1301 S Koke Mill Rd
Springfield IL 62711
Medical School: Other - 1983
Accepts Medicare: Yes
Participates In eRX: No
Participates In PQRS: Yes
Participates In EHR: Yes
License #: 036079986
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Awards & Recognitions
Dr. D Gordon Allan is associated with these group practices
|HCPCS Code||Description||Average Price||Average Price
Allowed By Medicare
|HCPCS Code:27487||Description:Revise/replace knee joint||Average Price:$9,603.00||Average Price Allowed
|HCPCS Code:27486||Description:Revise/replace knee joint||Average Price:$8,587.29||Average Price Allowed
|HCPCS Code:27137||Description:Revise hip joint replacement||Average Price:$7,464.32||Average Price Allowed
|HCPCS Code:27130||Description:Total hip arthroplasty||Average Price:$7,237.56||Average Price Allowed
|HCPCS Code:27447||Description:Total knee arthroplasty||Average Price:$7,243.27||Average Price Allowed
|HCPCS Code:27488||Description:Removal of knee prosthesis||Average Price:$6,362.91||Average Price Allowed
|HCPCS Code:29881||Description:Knee arthroscopy/surgery||Average Price:$3,946.00||Average Price Allowed
|HCPCS Code:29876||Description:Knee arthroscopy/surgery||Average Price:$3,576.00||Average Price Allowed
|HCPCS Code:73721||Description:Mri jnt of lwr extre w/o dye||Average Price:$1,945.00||Average Price Allowed
|HCPCS Code:73221||Description:Mri joint upr extrem w/o dye||Average Price:$1,945.00||Average Price Allowed
|HCPCS Code:73700||Description:Ct lower extremity w/o dye||Average Price:$1,364.00||Average Price Allowed
|HCPCS Code:20680||Description:Removal of support implant||Average Price:$1,277.00||Average Price Allowed
|HCPCS Code:11981||Description:Insert drug implant device||Average Price:$685.00||Average Price Allowed
|HCPCS Code:27093||Description:Injection for hip x-ray||Average Price:$456.00||Average Price Allowed
|HCPCS Code:G0180||Description:MD certification HHA patient||Average Price:$339.00||Average Price Allowed
|HCPCS Code:20610||Description:Drain/inject joint/bursa||Average Price:$276.26||Average Price Allowed
|HCPCS Code:77002||Description:Needle localization by xray||Average Price:$195.00||Average Price Allowed
|HCPCS Code:73520||Description:X-ray exam of hips||Average Price:$177.00||Average Price Allowed
|HCPCS Code:73550||Description:X-ray exam of thigh||Average Price:$162.00||Average Price Allowed
|HCPCS Code:99203||Description:Office/outpatient visit new||Average Price:$216.60||Average Price Allowed
|HCPCS Code:73562||Description:X-ray exam of knee 3||Average Price:$144.00||Average Price Allowed
|HCPCS Code:72100||Description:X-ray exam of lower spine||Average Price:$140.00||Average Price Allowed
|HCPCS Code:73030||Description:X-ray exam of shoulder||Average Price:$134.00||Average Price Allowed
|HCPCS Code:73510||Description:X-ray exam of hip||Average Price:$138.00||Average Price Allowed
|HCPCS Code:99214||Description:Office/outpatient visit est||Average Price:$197.22||Average Price Allowed
|HCPCS Code:73610||Description:X-ray exam of ankle||Average Price:$125.00||Average Price Allowed
|HCPCS Code:73560||Description:X-ray exam of knee 1 or 2||Average Price:$119.00||Average Price Allowed
|HCPCS Code:72170||Description:X-ray exam of pelvis||Average Price:$114.00||Average Price Allowed
|HCPCS Code:73590||Description:X-ray exam of lower leg||Average Price:$113.00||Average Price Allowed
|HCPCS Code:73500||Description:X-ray exam of hip||Average Price:$110.00||Average Price Allowed
|HCPCS Code:99202||Description:Office/outpatient visit new||Average Price:$149.16||Average Price Allowed
|HCPCS Code:99213||Description:Office/outpatient visit est||Average Price:$138.99||Average Price Allowed
|HCPCS Code:99212||Description:Office/outpatient visit est||Average Price:$82.89||Average Price Allowed
|HCPCS Code:J3301||Description:Triamcinolone acet inj NOS||Average Price:$16.00||Average Price Allowed
|HCPCS Code:J1030||Description:Methylprednisolone 40 MG inj||Average Price:$16.59||Average Price Allowed
|HCPCS Code:J7325||Description:Synvisc or Synvisc-One||Average Price:$18.50||Average Price Allowed
HCPCS Code Definitions
- Revision of total knee arthroplasty, with or without allograft; femoral and entire tibial component
- Radiologic examination, shoulder; complete, minimum of 2 views
- Revision of total knee arthroplasty, with or without allograft; 1 component
- Arthroplasty, knee, condyle and plateau; medial AND lateral compartments with or without patella resurfacing (total knee arthroplasty)
- Insertion, non-biodegradable drug delivery implant
- Radiologic examination, hips, bilateral, minimum of 2 views of each hip, including anteroposterior view of pelvis
- Radiologic examination, pelvis; 1 or 2 views
- Removal of prosthesis, including total knee prosthesis, methylmethacrylate with or without insertion of spacer, knee
- Arthroscopy, knee, surgical; synovectomy, major, 2 or more compartments (eg, medial or lateral)
- Arthroscopy, knee, surgical; with meniscectomy (medial OR lateral, including any meniscal shaving) including debridement/shaving of articular cartilage (chondroplasty), same or separate compartment(s), when performed
- Radiologic examination, spine, lumbosacral; 2 or 3 views
- Radiologic examination, ankle; complete, minimum of 3 views
- Office or other outpatient visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: A problem focused history; A problem focused examination; Straightforward medical decision making. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are self limited or minor. Typically, 10 minutes are spent face-to-face with the patient and/or family.
- Radiologic examination; tibia and fibula, 2 views
- Radiologic examination, hip, unilateral; 1 view
- Revision of total hip arthroplasty; acetabular component only, with or without autograft or allograft
- Magnetic resonance (eg, proton) imaging, any joint of upper extremity; without contrast material(s)
- Radiologic examination, knee; 3 views
- Radiologic examination, hip, unilateral; complete, minimum of 2 views
- Radiologic examination, femur, 2 views
- Radiologic examination, knee; 1 or 2 views
- Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material
- Office or other outpatient visit for the evaluation and management of a new patient, which requires these 3 key components: A detailed history; A detailed examination; Medical decision making of low complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of moderate severity. Typically, 30 minutes are spent face-to-face with the patient and/or family.
- Computed tomography, lower extremity; without contrast material
- Office or other outpatient visit for the evaluation and management of a new patient, which requires these 3 key components: An expanded problem focused history; An expanded problem focused examination; Straightforward medical decision making. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of low to moderate severity. Typically, 20 minutes are spent face-to-face with the patient and/or family.
- Fluoroscopic guidance for needle placement (eg, biopsy, aspiration, injection, localization device)
- Injection, triamcinolone acetonide, not otherwise specified, 10 mg
- Removal of implant; deep (eg, buried wire, pin, screw, metal band, nail, rod or plate)
- Injection procedure for hip arthrography; without anesthesia
- Arthroplasty, acetabular and proximal femoral prosthetic replacement (total hip arthroplasty), with or without autograft or allograft
- Office or other outpatient visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: An expanded problem focused history; An expanded problem focused examination; Medical decision making of low complexity. Counseling and coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of low to moderate severity. Typically, 15 minutes are spent face-to-face with the patient and/or family.
- Injection, methylprednisolone acetate, 40 mg
- Physician 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 to affirm the initial implementation of the plan of care that meets patient's needs, per certification period
- Arthrocentesis, aspiration and/or injection; major joint or bursa (eg, shoulder, hip, knee joint, subacromial bursa)
- Hyaluronan or derivative, synvisc or synvisc-one, for intra-articular injection, 1 mg
- Office or other outpatient visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: A detailed history; A detailed examination; Medical decision making of moderate complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of moderate to high severity. Typically, 25 minutes are spent face-to-face with the patient and/or family.
Medical Malpractice Cases
Medical Board Sanctions
Physical Medicine And Rehabilitation
*These referrals represent the top 10 that Dr. Allan has made to other doctors
Surgical simulators and hip fractures: a role in residency training? - Journal of surgical education
Orthopedic surgery residency training requires intellectual and motor skill development. In this study, we utilized a computer-based haptic simulator to examine a potential model for evaluation of resident proficiency and efficiency in the placement of a center guide wire during fixation of an intertrochanteric proximal femur fracture. We hypothesize the junior residents will utilize more fluoroscopy and require more time to complete the task.Postgraduate year (PGY) 1-5 residents completed the same task of placing a single central guide pin into a femoral head for a dynamic hip screw construct utilizing a haptic surgical simulator. Residents were divided into 2 groups (PGY 1-2 and PGY 3-5) and then evaluated based on final tip-apex distance (TAD), fluoroscopy time, time to complete the task, total number of distinct attempts at pin placement for each femur construct, as well as final 3-dimensional location of the pin from the isometric center of the femoral head.No statistically significant differences were noted between the 2 groups in total time or for tip-apex distance, anterior/posterior medial/lateral position, anterior/posterior superior/inferior, and lateral x-ray medial/lateral positioning measurements. Significant differences between Groups I and II were observed in anterior/posterior final position on the lateral view (p = 0.01), unique attempts (0.77 and 1.5, p = 0.03), and total fluoroscopic time (18.4 seconds and 12.9 seconds, p = 0.05).In this study, we displayed that based on our simulator model there was no statistical difference between Group I and II in time to completion, final placement on anterior/posterior (A/P) view, and tip-apex distance. There was a statistically significant difference in the anterior/posterior placement of the wire in lateral view between the 2 groups, fluoroscopy time, and number of attempts per trial. Our findings suggest a computer-based surgical simulator can identify measurable differences in surgical proficiency between junior and senior orthopedic surgery residents and may play an expanding role in resident education.Copyright Â© 2011 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.
Radiographic evaluation of midterm failure rates following metal-on-metal hip resurfacing. - The Journal of arthroplasty
This prospective study examined patient characteristics and radiographic findings for 89 subjects undergoing total hip resurfacing. Thirteen (14.6%) of 89 hips have required revision. Female sex, smaller implant size, and diagnosis of osteonecrosis were associated with lower device survival. No significant differences in acetabular cup angle and stem angle were observed between revised and nonrevised hips. Revision rates for the first 25 hips were 24% and 8% for the last 64 hips. Females accounted for 56% of subjects 1 to 25 and 23% of subjects 26 to 89. Despite representing only 33% of included subjects, females accounted for 62% of revision procedures. The lower device survival proportion in subjects 1 to 25 could not be attributed to acetabular or femoral component malpositioning and can likely be explained by a significantly higher proportion of females enrolled early in the study.Copyright Â© 2011 Elsevier Inc. All rights reserved.
Hospital outcome after emergent vs elective revision total hip arthroplasty. - The Journal of arthroplasty
This is a retrospective review of inpatient outcomes, based upon emergent or elective admission for revision total hip arthroplasty (THA) procedures performed between 2000 and 2006. Three hundred forty-two revision THA procedures (291 elective, 51 emergent) were identified. Emergent revisions were more likely to be older (69.9 vs 62.7; P = .003), women (72% vs 54%), require longer hospitalization (8.3 vs 3.8 days), and require a skilled care facility at discharge. No significant difference was observed in mortality. We identified 2 basic outcome measures suggesting that patients undergoing emergent revision will have a more complex hospitalization and require more assistance at discharge. Clarifying emergent vs elective THA at admission may assist in better planning and assessment of patient needs regarding rehabilitation, hospital management, and discharge planning.Copyright (c) 2010 Elsevier Inc. All rights reserved.
Effect of bone cement viscosity and set time on mantle area in total knee arthroplasty. - American journal of orthopedics (Belle Mead, N.J.)
To assess the impact of bone cement viscosity on total knee arthroplasty, we compared 1 high-viscosity and 2 medium-viscosity cements with respect to mantle area and zone-specific intrusion depths into the tibial plateau. We analyzed postoperative radiographs to determine penetration area and depth in 72 consecutive patients (79 knees) in whom DePuy II (n = 11), Endurance (n = 34), or Simplex-P (n = 34) cement was used. Penetration into the tibial plateau (anteroposterior zones 1-4) was significantly reduced with use of the high-viscosity DePuy II cement but did not differ significantly between the 2 medium-viscosity cements, Endurance and Simplex-P. Surgical and tourniquet times were significantly decreased with the quicker setting DePuy II cement. Given these findings, additional studies are warranted to assess the long-term impact of the lower intrusion depths found with DePuy II cement. Such differences in cement penetration could jeopardize long-term fixation and lead to higher long-term device failure rates.
Effect of hand packing versus cement gun pressurization on cement mantle in total knee arthroplasty. - Canadian journal of surgery. Journal canadien de chirurgie
Gun pressurization in total knee arthroplasty (TKA) may result in better cement penetration than hand packing, leading to fewer tibial plate failures. We compared cement intrusion characteristics between vacuum mixing and gun pressurization versus hand mixing and packing in the proximal tibia among patients undergoing TKA.We analyzed 6-week radiographs from 77 consecutive patients for cement area and zone-specific intrusion using computer-assisted image analysis.Penetration into tibial anteroposterior zones 1-6 was not significantly different between the techniques. Intrusion depths in anteroposterior zone 7 and lateral zone 2 were significantly increased with gun pressurization, but this increase was associated with significantly longer operating room and tourniquet times.We identified no obvious advantage of vacuum mixing with gun pressurization, suggesting that continued use of the hand-packing technique may be warranted. Additional long-term failure studies must be completed to compare these techniques.
Acetabular cup malalignment after total hip resurfacing arthroplasty: a case for elective revision? - Orthopedics
This article describes the clinical course of a patient with a resurfacing implant in a poor cup position in combination with elevated serum metal ions prior to implant failure. Following resurfacing, the patient had substantial improvement from baseline in pain and functional status. Postoperative radiographs indicated the acetabular cup in an abducted and excessively anteverted position. The acetabular component ultimately failed after 4.5 years and a traditional total hip arthroplasty revision was performed. Serum cobalt (Co) and chromium (Cr) concentrations had been collected postoperatively of the index procedure at 6 months, 1 year, 2 years, 3 years, and pre- and postoperatively at the time of implant revision. Serum cobalt and chromium ion levels were progressively elevated to approximately 400 times more than the expected range at all time points prior to revision. Elective revision had been considered due to acetabular malalignment and elevated metal ion levels, but not performed since the patient was doing well clinically. A recent study has shown a correlation between increased cup inclination and increased serum cobalt or chromium levels and this patient's levels were >40 times greater than that typically observed with this device. Early revision should be strongly considered if component malpositioning is noted, and abnormally elevated ion concentrations should signal the need for revision regardless of the patient's clinical status. The relationship of a malpositioned cup and uncharacteristically elevated metal ion levels is related to the metal-on-metal bearing coupling and likely applies to conventional metal-on-metal total hip prostheses as well.
Are honors received during surgery clerkships useful in the selection of incoming orthopaedic residents? - The Iowa orthopaedic journal
The purpose of this study was to review institutional statistics provided in dean's letters and determine the percentage of honors awarded by institution and clerkship specialty.Institutional and clerkship aggregate data were compiled from a review of dean's letters from 80 United States medical schools. The percentage of honors awarded during 3rd year clerkships during 2005 were collected for analysis. Across clerkship specialties, there were no statistically significant differences between the mean percentage of honors given by the medical schools examined with Internal Medicine (27.6%) the low and Psychiatry (33.5%) the high. However, inter-institutional variability observed within each clerkship was high, with surgery clerkship percentage of honors ranging from 2% to 75% of the students. This suggests some schools may be more lenient and other more stringent in awarding honors to their students. This inter-institutional variability makes it difficult to compare honors received by students from different medical schools and weakens the receipt of honors as a primary tool for evaluating potential incoming residents.
Impact of the 80-hour workweek on surgical exposure and national in-training examination scores in an orthopedic residency program. - Journal of surgical education
This study examines the impact of the 80-hour workweek on the number of surgical cases performed by PGY-2 through PGY-5 orthopedic residents. We also evaluated orthopedic in-training examination (OITE) scores during the same time period.Data were collected from the Accreditation Council for Graduate Medical Education (ACGME) national database for 3 academic years before and 5 years after July 1, 2003. CPT surgical procedure codes logged by all residents 3 years before and 5 years after implementation of the 80-hour workweek were compared. The average raw OITE scores for each class obtained during the same time period were also evaluated. Data were reported as the mean +/- standard deviation (SD), and group means were compared using independent t-tests.No statistical difference was noted in the number of surgical procedure codes logged before or after the institution of the 80-hour week during any single year of training. However, an increase in the number of CPT codes logged in the PGY-3 years after 2003 did approach significance (457.7 vs 551.9, p = 0.057). Overall, the average number of cases performed per resident increased each year after implementation of the work-hour restriction (464.4 vs 515.5 cases). No statistically significant difference was noted in the raw OITE scores before or after work-hour restrictions for our residents or nationally.We found no statistical difference for each residency class in the average number of cases performed or OITE scores, although the total number of cases performed has increased after implementation of the work-hour restrictions. We also found no statistical difference in the national OITE scores. Our data suggest that the impact of the 80-hour workweek has not had a detrimental effect on these 2 resident training measurements.
Multi-modal, pre-emptive analgesia decreases the length of hospital stay following total joint arthroplasty. - Orthopedics
Traditional treatment of pain following total joint arthroplasty involves postoperative oral narcotic medications and intravenous patient-controlled analgesia, both of which can result in significant postoperative morbidity. Multi-modal analgesia involving >or=2 classes of drugs acting on different receptor types may be as effective as single-narcotic/patient-controlled analgesia with fewer analgesic-related side effects. In addition, administering analgesia prior to surgery (pre-emptive) may reduce postoperative pain intensity. The current study was designed to compare the impact of multi-modal pre-emptive analgesia versus patient-controlled analgesia on postoperative nausea, rehabilitation participation, and length of stay following total joint arthroplasty. A retrospective chart review and comparison was performed for patients undergoing total joint arthroplasty who received either postoperatively patient-controlled analgesia or pre-emptive analgesia (scheduled postoperative oxycodone and a COX-2 inhibitor). Length of hospital stay for the pre-emptive group averaged 2.74 vs 3.28 days for patient-controlled analgesia patients. The patient-controlled analgesia group consumed significantly more intravenous morphine (17.7 mg vs 7.2) and experienced a three-fold increase in nausea. In addition, the patient-controlled analgesia group was twice as likely to miss therapy and nearly 2 times more likely to be discharged to an extended care facility. The use of pre-emptive oxycodone and a selective COX-2 inhibitor decreased postoperative narcotic requirements and increased participation in rehabilitation. In addition, patients receiving pre-emptive analgesics had a decreased hospital length of stay and reduced likelihood of discharge to a skilled nursing facility. These data support the continued study and use of pre-emptive multi-modal analgesia paradigms in this population.
Serum cobalt and chromium elevations following hip resurfacing with the Cormet 2000 device. - Journal of surgical orthopaedic advances
This study was designed to monitor serum cobalt (Co) and chromium (Cr) levels at multiple time points following hip resurfacing with the Cormet 2000 device. Serum samples were obtained preoperatively, at 6 months, 1, 2, and 3 years after surgery. Co/Cr levels (micro g/L) were determined by high-resolution inductively coupled plasma mass spectrometry. Thirty-five subjects were followed. Median preoperative Co/Cr levels were 0.21 and 0.22, respectively. Serum levels following device implantation were increased at all follow-up time points when compared to preoperative controls. Peak levels were observed at 1 year (Co, 3.34; Cr, 4.67) and levels at 3 years were trending down (Co, 2.08; Cr, 3.55), but this decrease was not statistically significant. This study is the first to report significant elevations in serum Co/Cr levels at multiple time points up to 3 years following hip resurfacing with the Cormet 2000 device. Future studies are needed to determine what serum Co/Cr levels are of clinical concern, particularly in outlier cases.
Map & Directions
1301 S Koke Mill Rd Springfield, IL 62711
3401 Conifer Dr
1301 S Koke Mill Rd
3700 W Bluffs Rd