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

Why is the Medicaid comparison limited to Texas 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. Texas (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.

Orthopaedic Surgery Center Of San Antonio LP (NPI 1083659866)

Field	Value
Entity Type	Organization
Organization	Orthopaedic Surgery Center Of San Antonio LP
Address	400 Concord Plaza Dr
City	San Antonio
State	TX
ZIP	78216
Taxonomy	Ambulatory Surgical Clinic/Center
NPI Enumerated	June 17, 2006

Payer Source	Total Paid
Medicare	$4.6M
Medicaid	$0

Key Findings

This entity reports $4.6M in lifetime Medicare revenue and has none (no Medicaid billing on file), making its recorded business effectively single‑payer (Medicare) in scope based on available claims. The provider’s NPI was enumerated on 2006-06-17 (~20 years ago), indicating an established ambulatory surgical clinic/center presence in SAN ANTONIO, TX.

Revenue is highly concentrated in a few major procedures: the top three Medicare codes (27447, 27130, 63685) together account for 46.6% of the provider’s total Medicare revenue. Notably, 27447 alone represents $1.2M (29.2% of Medicare revenue, 183 claims, $6534 avg paid/claim), while 27130 contributes $403.8K (9.9%) and 63685 contributes $305.9K (7.5%).

The CPT mix points to a primary orthopedic joint-replacement and arthroscopy operation with a significant spine/pain-management component: high-revenue joint replacements (27447 knee and 27130 hip) sit alongside spine neurostimulator procedures (63685, 63650) and large-volume epidural/facet injection codes (64483, 64493). This combination is consistent with an ambulatory surgery center that performs both major outpatient orthopedic procedures and integrated interventional pain services.

Competitive standing is uneven by procedure: the provider is a national outlier on several codes—27447 ranks #122 of 12089 (99th percentile; extreme outlier) and 29827 ranks #5 of 3445 (100th percentile; extreme outlier)—indicating volumes well above typical national peers for those services. At the same time, some high-revenue spine implant codes show only typical or midline national standing (63685 ranks in the 48th percentile; 27130 ranks in the 87th percentile), so dominance is procedure-specific rather than uniform across all service lines.

Several high-volume, lower‑unit‑price procedures support throughput and recurring outpatient visits: 64483 has 707 claims ($270 avg paid/claim, $190.9K revenue) and 64493 has 391 claims ($248 avg paid/claim, $97K revenue), while hand and wrist procedures such as 26055 (284 claims, $105.6K) and 29848 (178 claims, $85.3K) also feature prominently. These volumes suggest an operational model built around frequent, short procedures and interventional pain injections in addition to episodic high-revenue surgeries.

The provider shows concentrated excellence in multiple discrete procedure niches beyond joint replacement: several codes are labeled as “extreme outlier” or “notably above typical” nationally (for example, 29827, 64483, 29828, 26055, 64493, 29848, 25447, 26480), signaling programmatic scale in shoulder arthroscopy, transforaminal injections, biceps/rotator cuff procedures, trigger‑finger and carpal tunnel services. This pattern indicates specialized throughput in both upper-extremity and spine/pain modalities that differentiates it from average ambulatory centers.

Not all advanced spine procedures show the same prominence: SI fusion (27279) and basivertebral nerve ablation (64628) rank in the lower national percentiles (27279 at the 24th percentile; 64628 at the 30th percentile) and are described as typical or unremarkable in volume. That suggests the provider’s spine/pain footprint emphasizes neurostimulation and image‑guided injections more than percutaneous SI fusion or basivertebral ablation.

The combination of long tenure (NPI enumerated 2006-06-17 (~20 years ago)), concentrated revenue in a few high-yield orthopedics codes, and very high national ranks for several outpatient procedures implies a mature ASC that has scaled specific orthopedic and interventional pain services. For payers and competitors, this translates to a reliable local source of high-volume knee/shoulder procedures and outpatient pain management, while Medicaid is effectively absent from the reported payer mix.

Medicare: Complete Services Breakdown

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

56 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	180	$6,530	$1.2M
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…	60	$6,730	$403.8K
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…	20	$17,990	$305.9K
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…	160	$1,620	$250.5K
63650	In this procedure, the provider places electrodes in the epidural space to relieve pain and reduce or eliminate spasms.	70	$3,550	$234.2K
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).	710	$270	$190.9K
29828	The provider examines the tissue inside the shoulder joint with an arthroscope. She inserts additional instruments to repair an unstable biceps tendon, the fibrous band that connects the biceps…	80	$2,270	$177.1K
27279	The provider performs sacroiliac (SI) joint fusion using a percutaneous or minimally invasive approach. The SI joint is where the sacrum (the base of the spine) meets the ilium (part of the pelvic…	10	$10,780	$151K
64635	Under fluoroscopic or CT guidance, the provider applies an agent to a lower back joint to destroy nerve tissue.	220	$550	$122.5K
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…	280	$370	$105.6K

Showing 1–10 of 56

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 56 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Texas Distribution

Orthopaedic Surgery Center Of San Antonio LP — 14 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Texas

Full comparison — all codes billed, vs. state median

56 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
63685	74	160	20	$8,330	$216.7K
63650	59	160	50	$1,960	$147K
27279	18	20	20	$6,210	$117.9K
64628	20	30	20	$3,980	$91.6K
27654	1	10	20	$2,760	$46.9K
25608	1	10	20	$2,120	$44.5K
27447	8	760	30	$900	$38K
25607	1	10	10	$3,210	$35.3K
25609	5	20	20	$1,570	$26.7K
27130	34	430	20	$890	$26.7K

Showing 1–10 of 56

Nearby Providers

Other providers in the same ZIP code as Orthopaedic Surgery Center Of San Antonio LP, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Pyra Med Health Services, LLC	TX	Home Health Agency	$0	$67.7M
Wave Healthcare	TX	Durable Medical Equipment & Medical Supplies	$0	$65.3M
The Home Care Team, Inc.	TX	Home Health Agency	$0	$53.9M
Outreach Health Community Care Services LP	TX	Personal Care Attendant	$0	$52.8M
Ability Homecare, LLC	TX	Home Health Agency	$0	$52.5M
Pride Phc Services Inc	TX	Home Health Agency	$0	$51.6M
National Nursing And Rehab Sa Pediatrics, LLC	TX	Home Health Agency	$0	$46.3M
Alliance Medical Supply, LLC	TX	Durable Medical Equipment & Medical Supplies	$0	$34.8M
Stonebridge Behavioral Health, P.A.	TX	Clinical Psychologist	$0	$17.6M
Premieant Inc	TX	Adult Care Home Facility	$0	$12.9M

Orthopaedic Surgery Center Of San Antonio LP — Billing Profile & Reimbursement Data

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Orthopaedic Surgery Center Of San Antonio LP — 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

Nearby Providers

Frequently Asked Questions

References