs, each (HCPCS:A5120)

  3 DME suppliers used 14 Medicare Claims 580 Services Paid

Durable Medical Equipment

• DME-Medical/Surgical Supplies (DA000N)

  Adhesive remover, wipes, any type, each (HCPCS:A4456)

  4 DME suppliers used 27 Medicare Claims 1275 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.

Administration of hormonal anti-neoplastic chemotherapy under skin or into muscle

This procedure involves the injection of hormone-based anti-cancer drugs under the skin or into a muscle. These medications help to slow down or stop the growth of certain types of cancer cells. The process is usually quick and can be performed in a clinic or hospital.

This service was performed 23 times for 14 patients

Bcg live intravesical instillation, 1 mg

BCG live intravesical instillation is a procedure where a weakened form of a bacteria is introduced into your bladder. This helps your body's immune system to fight off certain bladder conditions. The procedure is generally safe and effective.

This service was performed 2,300 times for 13 patients

Biopsy of prostate gland

A biopsy of the prostate gland is a procedure where a small sample of tissue is taken from your body's internal gland, located near the bladder, for testing. This helps in diagnosing potential health issues. It's usually done with a fine needle and imaging technology for accuracy.

This service was performed 25 times for 25 patients

Crushing of stone of ureter with insertion of stent using an endoscope

This procedure involves using a thin, flexible tube (endoscope) to locate and break down kidney stones in the ureter. After this, a small tube (stent) is inserted to help maintain an open pathway for urine to flow.

This service was performed 27 times for 21 patients

Destruction and/or removal of growth of bladder and urethra using an endoscope, 0.5-2.0 cm

This procedure involves using a special instrument, an endoscope, to view and treat a small growth in the bladder and urethra. It's a minimally invasive method to remove or destroy growths measuring 0.5-2.0 cm, aiding in better urinary health.

This service was performed 17 times for 15 patients

Destruction and/or removal of growth of bladder and urethra using an endoscope, 2.0-5.0 cm

This procedure involves using a thin, flexible tool called an endoscope to examine and remove a growth in your bladder and urethra. The growth size ranges from 2.0-5.0 cm. This is done to ensure your urinary system functions properly.

This service was performed 11 times for 11 patients

Diagnostic exam of bladder and urethra using an endoscope

This procedure involves using a thin, flexible tube with a light, called an endoscope, to examine the bladder and urethra. It helps in identifying any abnormalities or issues that may be causing discomfort or other symptoms.

This service was performed 124 times for 100 patients

Established patient office or other outpatient visit, 20-29 minutes

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 338 times for 276 patients

Established patient office or other outpatient visit, 30-39 minutes

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

This service was performed 284 times for 236 patients

Established patient office or other outpatient visit, 40-54 minutes

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

This service was performed 29 times for 26 patients

Hernia repair (minimally invasive)

Hernia repair is a surgery to fix a hernia - a condition where an organ pushes through an opening in the muscle or tissue that holds it in place. Minimally invasive hernia repair involves small incisions, a tiny camera, and special surgical tools. This method often leads to quicker recovery, less pain, and reduced scarring compared to traditional surgery.

This service was performed for 1-10 patients

Imaging of urinary tract following injection of a contrast agent

This procedure involves injecting a contrast agent into your body to help highlight the urinary tract during imaging. The contrast agent makes your urinary tract more visible on the images, providing detailed information about its structure and function. This can help in diagnosing any potential issues.

This service was performed 49 times for 32 patients

Initial hospital inpatient care per day, typically 50 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 16 times for 16 patients

Insertion of stent in ureter using an endoscope

This procedure involves placing a small, flexible tube (stent) in your body's drainage system to help urine flow from the kidneys to the bladder. An endoscope, a thin tube with a light and camera, is used for precise placement.

This service was performed 43 times for 29 patients

Instillation of anti-cancer drug into bladder

This procedure involves introducing a medication into the bladder to help fight off harmful cells. A small tube is gently placed into the area where urine exits the body. Through this tube, the medication is delivered directly into the bladder for maximum effectiveness.

This service was performed 12 times for 12 patients

Instillation of anti-cancer drug into bladder

This procedure involves introducing a medication into the bladder to help fight off harmful cells. A small tube is gently placed into the area where urine exits the body. Through this tube, the medication is delivered directly into the bladder for maximum effectiveness.

This service was performed 46 times for 12 patients

Leuprolide acetate (for depot suspension), 7.5 mg

Leuprolide acetate is a medication that helps regulate certain hormone levels in your body. It's injected into your muscle once a month. This treatment can help manage various health conditions related to hormone imbalance. Always follow your doctor's instructions.

This service was performed 120 times for 12 patients

Melanoma (skin cancer) excision

Melanoma excision is a procedure where a surgeon removes melanoma, a type of skin cancer, and some surrounding healthy tissue. Local anesthesia is applied to numb the area. The goal is to completely remove the cancer and prevent its spread. Healing time varies.

This service was performed for 1-10 patients

New patient office or other outpatient visit, 30-44 minutes

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 29 times for 29 patients

New patient office or other outpatient visit, 45-59 minutes

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

This service was performed 52 times for 52 patients

Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional

This service involves an outpatient visit for established patients who may not need direct interaction with a healthcare professional. It could include reviewing test results, monitoring existing conditions, or adjusting treatment plans. It's typically done remotely, ensuring your comfort and convenience.

This service was performed 16 times for 14 patients

Prostate resection

Prostate resection is a procedure performed to alleviate discomfort caused by an enlarged prostate. This involves removing a portion of the prostate gland to ease pressure on the urinary tract, improving urine flow and reducing symptoms. It's performed under general or spinal anesthesia.

This service was performed for 83 patients

Removal of lymph nodes of both sides of pelvis using an endoscope

This procedure involves using a small camera (endoscope) to view and remove lymph nodes from both sides of your lower torso. Lymph nodes help filter harmful substances from the body. The procedure is done to prevent the spread of certain conditions.

This service was performed 21 times for 21 patients

Simple removal of foreign body, stone, or stent in urethra or bladder using an endoscope

This is a procedure to remove an object, stone, or tube from your urinary tract. An endoscope, a thin, flexible tube with a light and camera, is used to locate and remove the object. It is a safe and effective way to address the issue.

This service was performed 19 times for 18 patients

Surgical removal of prostate and surrounding lymph nodes using an endoscope

This is a minimally invasive procedure where a small camera (endoscope) is used to remove a gland located in the lower body and nearby small filtering structures. It's done to prevent the spread of unwanted cells and improve overall health.

This service was performed 23 times for 23 patients

Ultrasound scan of pelvic region through rectum

An ultrasound scan of the pelvic region through the rectum is a medical procedure where a small, smooth device is gently inserted into the rectum. This device uses sound waves to create images of the internal structures in the lower abdomen, aiding in diagnosis and treatment planning.

This service was performed 25 times for 25 patients

Urinalysis, manual test

A urinalysis is a simple, non-invasive test that checks the urine for various elements such as sugar, protein, and signs of infection. It can help detect many common conditions, including kidney disease and diabetes. The manual test involves a lab technician examining a urine sample.

This service was performed 280 times for 185 patients

Physician Visit Costs

The typical physician office visit costs for Medicare beneficiaries in this area are: $30.92 for a new patient copayment and $16.84 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 53215 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. Matthew Johnson is affiliated with the following medical facilities:

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