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NPI 1043526353 · Beverly, MA · Clinic/Center
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New England Surgery Center LLC is a clinic/center provider located in Beverly, Massachusetts. This profile covers 18 Medicare and 1 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 | New England Surgery Center LLC |
| Address | 900 Cummings Ctr |
| City | Beverly |
| State | MA |
| ZIP | 01915 |
| Taxonomy | Clinic/Center |
| NPI Enumerated | August 24, 2010 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $2.8M |
| Medicaid | $0 |
The provider is effectively a Medicare-focused ambulatory clinic: reported lifetime Medicare revenue is $2.8M while lifetime Medicaid revenue is $0, indicating no Medicaid billing on file and a single‑payer concentration in Medicare. This payer mix implies limited state‑payer exposure and a reliance on Medicare reimbursement dynamics for overall financial performance.
Revenue is highly concentrated in a small set of high‑value implant and pain‑management codes: the precomputed top three Medicare codes account for 60.4% of this provider’s total Medicare revenue, driven by 63685 ($676.2K, 24.2%), 64590 ($579.8K, 20.8%), and 63650 ($429.7K, 15.4%). Such concentration means changes to reimbursement or utilization of these specific device/implant codes would materially affect overall Medicare income.
The code mix and taxonomy (Clinic/Center) point to a specialty outpatient surgical operation with a strong emphasis on neuromodulation and interventional pain services: top codes include implant or replacement of spinal and peripheral/sacral/gastric neurostimulator pulse generators (63685, 64590) and epidural electrode placement (63650), which are typically performed in ambulatory surgical settings and have high average paid/claim amounts ($22540 for 63685 and $17571 for 64590). At the same time, the presence of codes for ESWL and a range of ENT/ophthalmic/minor urologic procedures indicates a diversified outpatient procedural footprint beyond neuromodulation.
National competitive standing on key neuromodulation codes is above average but not monopolistic: 63685 ranks #217 of 1281 providers (82th percentile; typical, unremarkable volume), 64590 ranks #58 of 561 (88th percentile; typical, unremarkable volume), and 63650 ranks #168 of 1371 (88th percentile; typical, unremarkable volume). These rankings suggest the clinic is a meaningful regional participant in implantable neuromodulation services with higher-than-median volumes on several leading codes, but it is not a dominant national outlier across the board.
The provider is an extreme national outlier on ESWL volume: 50590 generated $148.1K (5.3% of Medicare revenue) and ranks #12 of 1163 providers nationally (99th percentile; extreme outlier, far above typical national volume for this code). This atypically high ESWL activity relative to peers indicates a notable capacity or specialization in stone-treatment services that complements the clinic’s implant and interventional pain work.
Beyond neuromodulation and ESWL, the clinic reports meaningful volumes of ambulatory surgical procedures in ophthalmology and ENT: for example, 15823 accounts for $86.3K (3.1% of Medicare revenue) and 67904 accounts for $25.5K (0.9%), reflecting a broader outpatient procedural mix. This breadth suggests the operation likely manages a variety of same‑day surgical cases rather than exclusively device implantation.
The provider’s NPI was enumerated on 2010-08-24 (~16 years ago), indicating an established presence in the market. Longevity combined with concentrated high‑value implant services and the ESWL outlier position suggests an experienced clinical team and an operational model centered on durable device and procedure lines.
Concentration risk is material given the reliance on a few high‑paid device codes and the absence of Medicaid revenue; the top three Medicare codes make up 60.4% of Medicare revenue and many of those codes have high average paid/claim values (e.g., $22540 for 63685). Operational or reimbursement disruptions for implantable neurostimulation or device supply constraints would likely have an outsized impact on the practice’s Medicare revenue profile.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
18 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 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… | 30 | $22,540 | $676.2K |
| 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 | $17,570 | $579.8K |
| 63650 | In this procedure, the provider places electrodes in the epidural space to relieve pain and reduce or eliminate spasms. | 100 | $4,480 | $429.7K |
| 64561 | The provider, under imaging guidance, implants electrodes around nerves in the sacral region to reduce the pain along the path of the nerve. | 80 | $4,530 | $357.9K |
| 0275T | N/A | 40 | $4,390 | $153.5K |
| 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. | 20 | $9,010 | $153.1K |
| 50590 | Extracorporeal shock wave lithotripsy (ESWL) is a procedure used to destroy calculus (kidney stones) in the kidneys and ureters. | 130 | $1,160 | $148.1K |
| 15823 | In this procedure, the provider surgically trims excessive skin that weighs down the upper eyelid, typically to improve the cosmetic appearance of the face and due to the interference of the tissue… | 140 | $610 | $86.3K |
| 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… | 40 | $1,190 | $41.5K |
| 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… | 20 | $2,060 | $31K |
Showing 1–10 of 18
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 18 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
18 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| 64590 | 2 | 10 | 20 | $4,290 | $85.8K |
| 63650 | 1 | 10 | 40 | $1,690 | $74.5K |
| 63685 | 1 | 10 | 20 | $3,880 | $69.8K |
| 64561 | 1 | 10 | 20 | $1,620 | $55.2K |
| 0275T | 1 | 10 | 30 | $2,210 | $53K |
| 64628 | 2 | 10 | 10 | $1,880 | $30.1K |
| 67904 | 10 | 20 | 40 | $650 | $27.3K |
| 15823 | 1 | 40 | 30 | $610 | $24.8K |
| 50590 | 1 | 30 | 20 | $710 | $24.7K |
| 64721 | 67 | 80 | 30 | $400 | $18K |
Showing 1–10 of 18
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.
1 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 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… | 30 | $0 | $0 |
How this provider's Medicaid billing volume and revenue compare to other Massachusetts providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Massachusetts median
1 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 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… | 33 | 40 | 350 | $1 | $560 |
Other providers in the same ZIP code as New England Surgery Center LLC, ranked by combined Medicare and Medicaid revenue.
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