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NPI 1073039657 · E Providence, RI · Ambulatory Surgical Clinic/Center
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University Orthopedics, Inc. is a ambulatory surgical clinic/center provider located in E Providence, Rhode Island. This profile covers 15 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 | University Orthopedics, Inc. |
| Address | 1 Kettle Point Ave Ste 200 |
| City | E Providence |
| State | RI |
| ZIP | 02914 |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| NPI Enumerated | August 16, 2017 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $727.3K |
| Medicaid | $7.8K |
Medicare dominates this provider’s payer mix: reported lifetime Medicare revenue is $727.3K compared with just $7.8K in Medicaid, so the practice is effectively Medicare-driven rather than balanced across public payers. The Medicaid presence is negligible in scale relative to Medicare.
Revenue concentration on Medicare is high: the precomputed top 3 Medicare codes by revenue account for 61.0% of this provider's total Medicare revenue, driven primarily by 27130, 27447, and 63650. Those three codes combine high per-claim payments (27130 avg paid/claim $7549; 27447 avg paid/claim $7415; 63650 avg paid/claim $3907) and together make up the majority of Medicare dollars received.
Medicaid billing is fully concentrated in a single procedure type: the precomputed top 3 Medicaid codes by revenue account for 100.0% of Medicaid revenue, and Medicaid revenue consists entirely of 64493 (16 claims, $488 avg paid/claim, $7.8K revenue). In-state competitive standing for that code is modest (ranks #2 of 4 providers in-state, 67th percentile) and is described as a typical, unremarkable volume for this service.
The mix of billed services indicates an ambulatory surgical clinic focused on orthopedics and interventional pain care: high-revenue joint replacements (27130 hip; 27447 knee), spinal/pain procedures including spinal electrode placement and facet injections (63650, 64493, 64635, 64483), and hand/upper-extremity procedures (64721 carpal tunnel, 26055 trigger finger). This combination is consistent with an ASC model that performs both operative procedures and image-guided pain interventions.
National competitive standing across the provider’s largest Medicare codes is generally modest rather than dominant: 27130 is ranked #4193 of 8062 (45th percentile) and labeled a typical, unremarkable volume; 27447 is ranked #9226 of 12089 (21th percentile) and also labeled typical/unremarkable; 63650 ranks #987 of 1371 (26th percentile) and is likewise described as typical. These rankings suggest the provider has routine national volumes for major joint and spinal procedures rather than market-leading share.
There is a notable specialty strength in hand surgery procedures: 64721 shows 93 claims, $659 avg paid/claim and $61.3K revenue (8.4% of the provider's Medicare revenue) and is explicitly described as notably above typical national volume (94th percentile). That elevated activity for carpal tunnel/neuroplasty procedures differentiates the provider from peers and signals a relative area of clinical concentration.
Reliance on a few high-revenue procedure lines (the three Medicare codes that make up 61.0% of Medicare revenue) means overall revenue performance is sensitive to volume changes in joint arthroplasty and interventional spine services. Payer negotiation, capacity for joint cases, or shifts in referral patterns for these specific codes would therefore have an outsized impact on the practice’s top-line Medicare receipts.
The provider has an established NPI tenure consistent with an operating ambulatory surgery center: NPI enumerated 2017-08-16 (~9 years ago) and taxonomy is Ambulatory Surgical Clinic/Center. Tenure combined with the current code mix suggests an operating profile that has built both surgical and interventional pain line items over multiple years rather than being a recent entrant focused on a single procedure type.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
15 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 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… | 20 | $7,550 | $181.2K |
| 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… | 20 | $7,420 | $133.5K |
| 63650 | In this procedure, the provider places electrodes in the epidural space to relieve pain and reduce or eliminate spasms. | 30 | $3,910 | $128.9K |
| 64721 | Neuroplasty or transposition of the median nerve at the carpal tunnel is done to treat a condition called carpal tunnel syndrome (CTS). The carpal tunnel is a narrow tunnel in the wrist through which… | 90 | $660 | $61.3K |
| 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… | 180 | $280 | $49.4K |
| 64635 | Under fluoroscopic or CT guidance, the provider applies an agent to a lower back joint to destroy nerve tissue. | 80 | $550 | $43.1K |
| 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). | 120 | $300 | $37.3K |
| 26055 | Trigger finger, or stenosing tenosynovitis, is when a finger remains in a bent position. It is painful to open or close the finger. A swollen tendon or formation of knots or nodules in the tendon may… | 60 | $520 | $33.5K |
| 29827 | The provider examines the tissue inside the shoulder joint with an arthroscope. She inserts additional instruments to repair a torn rotator cuff, the grouping of muscles and tendons that surround and… | 10 | $1,870 | $22.5K |
| 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… | 20 | $630 | $11.9K |
Showing 1–10 of 15
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 15 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
15 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| 63650 | 2 | 10 | 40 | $1,670 | $70.1K |
| 27447 | 35 | 50 | 30 | $1,230 | $43K |
| 27130 | 15 | 30 | 20 | $1,250 | $33.8K |
| 29827 | 9 | 10 | 20 | $1,120 | $21.3K |
| 64721 | 1 | 10 | 40 | $440 | $17.8K |
| 64635 | 3 | 10 | 30 | $370 | $15.4K |
| 62323 | 17 | 20 | 50 | $140 | $13.2K |
| 64493 | 3 | 20 | 50 | $170 | $12.8K |
| 64483 | 4 | 20 | 50 | $190 | $12.2K |
| 26055 | 1 | 10 | 30 | $340 | $11.2K |
Showing 1–10 of 15
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 |
|---|---|---|---|---|
| 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… | 20 | $490 | $7.8K |
How this provider's Medicaid billing volume and revenue compare to other Rhode Island providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Rhode Island median
1 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average 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 | 10 | 20 | $640 | $21.9K |
Other providers in the same ZIP code as University Orthopedics, Inc., ranked by combined Medicare and Medicaid revenue.
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