Why are Medicare and Medicaid shown separately instead of combined?

They come from two different CMS data sources with no shared claim identifier, so they can't be reconciled into one number without double-counting or guessing. Every table and chart on this page keeps them fully separate.

Why is there no private/commercial revenue figure?

Private and commercial payer data comes from Transparency in Coverage files, which only publish negotiated rates — not claims or utilization volume. Without a volume figure, no revenue number can be computed for any provider from that data.

What does "Rank" mean in the Competitive Analysis & Benchmarks tables?

For a given CPT/HCPCS code, it's this provider's position by claims volume among all providers billing that same code at that geography level (State, National, or South Dakota for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to South Dakota only?

Medicaid is administered per-state with no single national fee schedule, so a state or national comparison the way Medicare has one isn't available. South Dakota (this provider's own state) is the only grouping that's conceptually meaningful.

Why are the numbers rounded to the nearest 10?

To avoid implying more precision than the underlying data supports at a single-provider level. Ratios are kept precise since they're a relative comparison, not a volume or dollar figure.

How current is this data?

The Medicare and Medicaid tables are both single current snapshots, not refreshed on a recurring schedule yet.

Rushmore Ambulatory Surgery Center (NPI 1013968718)

Field	Value
Entity Type	Organization
Organization	Rushmore Ambulatory Surgery Center
Address	620 Sheridan Lake Rd
City	Rapid City
State	SD
ZIP	57702
Taxonomy	Ambulatory Surgical Clinic/Center
NPI Enumerated	May 15, 2006

Payer Source	Total Paid
Medicaid	$4.6M
Medicare	$0

Key Findings

This facility is effectively single‑payer in the available data: there is no Medicare billing on file while Medicaid payments total $4.6M, so Medicaid represents the provider’s entire recorded public-payer revenue stream. Analysts should treat the provider as Medicaid‑dependent for the period captured rather than a mixed Medicare/Medicaid operator.

Revenue concentration is extreme: the precomputed top three Medicaid codes account for 100.0% of this provider’s Medicaid revenue, driven by code shares of 52.7% (41899), 24.4% (00170), and 22.9% (G0330). This means a very small set of service lines explains the entirety of reported Medicaid payments and any shifts in those codes would disproportionately affect overall revenue.

The code mix points to a dental rehabilitation–focused ambulatory surgery practice. Code 41899 is for procedures on teeth and adjoining alveolar structures, 00170 covers anesthesia for intraoral procedures, and G0330 covers facility services for dental rehabilitation requiring monitored anesthesia, together indicating the center primarily provides operative dental care delivered under anesthesia. This suggests a patient population and operational model centered on OR or procedure‑room dental cases rather than general ambulatory surgical subspecialties.

Claim volume and per‑claim payment patterns highlight how revenue is generated: 41899 has 5.4K claims at $448 avg paid/claim producing $2.4M revenue, 00170 has 6.5K claims at $173 avg paid/claim producing $1.1M revenue, and G0330 has 996 claims at $1061 avg paid/claim producing $1.1M revenue. The relatively high avg paid/claim for G0330 indicates that facility fees for monitored anesthesia/dental rehab are a major revenue component despite lower claim counts versus the other codes.

Competitive standing within South Dakota is strong on select dental/anesthesia codes: the provider ranks #1 of 8 in the state for 41899 (100th percentile) and is described as notably above typical state volume, and it ranks #2 of 22 for 00170 (95th percentile) also notably above typical state volume. For G0330 the provider ranks #1 of 3 in‑state (100th percentile) but the data labels its volume as typical and unremarkable for that code, indicating dominance in some niche procedures while participation in other related facility codes is less exceptional.

The provider has a long tenure: NPI enumerated 2006-05-15 (~20 years ago), which supports interpretation of the observed patterns as established practice behavior rather than a short‑term anomaly. Longevity combined with concentrated service lines suggests operational stability in the dental rehabilitation niche.

For payer and competitor monitoring, the combination of concentrated revenue (100.0% from three codes) and very high state percentiles on key dental/anesthesia codes signals two practical implications: first, changes in Medicaid reimbursement policy or utilization management for 41899, 00170, or G0330 could materially impact this provider’s Medicaid revenues; and second, network or referral shifts around dental rehabilitation and anesthesia services should be prioritized when assessing competitive risk and contract negotiations.

Medicaid: Complete Services Breakdown

Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.

3 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
41899	Use this code to report a procedure on the teeth and adjoining alveolar structures for which there is no specific code available.	5,430	$450	$2.4M
00170	The provider performs anesthesia services for a patient undergoing an intraoral procedure, including biopsy.	6,510	$170	$1.1M
G0330	Facility services for dental rehabilitation procedure(s) performed on a patient who requires monitored anesthesia (e.g., general, intravenous sedation (monitored anesthesia care) and use of an…	1,000	$1,060	$1.1M

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other South Dakota providers billing the same CPT/HCPCS codes.

Claims Volume vs. South Dakota Distribution

Rushmore Ambulatory Surgery Center — 3 of 3 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — South Dakota

Full comparison — all codes billed, vs. South Dakota median

3 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
41899	Use this code to report a procedure on the teeth and adjoining alveolar structures for which there is no specific code available.	1	10	150	$400	$440.3K
G0330	Facility services for dental rehabilitation procedure(s) performed on a patient who requires monitored anesthesia (e.g., general, intravenous sedation (monitored anesthesia care) and use of an…	1	10	330	$860	$383.1K
00170	The provider performs anesthesia services for a patient undergoing an intraoral procedure, including biopsy.	2	20	130	$150	$248.6K

Nearby Providers

Other providers in the same ZIP code as Rushmore Ambulatory Surgery Center, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Black Hills Works Inc	SD	Developmentally Disabled Services Day Training Agency	$0	$149.7M
Great Plains Tribal Chairmen's Health Board	SD	Pharmacy	$0	$36.4M
Black Hills Pediatric Dentistry	SD	Pediatric Dentistry	$0	$24.7M
Dakota Dental 4 Kids	SD	Dental Clinic/Center	$0	$7.1M
Oglala Sioux Tribe	SD	Obstetrics & Gynecology Physician	$0	$5.2M
Stay Graceful Inc	SD	In Home Supportive Care Agency	$0	$3.4M
Children's Care Hospital And School	SD	Rehabilitation Clinic/Center	$0	$2.1M
Rushmore Dental Products, Inc.	SD	Durable Medical Equipment & Medical Supplies	$0	$1.7M
Black Hills Orthopedic & Spine Center, Inc.	SD	Multi-Specialty Clinic/Center	$0	$1.7M
Black Hills Caregiving, LLC	SD	Home Health Agency	$0	$1.1M

Rushmore Ambulatory Surgery Center — Billing Profile & Reimbursement Data

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Rushmore Ambulatory Surgery Center — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References