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

Why is the Medicaid comparison limited to South Carolina 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 Carolina (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.

The Southeastern Spine Institute Ambulatory Surgery Center, LLC (NPI 1033373691)

Field	Value
Entity Type	Organization
Organization	The Southeastern Spine Institute Ambulatory Surgery Center, LLC
Address	1625 Hospital Drive
City	Mt. Pleasant
State	SC
ZIP	29464
Taxonomy	Ambulatory Surgical Clinic/Center
NPI Enumerated	July 14, 2008

Payer Source	Total Paid
Medicare	$4M
Medicaid	$0

Key Findings

The SOUTHEASTERN SPINE INSTITUTE ASC presents as a procedure-focused ambulatory surgical center with a clear spine and interventional pain service-line orientation; its top billed Medicare codes are predominantly spinal injections, neuroablations, and neuromodulation procedures (examples include 64493, 62323, 64635, 64483, 64628, 63650 and 63685), indicating the facility primarily delivers image-guided spine and pain interventions alongside a smaller volume of joint replacement work. This code mix suggests the center operates as a specialized spine/pain surgery practice rather than a broad multi-specialty ASC.

Medicare revenue concentration is high: total Medicare revenue is $4M and the precomputed top 3 Medicare codes by revenue account for 37.3% of the provider’s Medicare receipts. The single largest code, 64493, contributes $556.3K (14.0% of Medicare revenue), followed by 62323 with $483.6K (12.2%) and 64635 with $441.4K (11.1%), indicating reliance on a small set of image-guided spinal procedures for a large share of income.

This provider is effectively single-payer in the dataset: it has $4M in total Medicare revenue and no Medicaid billing on file, meaning Medicaid is not an active payer for this entity in the available records. For payer-mix assessments and network negotiations, treat this center as predominantly Medicare-focused based on the current claims picture.

The center shows extreme national concentration for many spine-related codes: it ranks #1 nationally for 64493, 62323, 64635, 64490 and 62321 and attains 100th-percentile or similar descriptors for those codes, which the source characterizes as “extreme outlier” volumes. These rankings indicate the center performs far higher volumes of specific spinal injection and ablation procedures than typical peers and functions as a major national outlier for several image-guided spine interventions.

For certain high-revenue device and implant procedures the provider’s standing is more typical: codes such as 27447 (total knee replacement) and 27130 (hip replacement) produce $358.5K (9.0%) and $329.9K (8.3%) respectively and are ranked in the 74th–78th percentiles nationally, describing ordinary, non-outlier volumes for joint arthroplasty relative to national peers. Likewise, high-cost neurostimulation hardware code 63685 yields $260.2K (6.5%) but sits at the 30th percentile, indicating occasional implant work at lower comparative volume.

The provider’s service mix also includes advanced interventional spine procedures with notable per-claim values: 64628 (basivertebral nerve ablation) accounts for $304.4K (7.7%) with a high avg paid/claim, and 63650 (epidural electrode placement) accounts for $288.1K (7.2%). These entries point to capacity for specialized, higher-acuity spine interventions and implantable device procedures beyond routine injections.

Tenure is long-standing: the NPI was enumerated on 2008-07-14 (approximately 18 years ago), indicating the entity has been in the Medicare provider population for nearly two decades, which supports observed scale and specialization. This longevity can be relevant when assessing referral relationships, established payer contracts, and operational stability.

Several codes flagged as “extreme outlier” are concentrated in image-guided injections of lumbar, cervical and sacral regions (64493, 62323, 64490, 62321, 64633 and G0260). Together these items signal that the practice’s clinical throughput is heavily weighted toward repeated percutaneous procedures and radiofrequency/neurolytic interventions, which may shape staffing, imaging resource needs, and supply/implant utilization in operational or network analyses.

Medicare: Complete Services Breakdown

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

21 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
64493	The provider injects a diagnostic or therapeutic substance into a single lumbar or sacral paravertebral facet (zygapophyseal) joint, or into the nerves that supply that joint, using imaging guidance…	2,170	$260	$556.3K
62323	The provider injects a diagnostic or a therapeutic substance, such as pain medication or a steroid, into the space around the spinal nerves of the lumbar (lower back) or sacral (caudal, or tailbone)…	1,990	$240	$483.6K
64635	Under fluoroscopic or CT guidance, the provider applies an agent to a lower back joint to destroy nerve tissue.	910	$490	$441.4K
64483	This procedure is the injection of an anesthetic agent and/or steroid in the form of a transforaminal epidural injection into a single level (either lumbar or sacral).	1,420	$290	$407K
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…	50	$6,760	$358.5K
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…	50	$7,020	$329.9K
64628	The provider uses a thermal (heat) method under imaging guidance to destroy an intraosseous basivertebral nerve. Use this code for the first two lumbar or sacral vertebral bodies treated at a session.	40	$7,430	$304.4K
63650	In this procedure, the provider places electrodes in the epidural space to relieve pain and reduce or eliminate spasms.	80	$3,690	$288.1K
63685	The provider inserts or replaces a spinal neurostimulator pulse generator or receiver. The system is one that requires surgical creation of a pocket for placement and that requires a connection…	10	$18,590	$260.2K
64490	The provider injects a diagnostic or therapeutic substance into a single cervical or thoracic paravertebral facet (zygapophyseal) joint, or into the nerves that supply that joint, using imaging…	620	$270	$164.8K

Showing 1–10 of 21

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 21 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. South Carolina Distribution

The Southeastern Spine Institute Ambulatory Surgery Center, LLC — 10 of 21 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — South Carolina

Full comparison — all codes billed, vs. state median

21 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
63685	27	40	20	$5,770	$138.5K
64628	2	10	30	$3,170	$107.9K
63650	2	40	40	$1,580	$66.5K
27447	92	220	40	$1,090	$61.9K
27130	55	150	40	$1,060	$44.7K
64483	1	130	90	$190	$33K
62323	1	130	80	$160	$28.8K
64493	1	130	70	$170	$22.7K
64635	1	110	40	$350	$22.4K
G0260	1	10	70	$210	$21.1K

Showing 1–10 of 21

Related Providers

Other providers that share a Tax Identification Number (TIN) with The Southeastern Spine Institute Ambulatory Surgery Center, LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Richard Frisch	SC	Orthopaedic Surgery Physician	$422.6K	$0
German Levin	SC	Physical Medicine & Rehabilitation Physician	$405.6K	$0
Thomas Anderson	SC	Neurological Surgery Physician	$387.6K	$0
Timothy Bryan	SC	Orthopaedic Surgery of the Spine Physician	$331.8K	$0
Eric Kim	CA	Neurology Physician	$300.8K	$0
Ryan Nobles	SC	Interventional Pain Medicine Physician	$258.6K	$0
John Parker	CA	Neurology Physician	$243K	$0
Romina Shirka	NV	Neurology Physician	$224.5K	$0
Benjamin Schell	SC	Orthopaedic Surgery of the Spine Physician	$214.6K	$0
Jonathan Chen	CA	Neurology Physician	$213.9K	$0

Nearby Providers

Other providers in the same ZIP code as The Southeastern Spine Institute Ambulatory Surgery Center, LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Coastal Therapy Services, Inc.	SC	Speech-Language Pathologist	$0	$6.8M
Bloom Children's Therapy	SC	Pediatric Occupational Therapist	$0	$3.5M
Christopher Michaelis	SC	Emergency Medicine Physician	$3.3M	$0
Carolina Family Care, Inc	SC	Clinical Medical Laboratory	$1.8M	$1.3M
East Cooper Community Hospital, Inc.	SC	General Acute Care Hospital	$0	$3M
Allergy & Asthma Consultants, LLP	SC	Allergy & Immunology Physician	$0	$2.6M
Francisco Folgar	SC	Ophthalmology Physician	$2.3M	$0
Amanda Acree	SC	Clinical Social Worker	$0	$2.3M
Charleston Radiologists PA	SC	Diagnostic Radiology Physician	$0	$2M
Path Finders Team Services	SC	Early Intervention Provider Agency	$0	$2M

The Southeastern Spine Institute Ambulatory Surgery Center, LLC — Billing Profile & Reimbursement Data

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The Southeastern Spine Institute Ambulatory 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

Related Providers

Nearby Providers

Frequently Asked Questions

References