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NPI 1164019485 · Waukesha, WI · Ambulatory Surgical Clinic/Center
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Waukesha Surgicenter, LLC is a ambulatory surgical clinic/center provider located in Waukesha, Wisconsin. This profile covers 13 Medicare and 9 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 | Waukesha Surgicenter, LLC |
| Address | 813 W Moreland Blvd |
| City | Waukesha |
| State | WI |
| ZIP | 53188 |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| NPI Enumerated | December 22, 2020 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $805.2K |
| Medicaid | $19.7K |
WAUKESHA SURGICENTER, LLC bills primarily as an Ambulatory Surgical Clinic/Center and its CPT mix is concentrated in interventional pain and neuromodulation procedures. The top Medicare codes — 63685, 62362, and 63650 — represent spinal neurostimulator generator implantation, programmable intrathecal pump implantation, and epidural electrode placement respectively, indicating a procedural focus on device implantation and advanced pain-management interventions rather than routine office-based injections.
Medicare revenue is the dominant clinical payer for this entity: total Medicare revenue is $805.2K and the precomputed top 3 Medicare codes account for 80.6% of that Medicare revenue. Those three codes individually account for $270.5K (63685, 33.6%), $196.1K (62362, 24.4%), and $182.7K (63650, 22.7%) of Medicare revenue, showing heavy dependence on a small set of high-revenue procedures.
Medicaid billing is very small relative to Medicare with total Medicaid revenue of $19.7K and its top 3 Medicaid codes accounting for 85.5% of Medicaid revenue. The Medicaid mix is concentrated in neurolytic and facet procedures: 64635 accounts for $12.9K (65.2%), 62323 for $2.2K (11.0%), and 64493 for $1.8K (9.3%), reflecting a similar interventional pain focus but at much lower payer volume.
The payer mix is effectively Medicare-dominant: $805.2K in Medicare revenue versus $19.7K in Medicaid revenue implies the center’s financial scale and case mix are driven almost entirely by Medicare payers. This suggests contracting, utilization oversight, and competitive benchmarking should prioritize Medicare procedure lines and reimbursement patterns.
Competitive standing varies by code: for Medicare, 62362 ranks #39 of 138 nationally (70th percentile) and represents a relatively strong national position for programmable pump implants, while 63685 ranks #741 of 1281 (36th percentile) and 63650 ranks #556 of 1371 (58th percentile), each described as "typical, unremarkable volume" for those codes. On the Medicaid side, 64635 is mid-ranked in-state at #18 of 35 (50th percentile), 62323 is modest at #31 of 51 (40th percentile), and 64493 is lower at #43 of 57 (23th percentile), all characterized as typical, unremarkable volume in-state.
There is a clear payment-intensity split within the procedure mix: Medicare averages for the top device procedures are high per claim ($18032 avg paid/claim for 63685 and $10321 avg paid/claim for 62362, with $3514 for 63650), while many diagnostic and injection codes pay at much lower rates (for example, 64633 $550 avg paid/claim and 64635 $561 avg paid/claim on Medicare; 64635 $87 avg paid/claim on Medicaid). This indicates revenue concentration driven by fewer, higher-paid device implantation episodes alongside a larger volume of lower-paid injection and facet procedures.
The provider’s NPI was enumerated on 2020-12-22 (~6 years ago), indicating a relatively recent enrollment window. Combined with the concentrated device-focused Medicare billing, the pattern is consistent with a specialized ambulatory surgical center that established its service mix after enrollment and now relies on a narrow set of advanced pain-interventional procedures for revenue generation.
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… | 20 | $18,030 | $270.5K |
| 62362 | The provider implants or replaces a programmable pump under the skin used for intrathecal or epidural infusion of medication. This service allows the continuous infusion of medications such as… | 20 | $10,320 | $196.1K |
| 63650 | In this procedure, the provider places electrodes in the epidural space to relieve pain and reduce or eliminate spasms. | 50 | $3,510 | $182.7K |
| 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… | 50 | $550 | $25.9K |
| 64635 | Under fluoroscopic or CT guidance, the provider applies an agent to a lower back joint to destroy nerve tissue. | 40 | $560 | $23.6K |
| 62350 | The provider implants, replaces, or repositions a previously implanted and tunneled intrathecal or epidural catheter. This procedure does not include a laminectomy. This service is done to instill… | 20 | $1,460 | $23.4K |
| 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). | 80 | $260 | $20.4K |
| G0260 | Injection procedure for sacroiliac joint; provision of anesthetic, steroid and/or other therapeutic agent, with or without arthrography | 100 | $200 | $19.7K |
| 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… | 70 | $250 | $17.9K |
| 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 | $240 | $15.6K |
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
13 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| 63685 | 9 | 30 | 10 | $7,060 | $105.9K |
| 62362 | 2 | 10 | 20 | $4,810 | $86.6K |
| 63650 | 10 | 20 | 50 | $1,720 | $86.2K |
| 62350 | 2 | 10 | 20 | $940 | $17.8K |
| G0260 | 7 | 20 | 50 | $210 | $16.8K |
| 64635 | 38 | 130 | 30 | $320 | $12.3K |
| 64483 | 41 | 170 | 40 | $160 | $9.8K |
| 64633 | 2 | 30 | 20 | $350 | $8.4K |
| 64493 | 25 | 150 | 40 | $150 | $7.9K |
| 62323 | 134 | 160 | 40 | $120 | $7.3K |
Showing 1–10 of 13
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.
9 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 64635 | Under fluoroscopic or CT guidance, the provider applies an agent to a lower back joint to destroy nerve tissue. | 150 | $90 | $12.9K |
| 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)… | 70 | $30 | $2.2K |
| 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… | 30 | $70 | $1.8K |
| 64636 | In this add on procedure, the provider destroys the facet joint nerve of a lumbar or sacral spinal segment using neurolytic agents like heat, electric current, or a chemical compound. He makes use of… | 170 | $10 | $1.7K |
| 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). | 40 | $30 | $900 |
| 64494 | In this add–on procedure, 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… | 20 | $10 | $220 |
| 99152 | The provider performing a diagnostic or therapeutic procedure administers medication to reduce consciousness, but not render the patient unconscious or asleep, in a patient five years of age or… | 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… | 20 | $0 | $0 |
| G8918 | Patient without preoperative order for iv antibiotic surgical site infection (ssi) prophylaxis | 20 | $0 | $0 |
How this provider's Medicaid billing volume and revenue compare to other Wisconsin providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Wisconsin median
9 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 64635 | Under fluoroscopic or CT guidance, the provider applies an agent to a lower back joint to destroy nerve tissue. | 18 | 40 | 150 | $250 | $108.4K |
| 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… | 43 | 60 | 80 | $130 | $60.6K |
| 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). | 43 | 60 | 140 | $130 | $51.8K |
| 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)… | 31 | 50 | 120 | $110 | $34.3K |
| 64636 | In this add on procedure, the provider destroys the facet joint nerve of a lumbar or sacral spinal segment using neurolytic agents like heat, electric current, or a chemical compound. He makes use of… | 16 | 30 | 140 | $50 | $27.3K |
| 64494 | In this add–on procedure, 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… | 41 | 50 | 80 | $50 | $23.2K |
| 99152 | The provider performing a diagnostic or therapeutic procedure administers medication to reduce consciousness, but not render the patient unconscious or asleep, in a patient five years of age or… | 71 | 80 | 190 | $10 | $5K |
| 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… | 35 | 40 | 130 | $0 | $0 |
| G8918 | Patient without preoperative order for iv antibiotic surgical site infection (ssi) prophylaxis | 17 | 20 | 220 | $0 | $0 |
Other providers in the same ZIP code as Waukesha Surgicenter, LLC, ranked by combined Medicare and Medicaid revenue.
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