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

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

Bluegrass Orthopaedics Surgical Division LLC (NPI 1164460812)

Key Findings

Field	Value
Entity Type	Organization
Organization	Bluegrass Orthopaedics Surgical Division LLC
Address	3475 Blazer Pkwy Ste 130
City	Lexington
State	KY
ZIP	40509
Taxonomy	Ambulatory Surgical Clinic/Center
NPI Enumerated	June 3, 2006

Payer Source	Total Paid
Medicare	$3.2M
Medicaid	$0

BLUEGRASS ORTHOPAEDICS SURGICAL DIVISION LLC is effectively a Medicare-focused ambulatory surgical practice: lifetime Medicare revenue is $3.2M while there is no Medicaid billing on file, indicating a de facto single-payer footprint in the available claims data. The provider’s NPI was enumerated on 2006-06-03 (~20 years ago), so this is an established practice with a long operational tenure.

Revenue is highly concentrated in a few high-value joint-replacement codes: the precomputed top 3 Medicare codes account for 93.7% of the provider’s total Medicare revenue, signaling that a small set of procedures drives the business. In particular, 27447 (299 claims, $6806 avg paid/claim, $2M revenue; 63.8% of Medicare revenue) and 27130 (100 claims, $6974 avg paid/claim, $697.4K revenue; 21.9% of Medicare revenue) are the dominant revenue streams.

The clinical mix strongly aligns with a high-volume orthopaedic joint-replacement and outpatient surgery model: the top codes are 27447 and 27130 (total knee and total hip arthroplasty codes) plus 27446 (knee reconstruction), which together form the overwhelming majority of billed Medicare revenue. Secondary procedure lines—arthroscopic shoulder repairs (29827, 29828), meniscectomies (29881, 29880), and carpal tunnel release (64721)—appear as much smaller revenue contributors, consistent with an ASC-style practice that focuses on major joint arthroplasty plus ancillary outpatient orthopaedic procedures.

27447 is a national outlier for this provider: it generates $2M in Medicare revenue (63.8% of the provider’s Medicare total) and ranks #27 of 12089 providers nationally (100th percentile; extreme outlier), which positions this entity as an unusually large national-volume performer for that specific procedure. 27130 also shows elevated volume relative to peers (100 claims, $6974 avg paid/claim, $697.4K revenue; ranks #214 of 8062 nationally, 97th percentile; notably above typical national volume), indicating that the practice is a major producer of both knee and hip replacement procedures compared with national peers.

By contrast, several common arthroscopy and minor procedure lines register modest contributions and typical peer standing: 27446 (38 claims, $6648 avg paid/claim, $252.6K revenue) ranks #61 of 450 providers (86th percentile; typical, unremarkable volume), and shoulder arthroscopy 29827 (40 claims, $1790 avg paid/claim, $71.6K revenue) ranks #316 of 3445 (90th percentile; typical, unremarkable volume). These volumes imply the center performs a mix of ancillary orthopaedic surgeries but does not dominate those sub-specialty markets to the same degree as it does for total knee arthroplasty.

The payer mix picture is effectively single-payer Medicare in available data: with $3.2M in Medicare receipts and no Medicaid billing on file, analysts should treat competitive and utilization comparisons against Medicare peers rather than Medicaid or mixed-payer benchmarks. The absence of Medicaid claims also suggests limited reliance on state program volumes or that Medicaid cases, if any, are routed elsewhere in the system.

Service intensity and reimbursement per case are consistent with major joint replacement economics: average paid per claim for the two largest codes is $6806 for 27447 and $6974 for 27130, reflecting high-payment, resource-intensive procedures as the backbone of this provider’s revenue. Lower-paid procedures such as carpal tunnel release (64721, $611 avg paid/claim) and meniscectomy (29881, $1011 avg paid/claim) together comprise only a small fraction of revenue, reinforcing the business dependence on a few large arthroplasty codes.

Despite being an established provider (~20 years since NPI enumeration), the practice’s competitive standing is mixed by code: it is an extreme national outlier and clear leader for 27447, markedly above peers for 27130, and otherwise a typical participant for many arthroscopy and hand-procedure codes. For payer/provider analysts, this pattern signals a specialist ambulatory surgical center with concentrated market strength in total knee and hip arthroplasty and routine participation (but not dominance) in ancillary orthopaedic procedures.

Medicare: Complete Services Breakdown

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

10 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…	300	$6,810	$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…	100	$6,970	$697.4K
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…	40	$6,650	$252.6K
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…	40	$1,790	$71.6K
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…	20	$2,320	$53.4K
64721	Neuroplasty or transposition of the median nerve at the carpal tunnel is done to treat a condition called carpal tunnel syndrome (CTS). The carpal tunnel is a narrow tunnel in the wrist through which…	50	$610	$27.5K
29881	The provider examines the inside of the knee joint with an arthroscope. She repairs the joint by removing the meniscus, a crescent shaped cartilage cushion, from either the medial or lateral…	30	$1,010	$26.3K
29880	In this procedure, the provider performs arthroscopic examination of the knee joint. She removes the damaged and torn meniscus from the medial and lateral compartments of the knee joint along with…	10	$1,050	$12.6K
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…	30	$370	$10.8K
76000	In this procedure, the provider uses fluoroscopy for up to one hour as an imaging technique to obtain real time images of internal structures.	10	$20	$250

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Saint Joseph Health System, Inc	KY	General Acute Care Hospital	$0	$67.4M
Scott-wilson, Inc.	KY	Home Infusion Therapy Pharmacy	$0	$24.5M
Labtox, LLC	KY	Clinical Medical Laboratory	$43.5K	$21.8M
Phi Health, LLC	KY	Air Ambulance	$2M	$13.2M
Retina And Vitreous Associates Of Kentucky PLLC	KY	Retina Specialist (Ophthalmology) Physician	$0	$13.3M
Key Assets Kentucky, Inc.	KY	Community/Behavioral Health Agency	$0	$10.8M
Grace Place Adult Day Center LLC	KY	Adult Day Care Clinic/Center	$0	$9.7M
Uhs Of Ridge LLC	KY	Psychiatric Hospital	$0	$9.1M
United Seating And Mobility LLC	KY	Durable Medical Equipment & Medical Supplies	$0	$8.6M
Ridge Outpatient Counseling, LLC	KY	Psychiatric Hospital Unit	$0	$5.2M

Bluegrass Orthopaedics Surgical Division LLC — Billing Profile & Reimbursement Data

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Bluegrass Orthopaedics Surgical Division LLC — Billing Profile & Reimbursement Data

Sign up for Bluegrass Orthopaedics Surgical Division LLC — Billing Profile & Reimbursement Data policy alerts

Key Findings

Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
27446	2	10	20	$2,080	$56.1K
27447	1	160	30	$1,090	$45.7K
27130	3	90	20	$1,090	$32.6K
29827	3	40	20	$760	$15.1K
64721	10	40	20	$360	$11.8K
29828	3	10	20	$640	$10.3K
29881	1	10	20	$490	$8.3K
26055	13	30	30	$250	$8.1K
29880	4	10	10	$450	$7.2K
76000	21	20	20	$10	$360