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NPI 1033135314 · Richmond, VA · Ambulatory Surgical Clinic/Center
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Med Atlantic Inc is a ambulatory surgical clinic/center provider located in Richmond, Virginia. This profile covers 47 Medicare and 8 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.
Provider details (source: NPPES NPI Registry)
| Field | Value |
|---|---|
| Entity Type | Organization |
| Organization | Med Atlantic Inc |
| Address | 9101 Stony Point Pkwy |
| City | Richmond |
| State | VA |
| ZIP | 23235 |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| NPI Enumerated | July 13, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $4.9M |
| Medicaid | $298.7K |
MED ATLANTIC INC is operating as an ambulatory surgical clinic/center with a procedure mix dominated by urology and related implantable-device interventions; Medicare and Medicaid billing show heavy use of cystourethroscopy/ureteroscopy codes (e.g., 52356, 52332, 52351) and stone/stone-fragmentation services (50590), plus higher‑priced implant codes such as 64590 and 54405, indicating a specialty ASC model focused on endoscopic urologic procedures and device implants. The presence of both high-volume cystoscopy codes and device-implant codes suggests the facility handles both diagnostic/therapeutic endoscopy and more complex surgical implant cases rather than only routine office procedures.
Revenue is concentrated with Medicare as the dominant payer by scale: Total Medicare revenue is $4.9M versus total Medicaid revenue of $298.7K, making Medicare the material revenue driver for this entity. Medicaid is present but small in absolute dollars compared with Medicare, so payer strategy and competitive positioning will be Medicare-centric.
The provider’s Medicare billing shows notable concentration: the precomputed top 3 Medicare codes account for 34.1% of total Medicare revenue, with 52356 generating $556.8K (12.6%), 55700 generating $485.5K (10.9%), and 64590 generating $469.5K (10.6%). This concentration around a handful of high-revenue procedures means changes in referral patterns, reimbursement, or code availability (for example, the deletion note on 55700) could materially affect facility revenue.
On Medicare competitive standing, MED ATLANTIC posts extreme national volumes for multiple cystoscopy and stone procedures: 55700 ranks #1 of 4425 providers nationally (100th percentile; extreme outlier), 52356 ranks #2 of 3090 providers nationally (100th percentile; extreme outlier), and 50590 ranks #4 of 1163 providers nationally (100th percentile; extreme outlier). Several other cystoscopy-related codes (e.g., 52332, 52351, 52234, 74420) also sit at or near the top of national rankings, indicating the facility is a major national outlier for specific urologic procedures and likely serves as a high-volume referral site for those services.
Medicaid billing is highly concentrated and locally prominent: the precomputed top 3 Medicaid codes account for 98.9% of Medicaid revenue, led by 52356 which contributes $268.1K (89.8%) and ranks #1 of 5 providers in-state (100th percentile; notably above typical state volume for this code). Other Medicaid codes (55700 at $20K and 55250 at $7.3K) are much smaller contributors, so Medicaid activity is effectively focused on the same principal urologic procedure that dominates Medicare billing.
The procedure mix includes a substantial component of implant and device reimbursement, with high average paid amounts reported for implant codes such as 64590 ($14,671 avg paid/claim, $469.5K revenue), 54405 ($12,521 avg paid/claim, $225.4K revenue), and 53445 ($12,651 avg paid/claim, $139.2K revenue). This pattern points to surgical capability for device placement and replacement (neuromodulation, penile prosthesis, artificial sphincter) and implies capital, supply, and device-contracting considerations that differentiate this ASC from low-complexity endoscopy centers.
Many of the provider’s billed procedure codes are flagged as statistical outliers or notably above typical volumes in the provided peer comparisons (labels such as "extreme outlier" and "notably above typical" appear across multiple CPTs), which supports characterization of MED ATLANTIC as a highly specialized, high-volume performer on discrete urologic services rather than a general multi‑service ASC. For payers and network planners, these outlier rankings suggest the center is an important node for specific urology workflows and referral patterns and may be a concentrated source of high-cost episodes tied to implantable-device care.
The practice has long tenure in the Medicare/Medicaid landscape, with its NPI enumerated on 2006-07-13 (~20 years ago), indicating an established operating history that aligns with the sustained high volumes reported on several national-ranking procedure codes. That longevity combined with concentrated, high-volume service lines suggests operational stability in its niche specialty offerings.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
47 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 52356 | The provider performs a cystourethroscopy, the inspection of the interior of the bladder, the urethra, prostatic urethra, and ureteric openings using a cystoscope passed through the urethra and into… | 330 | $1,670 | $556.8K |
| 55700 | Code deleted December 31, 2025. | 770 | $630 | $485.5K |
| 64590 | The provider inserts or replaces a peripheral, sacral, or gastric neurostimulator pulse generator or receiver. The system is one that requires surgical creation of a pocket for placement and that… | 30 | $14,670 | $469.5K |
| 55874 | Under imaging guidance, the provider inserts a needle through the perineum, the area between the anus and the scrotum, and injects one or more biodegradable materials, i.e., material that decomposes… | 120 | $2,700 | $329.4K |
| 64561 | The provider, under imaging guidance, implants electrodes around nerves in the sacral region to reduce the pain along the path of the nerve. | 90 | $3,790 | $329.4K |
| C9740 | Cystourethroscopy, with insertion of transprostatic implant; 4 or more implants | 60 | $5,480 | $301.2K |
| 54405 | The provider inserts inflatable synthetic material for a multicomponent, inflatable penile prosthesis into the penis of the patient. The provider also places a pump, the cylinders, and a reservoir… | 20 | $12,520 | $225.4K |
| 50590 | Extracorporeal shock wave lithotripsy (ESWL) is a procedure used to destroy calculus (kidney stones) in the kidneys and ureters. | 160 | $1,130 | $175.6K |
| 52332 | The provider performs cystourethroscopy, the inspection of the interior of the bladder, the urethra, prostatic urethra, and ureteric openings using a cystoscope passed through the urethra and into… | 220 | $760 | $164.2K |
| 52234 | The provider inspects the urethra, prostatic urethra (in men), the interior of the bladder, and ureteric openings using a cystoscope passed through the urethra and into the bladder; he destroys… | 140 | $1,050 | $141.9K |
Showing 1–10 of 47
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 47 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
47 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| C9740 | 2 | 10 | 30 | $5,580 | $189.6K |
| 54405 | 3 | 10 | 30 | $7,550 | $181.1K |
| 64590 | 1 | 10 | 20 | $4,000 | $76.1K |
| 53445 | 1 | 10 | 10 | $6,620 | $72.8K |
| 53440 | 1 | 10 | 20 | $3,950 | $59.3K |
| 64561 | 1 | 10 | 30 | $1,820 | $58.2K |
| C2642 | 1 | 10 | 810 | $70 | $57.7K |
| J0585 | 12 | 60 | 6,400 | $1 | $51.9K |
| 52354 | 1 | 10 | 20 | $1,400 | $35.1K |
| 52630 | 1 | 10 | 20 | $1,710 | $30.7K |
Showing 1–10 of 47
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
View: By Year1 / 3
Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
8 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 52356 | The provider performs a cystourethroscopy, the inspection of the interior of the bladder, the urethra, prostatic urethra, and ureteric openings using a cystoscope passed through the urethra and into… | 200 | $1,330 | $268.1K |
| 55700 | Code deleted December 31, 2025. | 50 | $410 | $20K |
| 55250 | This procedure involves cutting the vas deferens and suturing the ends, on both the left and right sides. The provider then performs a postoperative semen examination. Even though the CPT code… | 20 | $410 | $7.3K |
| 52332 | The provider performs cystourethroscopy, the inspection of the interior of the bladder, the urethra, prostatic urethra, and ureteric openings using a cystoscope passed through the urethra and into… | 10 | $250 | $3.2K |
| 6045F | No Summary found for this code | 40 | $0 | $0 |
| G8907 | Patient documented not to have experienced any of the following events: a burn prior to discharge; a fall within the facility; wrong site/side/patient/procedure/implant event; or a hospital transfer… | 290 | $0 | $0 |
| G8916 | Patient with preoperative order for iv antibiotic surgical site infection (ssi) prophylaxis, antibiotic initiated on time | 130 | $0 | $0 |
| G8918 | Patient without preoperative order for iv antibiotic surgical site infection (ssi) prophylaxis | 30 | $0 | $0 |
How this provider's Medicaid billing volume and revenue compare to other Virginia providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Virginia median
8 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 52356 | The provider performs a cystourethroscopy, the inspection of the interior of the bladder, the urethra, prostatic urethra, and ureteric openings using a cystoscope passed through the urethra and into… | 1 | 10 | 30 | $2,010 | $142.6K |
| 55700 | Code deleted December 31, 2025. | 1 | 10 | 50 | $410 | $20K |
| 55250 | This procedure involves cutting the vas deferens and suturing the ends, on both the left and right sides. The provider then performs a postoperative semen examination. Even though the CPT code… | 1 | 10 | 20 | $410 | $7.3K |
| 52332 | The provider performs cystourethroscopy, the inspection of the interior of the bladder, the urethra, prostatic urethra, and ureteric openings using a cystoscope passed through the urethra and into… | 1 | 10 | 10 | $250 | $3.2K |
| G8918 | Patient without preoperative order for iv antibiotic surgical site infection (ssi) prophylaxis | 12 | 20 | 70 | $1 | $20 |
| G8907 | Patient documented not to have experienced any of the following events: a burn prior to discharge; a fall within the facility; wrong site/side/patient/procedure/implant event; or a hospital transfer… | 9 | 30 | 150 | $1 | $10 |
| 6045F | No Summary found for this code | 1 | 10 | 40 | $0 | $0 |
| G8916 | Patient with preoperative order for iv antibiotic surgical site infection (ssi) prophylaxis, antibiotic initiated on time | 1 | 10 | 110 | $0 | $0 |
Other providers in the same ZIP code as Med Atlantic Inc, ranked by combined Medicare and Medicaid revenue.
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