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NPI 1154326650 · Scottsdale, AZ · Ambulatory Surgical Clinic/Center
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Scottsdale Surgical Partners LLC is a ambulatory surgical clinic/center provider located in Scottsdale, Arizona. This profile covers 52 Medicare and 6 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 | Scottsdale Surgical Partners LLC |
| Address | 8901 E. Raintree Dr. |
| City | Scottsdale |
| State | AZ |
| ZIP | 85260 |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| NPI Enumerated | June 20, 2005 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $3.1M |
| Medicaid | $1.1M |
SCOTTSDALE SURGICAL PARTNERS LLC is registered as an Ambulatory Surgical Clinic/Center (NPI enumerated 2005-06-20 (~21 years ago)) and its billing mix shows a blended outpatient specialty practice: high-volume GI endoscopy (multiple colonoscopy and upper endoscopy codes) alongside substantial orthopedic joint-replacement work. Medicare top codes include 27447 and 27130 (major joint arthroplasty) and 45380/45385/43239 (endoscopy), indicating the site supports both surgical orthopedics and endoscopic procedural lines in an ambulatory setting.
Medicare revenue is concentrated across a small set of procedures: the provider reports $3.1M in total Medicare revenue and its top 3 Medicare codes account for 46.5% of that revenue. The three highest-revenue Medicare codes by dollar value include 27447 ($570.2K, 20.2%), 27130 ($434.2K, 15.4%), and 45380 ($309K, 10.9%), so total knee and hip arthroplasty plus colonoscopy/biopsy are the primary Medicare drivers.
Medicaid revenue is highly concentrated in GI services: the provider reports $1.1M in total Medicaid revenue and the top 3 Medicaid codes account for 92.3% of Medicaid revenue. Those top Medicaid codes are 45380 ($436.1K, 39.1%), 43239 ($435.6K, 39.0%), and 45385 ($158.1K, 14.2%), which shows Medicaid dollars are almost entirely derived from colonoscopy and upper endoscopy procedures.
Payer mix comparison shows Medicare is larger in scale than Medicaid for this entity ($3.1M Medicare vs $1.1M Medicaid) and Medicaid business is even more narrowly concentrated into a few endoscopy services; this asymmetry suggests operational sensitivity if endoscopy volumes or Medicaid coverage change. Analysts should treat GI endoscopy as the primary Medicaid-facing service line while Medicare revenues are split between orthopedics and GI.
National competitive standing for endoscopy on Medicare is unusually strong: 45380 ranks #40 of 16427 providers nationally (100th percentile; extreme outlier, far above typical national volume), 45385 ranks in the 99th percentile, and 43239 ranks in the 99th percentile. By contrast, the provider’s joint-replacement codes (27447 and 27130) sit in the mid-to-high percentiles (88th and 86th respectively) and are characterized as typical, unremarkable volumes for those codes, so the practice appears nationally notable for endoscopy volume while being a more conventional participant in arthroplasty.
Within Arizona Medicaid peer comparisons, the provider is above median but not dominant for GI: 45380 ranks #14 of 120 in-state (89th percentile) and 43239 ranks #42 of 177 in-state (77th percentile), indicating strong but not exclusive market share in-state for endoscopy. This in-state position combined with national outlier status on Medicare endoscopy suggests the provider draws sizeable non-Medicaid endoscopy volume (Medicare and possibly commercially insured cases) beyond its local Medicaid footprint.
There are additional specialty niches reflected in the code mix beyond orthopedics and GI: Medicare-level ranks show notable volumes for ENT sinus surgery (31267 and 31288 — 31288 is rank #1 of 15 nationally, 100th percentile, notably above typical volume), shoulder arthroscopy (29827, 29880/29881), and select interventional pain codes (64483, 64493). This breadth confirms a multi-specialty ambulatory surgical center model rather than a single-procedure clinic, with some niche national leadership in low-volume specialized ENT procedures.
Revenue-concentration and percentile patterns imply both opportunity and operational risk: Medicaid revenue is highly dependent on three endoscopy codes (92.3% concentrated), while Medicare revenue, though broader, still has 46.5% tied to its top three codes. For contracting or network planning, payers should view the provider as a high-volume endoscopy and ambulatory surgical provider with substantial orthopedic activity and potential vulnerability to shifts in endoscopy policy or Medicaid coverage changes.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
52 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… | 80 | $6,870 | $570.2K |
| 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 | $7,360 | $434.2K |
| 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… | 870 | $360 | $309K |
| 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… | 620 | $450 | $280.5K |
| 27446 | In this procedure, the provider reconstructs the diseased or damaged medial or lateral compartment of the knee along with the femoral condyles and tibial plateaus to relieve pain and improve the… | 20 | $7,120 | $163.9K |
| 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… | 60 | $2,180 | $131K |
| 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. | 590 | $220 | $130.1K |
| 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). | 270 | $300 | $79.5K |
| G0105 | Colorectal cancer screening; colonoscopy on individual at high risk | 180 | $420 | $76.7K |
| 31267 | In this procedure, the provider inserts an endoscope into the nasal cavity. She then gains access to the maxillary sinus through a cut in the uncinate process. The provider opens the maxillary sinus… | 50 | $1,230 | $64K |
Showing 1–10 of 52
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 52 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
52 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| 27446 | 11 | 20 | 20 | $2,210 | $59.6K |
| 27447 | 42 | 290 | 40 | $1,290 | $59.3K |
| 27130 | 36 | 210 | 30 | $1,270 | $45.7K |
| C2639 | 1 | 10 | 1,510 | $30 | $41.8K |
| 64483 | 33 | 250 | 90 | $210 | $31K |
| 64635 | 63 | 210 | 60 | $390 | $30.3K |
| 45385 | 5 | 330 | 50 | $290 | $28.4K |
| 31288 | 1 | 10 | 20 | $1,280 | $28.2K |
| 29827 | 4 | 100 | 20 | $1,020 | $25.4K |
| 31267 | 3 | 20 | 20 | $860 | $23.9K |
Showing 1–10 of 52
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.
6 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 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… | 1,660 | $260 | $436.1K |
| 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. | 2,180 | $200 | $435.6K |
| 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… | 550 | $290 | $158.1K |
| 69436 | This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia. | 190 | $300 | $57K |
| 42820 | The provider removes the tonsils and adenoids in a patient younger than 12 years old. | 10 | $1,490 | $19.4K |
| G0121 | Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk | 40 | $230 | $9.4K |
How this provider's Medicaid billing volume and revenue compare to other Arizona providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Arizona median
6 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 42820 | The provider removes the tonsils and adenoids in a patient younger than 12 years old. | 37 | 40 | 210 | $1,710 | $1.2M |
| 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. | 42 | 180 | 590 | $250 | $360.9K |
| 69436 | This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia. | 21 | 40 | 190 | $540 | $334.2K |
| 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… | 14 | 120 | 330 | $280 | $206.3K |
| 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… | 28 | 80 | 150 | $290 | $157.8K |
| G0121 | Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk | 16 | 20 | 70 | $230 | $36.3K |
Other providers in the same ZIP code as Scottsdale Surgical Partners LLC, ranked by combined Medicare and Medicaid revenue.
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