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 Indiana for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Indiana 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. Indiana (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.

Midwest Specialty Surgery Center, LLC (NPI 1023373834)

Field	Value
Entity Type	Organization
Organization	Midwest Specialty Surgery Center, LLC
Address	6920 Gatwick Dr.
City	Indianapolis
State	IN
ZIP	46241
Taxonomy	Orthopaedic Surgery Physician
NPI Enumerated	July 8, 2012

Payer Source	Total Paid
Medicare	$2.2M
Medicaid	$0

Key Findings

MIDWEST SPECIALTY SURGERY CENTER, LLC is effectively a Medicare-focused orthopaedic surgery practice with total Medicare revenue of $2.2M and no Medicaid billing on file, meaning the provider operates as a single-payer public-program participant for the datasets shown. The absence of any Medicaid billing on file indicates payer mix is heavily skewed toward Medicare rather than a dual Medicare/Medicaid profile.

Revenue is highly concentrated in three major arthroplasty codes: 27447 accounts for $1M (45.4% of Medicare revenue), 27130 accounts for $582.5K (26.1%), and 27446 accounts for $563.3K (25.2%); these top 3 codes together account for 96.7% of this provider's total Medicare revenue. This concentration indicates that almost all Medicare dollars reported to this provider derive from hip and knee replacement procedures rather than a broad mix of orthopaedic services.

The code mix and the provider taxonomy of Orthopaedic Surgery Physician indicate a service-line strategy centered on major joint arthroplasty: 27447 and 27446 are knee replacement procedures and 27130 is hip replacement, which together dominate billing. Such a profile is consistent with a practice or surgery center focused on elective joint replacement cases rather than general orthopaedics or chronic non‑operative management.

Against national peers this provider shows above-typical volume and competitive standing on its principal arthroplasty codes: 27447 ranks #315 of 12089 (97th percentile, notably above typical national volume), 27130 ranks #470 of 8062 (94th percentile, notably above typical national volume), and 27446 ranks #12 of 450 (98th percentile, notably above typical national volume). These rank and percentile positions suggest the provider is a relatively major national actor for specific joint replacement procedures, particularly for 27446 where it sits among the very highest-volume providers.

One statistical outlier in the dataset is C9290 (Injection, bupivacaine liposome): this provider reported 72.6K claims for C9290 producing $72.6K revenue (3.2% of Medicare revenue) and ranks #6 of 451 (99th percentile; extreme outlier). Despite the very high claim count and outlier standing, the dollar impact of C9290 remains small relative to arthroplasty codes because the avg paid/claim is $1 and total revenue for the code is modest compared to joint replacement.

Secondary and ancillary procedure volumes are minimal relative to arthroplasty: 76000 shows 48 claims and $1.1K revenue (79th percentile, typical volume) and 20610 shows 19 claims and $437 revenue (13th percentile, typical volume). These lower-revenue imaging and injection codes appear to be occasional adjunct services rather than primary drivers of the business.

The provider has been enumerated since 2012-07-08 (~14 years ago), indicating a more established operation rather than a new entrant; given the high concentration in arthroplasty codes and the tenure, the practice likely has an established referral stream for joint replacement. That tenure combined with high national percentiles on core codes supports a profile of sustained specialization in major joint procedures.

From a payer negotiation and network strategy perspective, the combination of a single-payer public profile (Medicare-only billing on file), concentrated revenue in elective joint replacement codes, and top-percentile national ranks for those codes suggests this provider can be positioned as a specialty arthroplasty center of scale for Medicare populations, but lacks Medicaid exposure that payers would need to consider when assessing statewide access for low-income beneficiaries.

Medicare: Complete Services Breakdown

The CPT/HCPCS codes generating the most Medicare revenue for this provider.

6 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
27447	In this procedure, the provider replaces the damaged weight bearing surfaces of both the medial and lateral compartments in the knee joint using implants of metal or other strong materials. The…	140	$7,200	$1M
27130	In this procedure, the provider surgically replaces the hip joint by prosthesis, or artificial hip joint. He replaces both the femoral and acetabular components with or without using an autograft or…	80	$7,370	$582.5K
27446	In this procedure, the provider reconstructs the diseased or damaged medial or lateral compartment of the knee along with the femoral condyles and tibial plateaus to relieve pain and improve the…	80	$7,130	$563.3K
C9290	Injection, bupivacaine liposome, 1 mg	72,620	$1	$72.6K
76000	In this procedure, the provider uses fluoroscopy for up to one hour as an imaging technique to obtain real time images of internal structures.	50	$20	$1.1K
20610	In this procedure, the provider inserts a needle through the skin of a patient and into a major joint or bursa and then uses the syringe attachment to the needle to remove fluid or he may inject a…	20	$20	$440

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 6 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Indiana Distribution

Midwest Specialty Surgery Center, LLC — 3 of 6 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Indiana

Full comparison — all codes billed, vs. state median

6 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
27446	2	20	20	$2,640	$89.9K
27447	6	340	40	$1,130	$51.1K
27130	9	220	30	$1,280	$40.9K
C9290	1	20	7,580	$1	$14.8K
20610	851	1,000	50	$40	$4.6K
76000	11	50	30	$10	$730

Nearby Providers

Other providers in the same ZIP code as Midwest Specialty Surgery Center, LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Damar Services Inc	IN	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$53.7M
Advanced Physical Therapy, LLC	IN	Physical Therapist	$0	$31.2M
Aeratech Medical Inc	IN	Oxygen Equipment & Supplies (DME)	$0	$13.1M
E.m.a.s.inc	IN	Ambulance	$247.4K	$1.1M
Courtney Bumbalough	IN	Family Nurse Practitioner	$284K	$0
Heather Abbott	IN	Primary Care Nurse Practitioner	$258.1K	$0
Patrick Mann	IN	Physician Assistant	$256.4K	$0
Sarah Farmer	IN	Family Nurse Practitioner	$217K	$0
Michael Berend	IN	Orthopaedic Surgery Physician	$212.6K	$0
Joshua Carter	IN	Orthopaedic Surgery Physician	$204.2K	$0

Midwest Specialty Surgery Center, LLC — Billing Profile & Reimbursement Data

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Midwest Specialty Surgery Center, LLC — Billing Profile & Reimbursement Data

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Key Findings

Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References