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Ronald R Castonguay, MD

Orthopedic Surgery · Fresno

NPI 1154467074

Medicare standing
Clear
Enrolled, allowed to bill and order, not excluded
Plans that list them
Not verified
Not the same as out of network.
Offices
4
Since medical school
36 years
Graduated 1990

Offices

4 locations · Saint Agnes Medical Foundation · 161 clinicians in this group

Looking this up.

Hospitals listed: Saint Agnes Medical Center. That is not proof they admit you there this week.

Plan participation

Not verified

We could not verify current plan participation for this doctor. This does not mean they are out of network. Call Dr. Castonguay’s office to ask if they take your plan before you enroll.

Hospitals they work in

1 hospital

These rate the hospital, not this clinician. Most measures at most hospitals are no different from the national rate.

  • Saint Agnes Medical CenterFresno, CAAcute Care Hospital · Voluntary non-profit - Church · Has an emergency department · Birthing-friendlyPart of Trinity Health, which runs 105 hospitals in 16 statesPatients rate it 3 of 5 · 76% would definitely recommend it
    Overall rating: 2 of 5 starsBetter than the national rate — Catheter Associated Urinary Tract Infections (ICU + select Wards): 0.274, Oct 2024 – Sep 2025Better than the national rate — Central Line Associated Bloodstream Infection (ICU + select Wards): 0.312, Oct 2024 – Sep 2025Better than the national rate — Clostridium Difficile (C.Diff): 0.141, Oct 2024 – Sep 2025
See every measure and the patient survey for Saint Agnes Medical Center

Behind the star rating — Deaths: 0 better, 8 the same, 0 worse of 8 measures. Safety: 2 better, 6 the same, 0 worse of 8 measures. Readmissions: 0 better, 6 the same, 3 worse of 9 measures. The star rating is worked out from an earlier period than the measures below, so the two can disagree.

Every scored measure at Saint Agnes Medical Center
Catheter Associated Urinary Tract Infections (ICU + select Wards)Infections0.274BetterOct 2024 – Sep 2025
Central Line Associated Bloodstream Infection (ICU + select Wards)Infections0.312BetterOct 2024 – Sep 2025
Clostridium Difficile (C.Diff)Infections0.141BetterOct 2024 – Sep 2025
Abdominopelvic accidental puncture or laceration rateComplications and deaths1.06 (0.18 to 1.94) · 2,342 casesNo differentJul 2022 – Jun 2024
CMS Medicare PSI 90: Patient safety and adverse events compositeComplications and deaths1.02 (0.76 to 1.27)No differentJul 2022 – Jun 2024
Death rate among surgical inpatients with serious treatable complicationsComplications and deaths197.82 (152.64 to 243.01) · 103 casesNo differentJul 2022 – Jun 2024
Death rate for CABG surgery patientsComplications and deaths3.9 · 105 casesNoneJul 2022 – Jun 2025
Death rate for COPD patientsComplications and deaths7.3 · 300 casesNoneJul 2022 – Jun 2025
Death rate for heart attack patientsComplications and deaths11.9 · 295 casesNoneJul 2022 – Jun 2025
Death rate for heart failure patientsComplications and deaths10.8 · 768 casesNoneJul 2022 – Jun 2025
Death rate for pneumonia patientsComplications and deaths15.8 · 969 casesNoneJul 2022 – Jun 2025
Death rate for stroke patientsComplications and deaths11.2 · 304 casesNoneJul 2023 – Jun 2025
Hybrid Hospital-Wide All-Cause Risk Standardized Mortality RateComplications and deaths3.7 · 4,305 casesNoneJul 2024 – Jun 2025
Iatrogenic pneumothorax rateComplications and deaths0.24 (0.06 to 0.42) · 11,641 casesNo differentJul 2022 – Jun 2024
In-hospital fall-associated fracture rateComplications and deaths0.25 (0.07 to 0.43) · 12,213 casesNo differentJul 2022 – Jun 2024
Perioperative pulmonary embolism or deep vein thrombosis rateComplications and deaths4.76 (2.91 to 6.61) · 2,466 casesNo differentJul 2022 – Jun 2024
Postoperative acute kidney injury requiring dialysis rateComplications and deaths1.09 (0 to 2.49) · 864 casesNo differentJul 2022 – Jun 2024
Postoperative hemorrhage or hematoma rateComplications and deaths1.61 (0.26 to 2.96) · 2,362 casesNo differentJul 2022 – Jun 2024
Postoperative respiratory failure rateComplications and deaths10.1 (5.39 to 14.81) · 900 casesNo differentJul 2022 – Jun 2024
Postoperative sepsis rateComplications and deaths4.4 (1.2 to 7.59) · 882 casesNo differentJul 2022 – Jun 2024
Postoperative wound dehiscence rateComplications and deaths1.84 (0.41 to 3.27) · 541 casesNo differentJul 2022 – Jun 2024
Pressure ulcer rateComplications and deaths0.67 (0.14 to 1.19) · 9,626 casesNo differentJul 2022 – Jun 2024
Rate of complications for hip/knee replacement patientsComplications and deaths3.9 · 58 casesNoneApr 2023 – Mar 2025
MRSA BacteremiaInfections0.835No differentOct 2024 – Sep 2025
SSI - Abdominal HysterectomyInfections1.182No differentOct 2024 – Sep 2025
SSI - Colon SurgeryInfections1.004No differentOct 2024 – Sep 2025
Acute Myocardial Infarction (AMI) 30-Day Readmission RateUnplanned return visits15.8 · 412 casesNoneJul 2023 – Jun 2025
Heart failure (HF) 30-Day Readmission RateUnplanned return visits22.6 · 1,002 casesNoneJul 2023 – Jun 2025
Hospital return days for heart attack patientsUnplanned return visits28.8 · 296 casesNoneJul 2022 – Jun 2025
Hospital return days for heart failure patientsUnplanned return visits25.5 · 894 casesNoneJul 2022 – Jun 2025
Hospital return days for pneumonia patientsUnplanned return visits17.8 · 981 casesNoneJul 2022 – Jun 2025
Pneumonia (PN) 30-Day Readmission RateUnplanned return visits18.1 · 1,061 casesNoneJul 2023 – Jun 2025
Rate of readmission after hip/knee replacementUnplanned return visits5 · 56 casesNoneJul 2023 – Jun 2025
Rate of readmission for CABGUnplanned return visits13.4 · 150 casesNoneJul 2023 – Jun 2025
Rate of readmission for chronic obstructive pulmonary disease (COPD) patientsUnplanned return visits20.3 · 412 casesNoneJul 2023 – Jun 2025
Rate of unplanned hospital visits after colonoscopy (per 1,000 colonoscopies)Unplanned return visits12.3 (9.6 to 15.9) · 1,324 casesNo differentJan 2022 – Dec 2024
Ratio of unplanned hospital visits after hospital outpatient surgeryUnplanned return visits0.9 (0.7 to 1.1) · 863 casesNo differentJan 2024 – Dec 2024

What patients said (812 patients answered, 32% of those asked)

Patient survey stars by topic at Saint Agnes Medical Center
Cleanliness4
Nurse communication3
Doctor communication2
Communication about medicines3
Discharge information3
Overall hospital rating4
Quietness3
Recommend hospital4
Share of patients giving the best answer at Saint Agnes Medical Center
Room was "always" clean73%
Nurses "always" communicated well73%
Doctors "always" communicated well74%
Staff "always" explained61%
Yes, staff "did" give patients this information85%
Yes, staff "did" give patients information about help after discharge83%
Doctors "always" explained things so they could understand70%
Doctors "always" listened carefully73%
Doctors "always" treated them with courtesy and respect80%
Patients who gave a rating of "9" or "10" (high)71%
Staff "always" explained new medications75%
Nurses "always" explained things so they could understand68%
Nurses "always" listened carefully70%
Nurses "always" treated them with courtesy and respect80%
"Always" quiet at night50%
"YES", patients would definitely recommend the hospital76%
Staff "always" explained possible side effects47%
Yes, staff "did" give patients information about possible symptoms87%

Original Medicare doctor bills

$30,861

Medicare paid this office $30,861 for 70 people.

This is what Medicare paid the clinician — not Medicare Advantage, and not the pharmacy.

Largest Original Medicare bills
Return visit (30+ min)34$4,509$92
Long return visit (40+ min)12$1,645$137
Short return visit (20+ min)18$1,599$70
New patient visit (45+ min)12$1,473$123

Procedures Medicare counted

Procedure volume Medicare published
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10None
Upper limb (arm) arthroscopy (minimally invasive joint repair)49More than 86% of doctors who do this

Procedures year by year

Procedures billed to Original Medicare by year
Procedure201920202021202220232024
Aspiration and/or injection of fluid from large joint6127485330–
Treatment of broken neck of thigh bone with bone implant3120––––

Times billed to Original Medicare each year. A blank year means fewer than 11 people had it, or none: Medicare does not publish smaller counts. Medicare Advantage patients are not included.

Who their Medicare patients are

70 Original Medicare patients in 2024. Average age 72 · Women 56% · Also on Medicaid 47% · Health risk score 1.36. Above the middle of the specialty; the typical orthopedic surgery clinician is at 1.13.

Conditions among them: High blood pressure 75% · Diabetes 41% · Chronic kidney disease 34% · Coronary heart disease 30% · Depression 24% · Heart failure 23%.

The office billed $125,772, Medicare allowed $40,011 and paid $30,861; for 1,305 services of 29 kinds; $135 of it was for drugs given in the office and $30,726 for care.

Original Medicare patients only. A risk score of 1.0 is the average Medicare patient; higher means sicker. Any count under 11 is hidden.

Year by year

Original Medicare by year
2024701,305721.36$125,772$30,861
202374245731.16$97,012$25,915
2022190656731.08$228,395$67,514
2021232842731.33$268,315$88,875
2020179599741.60$263,656$77,770
2019213961771.71$393,926$114,902
20182251,050751.53$598,692$113,086
20172291,666751.27$549,925$109,551
20161731,646741.23$377,977$73,871
2015160815741.08$318,517$64,359
2014180835741.07$313,693$64,634
20132361,207741.11$459,188$93,590

Original Medicare only. A service billed for fewer than 11 people in a year is hidden, so the lines can add up to less than the year's total.

See the services billed each year

2023: 5 services

Original Medicare services billed in 2023
Return visit (30+ min)32$4,392$98
Short return visit (20+ min)32$2,574$56
Long return visit (40+ min)18$2,325$129
Aspiration and/or injection of fluid from large joint21$1,407$47
Injection, methylprednisolone acetate, 40 mg20$233None

2022: 10 services

Original Medicare services billed in 2022
Return visit (30+ min)76$9,275$94
Short return visit (20+ min)75$8,915$71
New patient visit (45+ min)52$5,775$111
Aspiration and/or injection of fluid from large joint39$2,375$45
Long return visit (40+ min)11$1,336$121
New patient visit (30+ min)13$1,080$83
X-ray of shoulder, minimum of 2 views26$621$21
X-ray of knee, 3 views18$470$23
Injection, methylprednisolone acetate, 80 mg15$157None
Injection, methylprednisolone acetate, 40 mg26$146None

2021: 12 services

Original Medicare services billed in 2021
Long return visit (40+ min)84$18,168$142
New patient visit (45+ min)112$13,732$123
Return visit (30+ min)61$7,335$97
Short return visit (20+ min)37$3,526$71
Aspiration and/or injection of fluid from large joint34$2,460$51
X-ray of shoulder, minimum of 2 views54$1,295$21
X-ray of knee, 3 views43$1,025$22
X-ray of wrist, minimum of 3 views17$798$25
X-ray of hip, 2-3 views13$595$26
X-ray of ankle, minimum of 3 views13$318$21
Injection, methylprednisolone acetate, 80 mg21$204None
Injection, methylprednisolone acetate, 40 mg17$108None

2020: 10 services

Original Medicare services billed in 2020
Treatment of broken neck of thigh bone with bone implant20$20,352$1,018
Return visit (30+ min)48$6,002$90
Short return visit (20+ min)66$4,896$52
New patient visit (30+ min)50$4,107$82
Initial hospital care with straightforward or low level of medical decision making, per day at least 40 minutes27$2,252$83
Aspiration and/or injection of fluid from large joint21$1,287$48
X-ray of knee, 3 views23$661$24
X-ray of hip, 2-3 views18$641$27
X-ray of shoulder, minimum of 2 views28$620$16
Injection, methylprednisolone acetate, 40 mg14$87None

2019: 13 services

Original Medicare services billed in 2019
Treatment of broken neck of thigh bone with bone implant31$30,614$988
Short return visit (20+ min)114$14,475$57
New patient visit (30+ min)51$4,214$83
Aspiration and/or injection of fluid from large joint33$2,978$49
Return visit (30+ min)32$2,857$87
Initial hospital care with straightforward or low level of medical decision making, per day at least 40 minutes30$2,356$79
X-ray of shoulder, minimum of 2 views38$405$8
X-ray of knee, 1-2 views43$380$6
Injection, methylprednisolone acetate, 40 mg32$372None
X-ray of ankle, minimum of 3 views11$272$7
X-ray of both knees while standing35$238$7
X-ray of pelvis, 1-2 views24$237$7
X-ray of hip, 1 view18$210$8

2018: 12 services

Original Medicare services billed in 2018
Treatment of broken neck of thigh bone with plate/screw implant18$17,807$989
Replacement of knee joint, both sides of knee13$14,200$1,092
Short return visit (20+ min)130$12,734$54
New patient visit (30+ min)78$6,091$78
Initial hospital care with straightforward or low-level medical decision making at least 55 minutes40$4,406$110
Return visit (30+ min)44$4,255$79
Aspiration and/or injection of fluid from large joint44$2,905$48
X-ray of knee, 1-2 views73$2,326$22
X-ray of hip, 2-3 views32$1,337$30
X-ray of shoulder, minimum of 2 views33$941$20
Injection, methylprednisolone acetate, 40 mg44$661None
X-ray of both knees while standing28$579$21

2017: 15 services

Original Medicare services billed in 2017
Treatment of broken neck of thigh bone with plate/screw implant18$16,827$935
Short return visit (20+ min)140$14,410$53
Treatment of upper end of broken thigh bone with placement of stabilizing device or prosthetic replacement14$13,528$902
Replacement of knee joint, both sides of knee11$11,512$1,047
Return visit (30+ min)49$4,814$79
New patient visit (30+ min)61$4,641$76
Initial hospital care with straightforward or low-level medical decision making at least 55 minutes45$4,627$103
Aspiration and/or injection of fluid from large joint57$3,998$45
X-ray of knee, 1-2 views71$1,991$23
X-ray of both knees while standing65$1,802$27
X-ray of hip, 2-3 views39$1,543$31
New patient visit (45+ min)11$1,129$103
X-ray of shoulder, minimum of 2 views29$1,072$21
Injection, methylprednisolone acetate, 40 mg60$785None
Unclassified drugs48$153None

2016: 12 services

Original Medicare services billed in 2016
Short return visit (20+ min)105$10,657$56
Return visit (30+ min)49$5,670$74
Aspiration and/or injection of fluid from large joint60$5,196$46
New patient visit (30+ min)51$4,199$82
X-ray of knee, 1-2 views64$1,948$25
X-ray of both knees while standing61$1,875$28
Initial hospital care with straightforward or low-level medical decision making at least 55 minutes19$1,683$89
New patient visit (45+ min)15$1,378$92
X-ray of hip, 2-3 views26$984$33
X-ray of shoulder, minimum of 2 views33$961$23
Injection, methylprednisolone acetate, 40 mg61$756None
Unclassified drugs51$311None

2015: 11 services

Original Medicare services billed in 2015
Replacement of knee joint, both sides of knee11$11,492$1,045
Short return visit (20+ min)109$10,442$52
Return visit (30+ min)56$5,923$82
Aspiration and/or injection of fluid from large joint60$4,777$46
New patient visit (30+ min)53$3,868$73
X-ray of knee, 1-2 views67$1,644$21
X-ray of both knees while standing63$1,445$22
Initial hospital care with straightforward or low-level medical decision making at least 55 minutes12$1,251$104
X-ray of shoulder, minimum of 2 views23$482$19
X-ray of ribs of one side of body, minimum of 2 views14$407$27
Injection, methylprednisolone acetate, 40 mg60$263None

2014: 11 services

Original Medicare services billed in 2014
Short return visit (20+ min)132$13,172$52
Replacement of knee joint, both sides of knee11$11,480$1,044
Aspiration and/or injection of fluid from large joint57$4,792$46
New patient visit (30+ min)50$3,910$78
Return visit (30+ min)35$3,087$77
X-ray of ribs of one side of body, minimum of 2 views39$1,306$30
X-ray of both knees while standing45$1,270$27
Initial hospital care with straightforward or low-level medical decision making at least 55 minutes12$1,262$105
X-ray of knee, 1-2 views46$1,234$23
X-ray of shoulder, minimum of 2 views22$620$25
Injection, methylprednisolone acetate, 40 mg56$210None

2013: 11 services

Original Medicare services billed in 2013
Short return visit (20+ min)156$16,857$52
Replacement of knee joint, both sides of knee11$13,893$1,158
New patient visit (30+ min)93$6,935$75
Return visit (30+ min)70$6,622$69
Aspiration and/or injection of fluid from large joint80$6,588$45
X-ray of both knees while standing73$2,008$28
X-ray of knee, 1-2 views69$1,999$24
X-ray of ribs of one side of body, minimum of 2 views42$1,644$32
Initial hospital care with straightforward or low-level medical decision making at least 55 minutes11$1,126$102
X-ray of shoulder, minimum of 2 views48$1,110$23
Injection, methylprednisolone acetate, 40 mg79$284None

Medicaid work

$0 in 2023

Medicaid paid $0 for 40 billed services this clinician did in 2023, up to 14 people in a month for one service.

Medicaid and CHIP claims where this clinician did the service, fee-for-service and managed care together. Any month with fewer than 11 patients is hidden, so small Medicaid practices undercount.

Largest Medicaid services in 2023
Short return visit (20+ min)12$0
Return visit (30+ min)28$0
Medicaid work by year
202340214$0
2022224429$147
202164120$76
See the largest Medicaid services in earlier years

2022

Largest Medicaid services in 2022
New patient visit (45+ min)58$66
Short return visit (20+ min)112$66
Radiologic examination, knee; 3 views12$16
Return visit (30+ min)42$0

2021

Largest Medicaid services in 2021
New patient visit (45+ min)64$76

Drugs they prescribed that Part D paid

This is pharmacy cost, not the office bill, and not what patients paid.

Opioids were 68% of their 19 Part D prescriptions in 2019. Too few prescriptions to judge: with under about 50 a year, a handful of patients can swing this share.

Part D prescriptions only. A drug prescribed to fewer than 11 people in a year is hidden.

Year by year

Part D prescribing by year
20201211None0%$61
2019191468% (13)None$390
2018342465% (22)None$889
2017513267% (34)None$1,380
2016522777% (40)None$1,721
2015603072% (43)None$2,847
20141063670% (74)None$3,915
20131674477% (128)None$6,986

Part D prescriptions only. A drug prescribed to fewer than 11 people in a year is hidden.

See the drugs prescribed each year

2018: 1 drug

Part D drugs prescribed in 2018
Hydrocodone-Acetaminophen17$165$10

2017: 1 drug

Part D drugs prescribed in 2017
Hydrocodone-Acetaminophen30$375$13

2016: 1 drug

Part D drugs prescribed in 2016
Hydrocodone-Acetaminophen33$858$26

2015: 1 drug

Part D drugs prescribed in 2015
Hydrocodone-Acetaminophen38$654$17

2014: 2 drugs

Part D drugs prescribed in 2014
Hydrocodone-Acetaminophen70$1,131$16
Ibuprofen12$120$10

2013: 3 drugs

Part D drugs prescribed in 2013
Enoxaparin14$4,623$330
Hydrocodone-Acetaminophen115$2,066$18
Ibuprofen21$149$7

Money from drug and device companies

$1,357 in 2025

Industry payments by year
2025111None$1,357
2024215None$1,556
202311None$25
201911None$31

Paid work is consulting, speaking, honoraria and royalties, as opposed to meals and travel.

A payment is not proof that care is biased.

Payments by company
StrykerBlueprint Patient Specific Instrumentation$1,357
11 payments
  • Meals for Blueprint Patient Specific Instrumentation · 2025-09-08 · $24
  • Travel for Blueprint Patient Specific Instrumentation · 2025-07-28 · $82
  • Meals for Aequalis Ascend Flex · 2025-07-26 · $164
  • Meals for Aequalis Perform Reversed · 2025-07-26 · $52
  • Meals for Aequalis Ascend Flex · 2025-07-25 · $70
  • Meals for Aequalis Perform · 2025-07-25 · $23
  • Travel for Blueprint Patient Specific Instrumentation · 2025-07-25 · $344
  • Meals for Aequalis Perform · 2025-07-08 · $113
  • Travel for Blueprint Patient Specific Instrumentation · 2025-06-16 · $315
  • Meals for Aequalis Perform+ · 2025-02-10 · $8
  • Meals for Blueprint Patient Specific Instrumentation · 2025-01-14 · $162
See all 11 published payments
Every published payment
StrykerMeals · 2025-09-08Blueprint Patient Specific Instrumentation$24
StrykerTravel · 2025-07-28Blueprint Patient Specific Instrumentation$82
StrykerMeals · 2025-07-26Aequalis Ascend Flex$164
StrykerMeals · 2025-07-26Aequalis Perform Reversed$52
StrykerMeals · 2025-07-25Aequalis Ascend Flex$70
StrykerMeals · 2025-07-25Aequalis Perform$23
StrykerTravel · 2025-07-25Blueprint Patient Specific Instrumentation$344
StrykerMeals · 2025-07-08Aequalis Perform$113
StrykerTravel · 2025-06-16Blueprint Patient Specific Instrumentation$315
StrykerMeals · 2025-02-10Aequalis Perform+$8
StrykerMeals · 2025-01-14Blueprint Patient Specific Instrumentation$162
See earlier years (2024, 2023, 2019)

2024: $1,556

Payments by company in 2024
StrykerBlueprint Patient Specific Instrumentation$1,532
13 payments
  • Meals for Blueprint Patient Specific Instrumentation · 2024-12-09 · $22
  • Meals for Blueprint Patient Specific Instrumentation · 2024-12-09 · $1
  • Meals for Aequalis Ascend Flex · 2024-07-17 · $104
  • Meals for Blueprint Patient Specific Instrumentation · 2024-07-13 · $25
  • Meals for Blueprint Patient Specific Instrumentation · 2024-07-13 · $88
  • Meals for Blueprint Patient Specific Instrumentation · 2024-07-13 · $75
  • Travel for Blueprint Patient Specific Instrumentation · 2024-07-13 · $48
  • Meals for Blueprint Patient Specific Instrumentation · 2024-07-12 · $174
  • Meals for Aequalis Perform · 2024-07-12 · $50
  • Travel for Blueprint Patient Specific Instrumentation · 2024-07-12 · $331
  • Travel for Blueprint Patient Specific Instrumentation · 2024-07-08 · $23
  • Travel for Blueprint Patient Specific Instrumentation · 2024-05-31 · $431
  • Meals for Aequalis Ascend Flex · 2024-05-16 · $160
Boston ScientificWavewriter Alpha Prime 16$24
2 payments
  • Meals for Wavewriter Alpha Prime 16 · 2024-05-23 · $19
  • Meals for Wavewriter Alpha Prime 16 · 2024-05-20 · $5

2023: $25

Payments by company in 2023
Cornerstone Medical AssociatesNone$25
1 payment
  • Meals · 2023-11-09 · $25

2019: $31

Payments by company in 2019
Sequoia SurgicalNone$31
1 payment
  • Meals · 2019-10-29 · $31

Checkups this office reported

Medicare did not publish checkup rates for this clinician.

Medicare’s overall office score
72.7 / 100
Scores the office’s reporting and systems. It is not a grade for how the doctor treats you.

Professional record

NPI
1154467074
Gender
Male
More record details
Sole proprietor
No
Medicaid ID
CA 00A551670
Taxonomy
Federal specialty code 174400000X (174400000X)
Mailing address
7255 N Cedar Ave, Fresno, CA, 93720
NPI first listed
2007-01-29
NPI last updated
2009-06-11

This is when the NPI record was last certified, not a medical board exam.