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

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

Orthopaedic Specialty Surgery Center LLC (NPI 1174708390)

Field	Value
Entity Type	Organization
Organization	Orthopaedic Specialty Surgery Center LLC
Address	40 Old Ridgebury Rd Ste 201
City	Danbury
State	CT
ZIP	06810
Taxonomy	Ambulatory Surgical Clinic/Center
NPI Enumerated	January 7, 2008

Payer Source	Total Paid
Medicare	$1.9M
Medicaid	$0

Key Findings

ORTHOPAEDIC SPECIALTY SURGERY CENTER LLC bills to Medicare as an Ambulatory Surgical Clinic/Center and its Medicare mix is dominated by major joint procedures, consistent with an orthopedic surgery-focused ASC. The provider reports Total Medicare revenue of $1.9M and the top billings are for joint replacement and arthroscopic repair codes, indicating the operation primarily delivers surgical care rather than broad outpatient medical services.

Revenue is highly concentrated in a small set of procedures: the precomputed top 3 Medicare codes by revenue account for 88.0% of this provider's total Medicare revenue. In particular, code 27447 alone represents $1M (55.4% of Medicare revenue) and code 27130 contributes $526.6K (28.0% of Medicare revenue), leaving only a small share to other services.

This entity is effectively single‑payer in scope for the data available: Total Medicare revenue is $1.9M while there is no Medicaid billing on file. The absence of Medicaid billing means the provider’s near-term revenue profile, as observed here, will be particularly sensitive to Medicare reimbursement trends and referral patterns.

On the national competitive scale for knee replacement, the provider is a high-volume outlier: 27447 shows 134 claims, $7768 avg paid/claim and $1M revenue, and it ranks #378 of 12089 providers nationally (97th percentile; notably above typical national volume for this code). That rank and dollar volume position the center as a significant producer of knee arthroplasty relative to peers.

Hip replacement activity is solid but not extreme: 27130 shows 65 claims, $8102 avg paid/claim and $526.6K revenue and ranks #839 of 8062 providers nationally (89th percentile; typical, unremarkable volume). This suggests meaningful hip arthroplasty throughput, but hip volume is less dominant versus national leaders than the center’s knee volume.

The provider also bills a mix of arthroscopic and injection procedures that supplement its joint-replacement business, including 29827 (35 claims, $2463 avg paid/claim, $86.2K revenue; ranks #438 of 3445, 87th percentile) and 29881 (44 claims, $1205 avg paid/claim, $53K revenue; ranks #46 of 1125, 96th percentile; notably above typical national volume). Pain‑management and facet procedures such as 64635 and 64493 appear as ancillary services, reflecting integrated perioperative or nonoperative spine and joint care.

Several codes show much lower relative volumes versus peers, indicating narrower service lines beyond the core joint work: for example, 64721 (carpal tunnel) ranks in the 10th percentile and 29848 (endoscopic wrist) ranks in the 1st percentile nationally, and both contribute only small shares of Medicare revenue. These low-percentile codes underscore that the center’s breadth of hand/wrist or minor procedures is limited compared with larger multispecialty centers.

The provider’s NPI was enumerated on 2008-01-07 (~18 years ago), indicating an established operation in Danbury, CT. Combined with the concentrated revenue mix—dominated by a few high-dollar joint replacement codes—this tenure suggests a stable, specialty-focused ASC that depends heavily on orthopedic surgical volume and referral streams.

Medicare: Complete Services Breakdown

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

16 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…	130	$7,770	$1M
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…	70	$8,100	$526.6K
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	$2,460	$86.2K
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…	40	$1,210	$53K
64635	Under fluoroscopic or CT guidance, the provider applies an agent to a lower back joint to destroy nerve tissue.	50	$560	$25.7K
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…	20	$1,210	$24.1K
C9290	Injection, bupivacaine liposome, 1 mg	19,950	$1	$20K
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…	60	$290	$16.6K
29824	The provider examines the tissue inside the shoulder joint with an arthroscope and inserts additional instruments to remove a portion of the clavicle, or collarbone. An arthroscopic Mumford procedure…	10	$1,110	$14.5K
29823	The provider examines the tissue inside the shoulder joint with an arthroscope. He inserts additional instruments and excises extensive damaged tissues in the shoulder joint caused by trauma to the…	20	$660	$13.8K

Showing 1–10 of 16

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 16 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Connecticut Distribution

Orthopaedic Specialty Surgery Center LLC — 2 of 16 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Connecticut

Full comparison — all codes billed, vs. state median

16 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
27447	1	160	20	$1,320	$39.6K
27130	5	100	20	$1,200	$34.9K
29827	5	30	20	$1,350	$29.7K
29881	1	10	20	$1,100	$22K
29880	4	10	20	$1,010	$21.2K
64635	12	40	30	$470	$18.5K
64721	34	40	30	$490	$16.2K
29848	32	30	20	$480	$14K
64493	22	60	50	$200	$13.3K
62323	63	90	40	$190	$12.3K

Showing 1–10 of 16

Nearby Providers

Other providers in the same ZIP code as Orthopaedic Specialty Surgery Center LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Danbury Hospital	CT	General Acute Care Hospital	$0	$123.8M
Family And Children's Aid, Inc.	CT	Adolescent and Children Mental Health Clinic/Center	$0	$64M
Midwestern Connecticut Council On Alcoholism, Inc	CT	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$39.9M
Connecticut Institute For Communities Inc	CT	Federally Qualified Health Center (FQHC)	$0	$32.8M
Nuvance Health Medical Practice Ct, Inc.	CT	Internal Medicine Physician	$0	$20.2M
Connecticut Institute For Communities Inc	CT	Federally Qualified Health Center (FQHC)	$0	$14.9M
Connecticut Counseling Centers, Inc.	CT	Methadone Clinic	$243.5K	$12.1M
Center For Pediatric Medicine	CT	Pediatrics Physician	$0	$9.4M
Optimum Medical LLC	CT	Pediatrics Physician	$0	$8.9M
Kids Dental Specialists LLC	CT	Pediatric Dentistry	$0	$7.8M

Orthopaedic Specialty Surgery Center LLC — Billing Profile & Reimbursement Data

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Orthopaedic Specialty Surgery Center LLC — Billing Profile & Reimbursement Data

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Key Findings

Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References