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NPI 1093736795 · Hattiesburg, MS · Ambulatory Surgical Clinic/Center
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Hattiesburg Clinic PA is a ambulatory surgical clinic/center provider located in Hattiesburg, Mississippi. This profile covers 53 Medicare and 19 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 | Hattiesburg Clinic PA |
| Address | 415 S 28th Ave |
| City | Hattiesburg |
| State | MS |
| ZIP | 39401 |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| NPI Enumerated | July 21, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $4.5M |
| Medicaid | $2.4M |
Payer mix and scale: HATTIESBURG CLINIC PA reports $4.5M in total Medicare revenue and $2.4M in total Medicaid revenue, so Medicare is the larger single payer on file while the clinic maintains material Medicaid activity. The dual-payer footprint indicates the site operates across both fee-for-service Medicare and state Medicaid populations rather than being effectively single-payer.
Medicare revenue concentration: the provider's top 3 Medicare codes (C9740, 45385, 64590) account for 29.0% of its Medicare revenue, showing a measurable concentration in a handful of high-revenue procedures. That concentration suggests targeted service lines drive a significant share of Medicare billings while the remainder of revenue is distributed across many other procedural codes.
Medicaid revenue concentration: the top 3 Medicaid codes (43239, 45385, 45380) account for 52.1% of Medicaid revenue, indicating Medicaid revenue is heavily concentrated in a small set of endoscopic and GI procedures. This level of concentration implies the clinic’s Medicaid business is particularly reliant on upper and lower endoscopy volumes.
Business/service-line implications: the clinic’s code mix points to an ambulatory surgical center focused on GI endoscopy (45385, 45380, 43239), urology/cystoscopic procedures and stent work (52356, 52332, 52281, 52310), and interventional pain/neuromodulation and device work (64590, 63650, 63685, 64561). The presence of C2638 (brachytherapy source) and (prostate seed placement) further indicates occasional oncologic/procedural services performed in an outpatient procedural setting. Together these codes are consistent with an ambulatory surgical clinic operating high procedural throughput across gastroenterology, urology, and interventional pain/neuromodulation.
Competitive standing on Medicare-coded services: HATTIESBURG CLINIC PA ranks at very high national percentiles for multiple codes — for example, 45385 is listed as a 100th percentile extreme outlier, 52356 is 100th percentile extreme outlier (rank #8 of 3090), 52281 ranks #3 of 693 (100th percentile, extreme outlier), and C2638 ranks #1 of 5 (100th percentile). These rankings indicate the provider is a major national outlier on several GI and urology procedures rather than a marginal participant.
Competitive standing within the state Medicaid market: for Medicaid-volume codes the provider also ranks prominently statewide — 45385 is #1 of 26 providers in-state (100th percentile; notably above typical state volume), 43239 is #8 of 73 (90th percentile), and 64493 is #3 of 36 (94th percentile). Those state-level rankings suggest the clinic is a leading regional provider of endoscopy and certain interventional pain services for Medicaid patients.
Statistical outliers and volume nuance: many of the high-revenue Medicare and Medicaid codes are flagged as “extreme outlier” or “notably above typical” in either national or state comparisons (examples include 45385, 45380, 52356, 52281, and 64493), while several high-cost device codes (e.g., 64590 with $12828 avg paid/claim, 63685 with $16399 avg paid/claim) appear at more typical or unremarkable national volumes. This mix means the clinic pairs unusually high procedural volumes in endoscopy and cystoscopy with selective use of higher-cost implants and neurostimulators at market-typical frequency.
Tenure and operational stability: the NPI was enumerated on 2006-07-21 (~20 years ago), indicating a long-established ambulatory surgical clinic presence. Combined with sustained multi-year Medicare and Medicaid billing and concentrated high-volume procedural lines, the data point to an established, operationally mature outpatient surgical practice with persistent specialty throughput.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
53 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| C9740 | Cystourethroscopy, with insertion of transprostatic implant; 4 or more implants | 80 | $4,790 | $401.9K |
| 45385 | The provider examines the colon and rectum using a colonoscope, a long, thin flexible tubular instrument with a light source and camera. He removes one or more tumors, polyps, or other lesions with a… | 1,010 | $380 | $387K |
| 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… | 20 | $12,830 | $307.9K |
| 63650 | In this procedure, the provider places electrodes in the epidural space to relieve pain and reduce or eliminate spasms. | 60 | $3,260 | $202.1K |
| 64561 | The provider, under imaging guidance, implants electrodes around nerves in the sacral region to reduce the pain along the path of the nerve. | 60 | $3,310 | $185.3K |
| 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… | 130 | $1,440 | $181.9K |
| 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 | $16,400 | $180.4K |
| 45380 | The provider examines the rectum and colon using a flexible colonoscope, a tubular instrument with a light source and camera, to look for the cause of a patient's symptoms, which may include… | 630 | $280 | $174K |
| 52281 | The provider uses a cystoscope to view inside the urethra and bladder of a male or female patient. The procedure must include calibrating or dilating a urethral stricture or stenosis. The procedure… | 300 | $550 | $167.3K |
| C2638 | Brachytherapy source, stranded, iodine-125, per source | 5,270 | $30 | $152.8K |
Showing 1–10 of 53
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 53 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
53 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| C9740 | 1 | 10 | 70 | $5,000 | $349.8K |
| 63685 | 19 | 20 | 30 | $7,940 | $277.9K |
| 64590 | 12 | 20 | 30 | $6,100 | $201.4K |
| 0627T | 16 | 20 | 40 | $3,200 | $163K |
| 63650 | 11 | 20 | 80 | $1,890 | $160.4K |
| C2638 | 1 | 10 | 5,270 | $30 | $154.5K |
| 64561 | 9 | 20 | 40 | $2,180 | $141.6K |
| J0585 | 15 | 30 | 5,890 | $1 | $46.9K |
| 0275T | 5 | 10 | 20 | $1,410 | $42.4K |
| 45385 | 3 | 120 | 110 | $270 | $41.9K |
Showing 1–10 of 53
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.
19 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 43239 | The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis. | 3,650 | $130 | $474.5K |
| 45385 | The provider examines the colon and rectum using a colonoscope, a long, thin flexible tubular instrument with a light source and camera. He removes one or more tumors, polyps, or other lesions with a… | 2,410 | $190 | $459.5K |
| 45380 | The provider examines the rectum and colon using a flexible colonoscope, a tubular instrument with a light source and camera, to look for the cause of a patient's symptoms, which may include… | 1,940 | $170 | $322.5K |
| 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… | 1,830 | $160 | $285.3K |
| 43248 | The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum; then through the scope, he passes a guidewire over which he passes dilators through the… | 1,330 | $130 | $175.7K |
| 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)… | 1,390 | $120 | $171.7K |
| 45378 | The provider examines the colon and rectum using a colonoscope, a flexible tube with a camera at its inserted end. If he sees any areas of abnormal mucosa or tissue, he takes samples using a brush… | 860 | $180 | $155.1K |
| 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). | 770 | $170 | $128.4K |
| 52000 | In this procedure, the provider performs an examination of the interior of the bladder, the urethra, and the ureteric openings by means of a cystourethroscope, a thin flexible or rigid tube with a… | 560 | $100 | $53.3K |
| 43235 | The provider inserts an endoscope through the mouth and down into the esophagus, stomach, and duodenum for diagnostic purposes; the provider may collect specimens by brushing or washing. | 360 | $120 | $42.6K |
Showing 1–10 of 19
How this provider's Medicaid billing volume and revenue compare to other Mississippi providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Mississippi median
19 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 43239 | The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis. | 8 | 70 | 200 | $180 | $200.4K |
| 45380 | The provider examines the rectum and colon using a flexible colonoscope, a tubular instrument with a light source and camera, to look for the cause of a patient's symptoms, which may include… | 4 | 30 | 420 | $210 | $165.6K |
| 64635 | Under fluoroscopic or CT guidance, the provider applies an agent to a lower back joint to destroy nerve tissue. | 5 | 20 | 40 | $420 | $105.7K |
| 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… | 3 | 40 | 160 | $170 | $90.1K |
| 45385 | The provider examines the colon and rectum using a colonoscope, a long, thin flexible tubular instrument with a light source and camera. He removes one or more tumors, polyps, or other lesions with a… | 1 | 30 | 170 | $190 | $89.5K |
| 43248 | The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum; then through the scope, he passes a guidewire over which he passes dilators through the… | 2 | 10 | 190 | $130 | $65.1K |
| 45378 | The provider examines the colon and rectum using a colonoscope, a flexible tube with a camera at its inserted end. If he sees any areas of abnormal mucosa or tissue, he takes samples using a brush… | 4 | 30 | 80 | $200 | $58K |
| 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). | 8 | 30 | 110 | $120 | $55.7K |
| 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)… | 4 | 40 | 280 | $110 | $46.9K |
| 43235 | The provider inserts an endoscope through the mouth and down into the esophagus, stomach, and duodenum for diagnostic purposes; the provider may collect specimens by brushing or washing. | 3 | 10 | 80 | $160 | $40.5K |
Showing 1–10 of 19
Other providers in the same ZIP code as Hattiesburg Clinic PA, ranked by combined Medicare and Medicaid revenue.
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