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NPI 1104896422 · Coeur D Alene, ID · Ambulatory Surgical Clinic/Center
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North Idaho Pain Center LLC is a ambulatory surgical clinic/center provider located in Coeur D Alene, Idaho. This profile covers 13 Medicare and 7 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 | North Idaho Pain Center LLC |
| Address | 1686 W Riverstone Dr Ste 2 |
| City | Coeur D Alene |
| State | ID |
| ZIP | 83814 |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| NPI Enumerated | January 26, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $716.5K |
| Medicaid | $43.9K |
NORTH IDAHO PAIN CENTER LLC is an ambulatory surgical clinic focused on interventional pain management and spinal procedures; its Medicare top codes are 63685, 63650 and 64635 which reflect spinal neurostimulator implantation/replacement, epidural electrode placement, and neurolytic/ablation procedures. The presence of multiple imaging-guided injection and neurostimulation codes indicates the practice operates as a procedure-oriented pain clinic performing device implantation and a high volume of targeted spine injections.
Revenue concentration on Medicare is high: the precomputed top 3 Medicare codes account for 61.8% of total Medicare revenue, with 63685 alone contributing $205.2K (28.6% of Medicare revenue) and 63650 contributing $174.3K (24.3%). This indicates a small number of high-revenue procedural codes drive the majority of Medicare billing.
On Medicaid the provider is even more concentrated: the top 3 Medicaid codes account for 91.3% of total Medicaid revenue, led by G0260 ($21.2K, 48.4%) and 62323 ($14.3K, 32.7%). Medicaid activity is dominated by sacroiliac joint injections and lumbar epidural injections, suggesting the clinic bills similar procedural services across both payers but with a particularly concentrated Medicaid mix.
Payer mix is skewed toward Medicare by scale: lifetime Medicare revenue is $716.5K versus Medicaid revenue of $43.9K, so Medicare represents the clear majority of recorded public-payer revenue. This profile reads like a practice whose patient population and revenue base are largely Medicare-driven, with Medicaid present but comparatively minor.
In competitive standing for key Medicare codes the clinic shows mixed placement: 63685 ranks #1135 of 1281 (0th percentile) indicating typical, unremarkable national volume for spinal neurostimulator generator procedures, while 64635 ranks in the 92th percentile and 64493 ranks in the 96th percentile, both described as notably above typical national volume. In other words, the clinic is a modest national player for high-revenue device work but a high-volume performer for several imaging-guided injection and ablation services.
Within Idaho Medicaid the clinic is a leading provider for G0260, ranking #1 of 3 providers in-state (100th percentile) for sacroiliac joint injection volume. For other in-state Medicaid codes like 62323 it ranks #4 of 12 (73th percentile), indicating it is a meaningful but not exclusive provider of lumbar epidural-type services in-state. Overall, Medicaid competitive standing is strong for sacroiliac injections and solid for lumbar injections.
The provider has a long tenure in national enrollment, with NPI enumeration on 2006-01-26 (approximately 20 years ago), which supports that its current billing patterns are produced by an established ambulatory surgical clinic rather than a new entrant. This longevity aligns with the presence of higher-complexity device procedures alongside routine injection workflows.
Several codes are statistical outliers relative to peers: G0260 and 64493 are labeled notably above typical national or in-state volume (95th and 96th percentiles respectively), highlighting unusually high activity in sacroiliac and facet/injection services. Conversely, 63685 is described as typical/unremarkable volume nationally, underscoring a contrast between high injection volumes and more typical device implantation volumes at this clinic.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
13 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… | 10 | $18,650 | $205.2K |
| 63650 | In this procedure, the provider places electrodes in the epidural space to relieve pain and reduce or eliminate spasms. | 50 | $3,710 | $174.3K |
| 64635 | Under fluoroscopic or CT guidance, the provider applies an agent to a lower back joint to destroy nerve tissue. | 120 | $510 | $63.2K |
| 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… | 240 | $260 | $62.7K |
| G0260 | Injection procedure for sacroiliac joint; provision of anesthetic, steroid and/or other therapeutic agent, with or without arthrography | 290 | $210 | $59.9K |
| 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)… | 190 | $240 | $44.1K |
| 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). | 140 | $290 | $42K |
| 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… | 60 | $280 | $16.9K |
| 62321 | 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 cervical (neck) or thoracic (upper and middle back)… | 70 | $240 | $16.1K |
| 64624 | The provider uses a chemical, heat, or radiofrequency as a neurolytic agent to destroy branches of the genicular nerves that supply the knee joint; imaging guidance is included, if performed, so it… | 30 | $560 | $15.8K |
Showing 1–10 of 13
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 13 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
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.
7 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| G0260 | Injection procedure for sacroiliac joint; provision of anesthetic, steroid and/or other therapeutic agent, with or without arthrography | 180 | $120 | $21.2K |
| 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)… | 100 | $150 | $14.3K |
| 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… | 20 | $190 | $4.5K |
| 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). | 20 | $240 | $3.8K |
| G8918 | Patient without preoperative order for iv antibiotic surgical site infection (ssi) prophylaxis | 20 | $1 | $20 |
| 77002 | The provider uses fluoroscopic guidance to place a needle for biopsy, aspiration, injection, or localization of a device to detect any lesions in any area of the body, except for the spine, or to… | 20 | $0 | $0 |
| 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… | 170 | $0 | $0 |
How this provider's Medicaid billing volume and revenue compare to other Idaho providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Idaho median
7 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… | 6 | 10 | 50 | $360 | $57.4K |
| 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). | 12 | 10 | 30 | $240 | $26.4K |
| 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 | 10 | 60 | $170 | $25.2K |
| G0260 | Injection procedure for sacroiliac joint; provision of anesthetic, steroid and/or other therapeutic agent, with or without arthrography | 1 | 10 | 70 | $100 | $9.3K |
| 77002 | The provider uses fluoroscopic guidance to place a needle for biopsy, aspiration, injection, or localization of a device to detect any lesions in any area of the body, except for the spine, or to… | 5 | 10 | 80 | $30 | $5.2K |
| G8918 | Patient without preoperative order for iv antibiotic surgical site infection (ssi) prophylaxis | 11 | 10 | 260 | $1 | $740 |
| 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… | 12 | 20 | 210 | $1 | $680 |
Other providers in the same ZIP code as North Idaho Pain Center LLC, ranked by combined Medicare and Medicaid revenue.
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