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NPI 1043819873 · Lone Tree, CO · Ambulatory Surgical Clinic/Center
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Lone Tree Surgery Center, LLC is a ambulatory surgical clinic/center provider located in Lone Tree, Colorado. 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 | Lone Tree Surgery Center, LLC |
| Address | 9218 Kimmer Dr Ste 101 |
| City | Lone Tree |
| State | CO |
| ZIP | 80124 |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| NPI Enumerated | October 22, 2020 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $2.3M |
| Medicaid | $20.8K |
This provider is an ambulatory surgical clinic with a clear interventional pain and spine focus: the Medicare top codes are implant and neurostimulation procedures (63685, 63650) and targeted neuroablative therapy (64628), and the listed services include image-guided injections, nerve ablations, and neurostimulator implantation. The average paid/claim figures shown (for example $18815 avg paid/claim for 63685 and $7703 avg paid/claim for 64628) indicate material device- and procedure-driven revenue streams consistent with a specialty outpatient surgery center handling spine and pain-management interventions.
Revenue is highly concentrated in a few high-value Medicare services: the precomputed top-3 Medicare codes account for 52.1% of this provider's total Medicare revenue, with 63685 ($620.9K, 26.5%), 63650 ($329.1K, 14.1%), and 64628 ($269.6K, 11.5%) listed as the leading drivers. This concentration suggests the business is dependent on a small set of implant and ablation procedures for the majority of Medicare income.
Medicare dominates this provider’s payer mix: total Medicare revenue is $2.3M versus total Medicaid revenue of $20.8K, so Medicare accounts for the overwhelming share of reported public-payer billing and the center operates effectively as a Medicare-focused revenue source. Medicaid billing is present but immaterial by scale compared with Medicare, indicating limited participation or low Medicaid patient volume relative to Medicare.
On several image-guided injection and ablation codes the center is a high-volume outlier nationally: 64483 ranks 42 of 8202 (100th percentile; extreme outlier), 64635 ranks 74 of 5957 (99th percentile; extreme outlier), 64493 ranks 88 of 7519 (99th percentile; extreme outlier), and 64490 ranks 13 of 3759 (100th percentile; extreme outlier). These rankings indicate the facility performs substantially more of these particular procedures than typical peers, consistent with a procedural specialization in spinal injections and facet/neurolytic interventions.
For some major implant codes the provider’s national standing is more typical: 63685 ranks 180 of 1281 (85th percentile) and 63650 ranks 210 of 1371 (84th percentile), both described as typical, unremarkable volume for those codes. This combination—extreme outlier volumes on certain injection/ablation codes alongside typical national volume for some implant codes—suggests the center pairs high-volume outpatient pain procedures with a stable program of implants and lead/electrode placements.
Medicaid activity is narrowly concentrated: the single Medicaid code reported is 64483, which represents 100.0% of this provider's total Medicaid revenue ($20.8K) and ranks 21 of 58 in-state (65th percentile; typical, unremarkable volume). That concentration implies the provider’s Medicaid exposure is focused on transforaminal epidural injections rather than a broader set of outpatient procedures.
Tenure and operational history are modest but established: the NPI was enumerated on 2020-10-22 (~6 years ago), indicating several years of claims history but not decades of operation. Given the high-volume standing on multiple advanced interventional codes, the center appears to have scaled a focused service mix in that timeframe.
From a competitive and contracting perspective, payers and system planners should view this entity as a regional/high-volume specialty outpatient center for interventional spine and pain care: it is a major outlier on multiple injection and ablation codes compared with national peers, while its implant-related codes produce substantial Medicare revenue but at more typical national ranks. Contracting discussions should account for the provider’s reliance on a concentrated set of high-reimbursement services and its limited Medicaid footprint when assessing network value and payment arrangements.
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 | $18,820 | $620.9K |
| 63650 | In this procedure, the provider places electrodes in the epidural space to relieve pain and reduce or eliminate spasms. | 90 | $3,830 | $329.1K |
| 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 | $7,700 | $269.6K |
| 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). | 880 | $300 | $261.1K |
| 64635 | Under fluoroscopic or CT guidance, the provider applies an agent to a lower back joint to destroy nerve tissue. | 280 | $510 | $141.2K |
| 64555 | A neurostimulator includes electrodes which are inserted under the skin and induced by a generator to stimulate the nerve tissue. Use of this stimulator involves implantation of electrodes around a… | 30 | $4,360 | $130.9K |
| 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… | 440 | $260 | $114.8K |
| 0275T | N/A | 30 | $3,640 | $105.4K |
| 64633 | In this procedure, the provider destroys the facet joint nerve of a cervical or thoracic spinal segment using neurolytic agents like heat, electric current, or a chemical compound. He makes use of… | 150 | $530 | $80.6K |
| 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… | 270 | $280 | $75.6K |
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 |
|---|---|---|---|---|---|
| 63685 | 3 | 10 | 10 | $9,170 | $183.3K |
| 64628 | 2 | 10 | 20 | $4,110 | $98.5K |
| 63650 | 2 | 20 | 30 | $2,230 | $98K |
| 64555 | 2 | 10 | 30 | $2,170 | $69.4K |
| 0275T | 1 | 10 | 10 | $2,680 | $45.6K |
| 64483 | 2 | 160 | 70 | $200 | $23.6K |
| G0260 | 4 | 20 | 80 | $210 | $22.2K |
| 64635 | 2 | 110 | 30 | $400 | $20.2K |
| 64493 | 2 | 140 | 50 | $190 | $15K |
| 64633 | 2 | 50 | 20 | $410 | $13.1K |
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 |
|---|---|---|---|---|
| 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). | 260 | $80 | $20.8K |
How this provider's Medicaid billing volume and revenue compare to other Colorado providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Colorado median
1 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 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). | 21 | 60 | 110 | $170 | $89.2K |
Other providers in the same ZIP code as Lone Tree Surgery Center, LLC, ranked by combined Medicare and Medicaid revenue.
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