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

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

Proliance Surgeons, Inc., P.s. (NPI 1194727883)

Field	Value
Entity Type	Organization
Organization	Proliance Surgeons, Inc., P.s.
Address	7308 Bridgeport Way W Ste 102
City	Lakewood
State	WA
ZIP	98499
Taxonomy	Ambulatory Surgical Clinic/Center
NPI Enumerated	August 11, 2005

Payer Source	Total Paid
Medicare	$1.7M
Medicaid	$0

Key Findings

This provider is effectively a single-payer Medicare operator: lifetime Medicare revenue is $1.7M and there is no Medicaid billing on file, so the practice’s public-pay scale and risk exposure are concentrated entirely in Medicare. The absence of any Medicaid claims suggests limited engagement with state programs or a patient mix that does not depend on Medicaid reimbursement.

Revenue concentration is high: the precomputed top 3 Medicare codes (27447, 27130, 63685) account for 55.6% of the provider’s total Medicare revenue. Those three codes alone generate $406K (27447), $308.3K (27130), and $229.1K (63685), indicating a business profile driven by large, high-revenue surgical episodes.

The code mix and values point to an orthopedic- and spine-focused ambulatory surgical center model: primary revenue drivers are joint arthroplasties (27447 knee arthroplasty and 27130 hip arthroplasty) and an implantable spinal device (63685 spinal neurostimulator pulse generator). Supplementary procedure volume in shoulder arthroscopy (29827), carpal tunnel/endoscopic median nerve procedures (29848, 64721), and foot procedures (28285, 28750) shows a broad musculoskeletal surgical practice consistent with the Ambulatory Surgical Clinic/Center taxonomy.

Competitive standing on the top arthroplasty codes is modest nationally: 27447 ranks #3172 of 12089 providers (73rd percentile) and 27130 ranks #2291 of 8062 providers (70th percentile), both described as typical, unremarkable volume for those codes. The spinal neurostimulator code 63685 is listed with rank #1135 of 1281 providers and a 0th percentile label but characterized in the source as typical/unremarkable, which together indicate the provider participates in these high-revenue procedures without being a dominant national outlier.

Several outpatient specialty procedures show above-typical national volume, signaling focused surgical strengths in certain niches: 29827 (rotator cuff repair) ranks #112 of 3445 providers (97th percentile; notably above typical), 29848 (endoscopic carpal tunnel) ranks #56 of 1333 (96th percentile; notably above typical), 26055 (trigger finger release) ranks #118 of 2946 (96th percentile; notably above typical), and 28285 (hammertoe repair) ranks #24 of 955 (98th percentile; notably above typical). These high-percentile listings suggest the center draws steady elective outpatient orthopedics caseloads in hand, foot, and shoulder procedures.

The provider performs a mix of a few high-value, low-volume implant procedures alongside many mid/low-value, higher-volume outpatient procedures: for example, 63685 carries a high avg paid/claim of $20825 across 11 claims generating $229.1K, while 27447 and 27130 have avg paid/claim near $7807–$7904 with 52 and 39 claims respectively. Conversely, C9290 appears as a very high-count, low-dollar item (10.1K claims at $1 avg paid/claim for $10.1K revenue), indicating routine supply/drug-level billing that contributes little to total revenue despite volume.

Tenure is long-standing: the NPI was enumerated on 2005-08-11 (~21 years ago), indicating the provider has been in the Medicare billing environment for two decades, which supports interpretation of the observed specialty mix as an established operational pattern rather than a short-term anomaly.

The lack of any Medicaid billing creates both strategic limits and clarity for payers and partners: with $1.7M in Medicare revenue and no Medicaid on file, the provider has limited payer diversification and may have constrained exposure to state program payment dynamics, which is important context for contracting, network adequacy assessments, or care-access planning where Medicaid participation is relevant.

Medicare: Complete Services Breakdown

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

27 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…	50	$7,810	$406K
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…	40	$7,900	$308.3K
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	$20,830	$229.1K
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	$2,020	$123.1K
63047	The provider performs a laminectomy (excision of the thin bony plate at the back of a vertebra), facetectomy (excision of an area of a vertebra characterized by its smooth surface), and foraminotomy…	30	$2,560	$76.7K
29848	The provider inserts an endoscope into the wrist joint to divide the transverse carpal ligament and reduce compression on the median nerve in the carpal tunnel that results in pain and numbness.	120	$570	$65.8K
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…	110	$490	$52.7K
28285	The provider repairs a hammertoe deformity, a painful condition in which the toe remains permanently bent in a downward position.	90	$610	$51.9K
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	$2,400	$45.6K
28750	In this procedure, the provider surgically immobilizes the metatarsophalangeal joint of the great toe. A metatarsophalangeal joint is a joint between the first metatarsal of the foot and the first…	10	$3,810	$41.9K

Showing 1–10 of 27

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 27 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Washington Distribution

Proliance Surgeons, Inc., P.s. — 3 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Washington

Full comparison — all codes billed, vs. state median

27 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
63685	31	30	20	$8,250	$148.4K
27447	72	320	30	$1,190	$46.3K
27130	75	230	30	$1,060	$37.1K
28750	8	10	20	$2,020	$36.3K
29828	7	30	20	$1,240	$28.4K
29827	5	90	20	$1,130	$26.1K
23430	18	30	20	$920	$20.2K
29881	6	30	20	$950	$20K
64483	32	160	50	$200	$19.7K
64721	54	70	30	$450	$19.7K

Showing 1–10 of 27

Related Providers

Other providers that share a Tax Identification Number (TIN) with Proliance Surgeons, Inc., P.s., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Proliance Surgeons Inc P S	WA	Ambulatory Surgical Clinic/Center	$2.4M	$680
Proliance Surgeons Inc Ps	WA	Ambulatory Surgical Clinic/Center	$1.4M	$0
Proliance Surgeons, Inc., P.s.	WA	Ambulatory Surgical Clinic/Center	$1.3M	$0
Proliance Surgeons, Inc., P.s.	WA	Ambulatory Surgical Clinic/Center	$1.1M	$24.2K
The Retina Surgery Center LLC	WA	Ambulatory Surgical Clinic/Center	$1.1M	$0
Proliance Surgeons Inc P S	WA	Ambulatory Surgical Clinic/Center	$830.4K	$0
Proliance Surgeons Inc P S	WA	Ambulatory Surgical Clinic/Center	$793.8K	$0
Proliance Surgeons Inc P S	WA	Ambulatory Surgical Clinic/Center	$617.8K	$0
Stacia Smith	WA	Orthopaedic Surgery Physician	$324.7K	$0
Timothy Alton	WA	Orthopaedic Surgery Physician	$313.4K	$0

Nearby Providers

Other providers in the same ZIP code as Proliance Surgeons, Inc., P.s., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Greater Lakes Mental Health Foundation Inc	WA	Mental Illness Community Based Residential Treatment Facility	$0	$56M
Rainier Internal Medicine LLC	WA	Primary Care Clinic/Center	$164.9K	$35.1M
Saint Clare Hospital	WA	General Acute Care Hospital	$0	$30M
Pediatric Services Of America, LLC	WA	Nursing Care Agency	$0	$22.4M
Capstone Medical LLC	WA	Durable Medical Equipment & Medical Supplies	$0	$20.7M
Chen And Su, Ps	WA	Orthodontics and Dentofacial Orthopedics Dentistry	$0	$6.3M
Wchs Inc	WA	Methadone Clinic	$171.3K	$6M
Total Renal Care Inc	WA	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$4.6M
Thi Nguyen	WA	General Practice Dentistry	$0	$3.7M
Asian American Chemical Dependency Treatment Services	WA	Community/Behavioral Health Agency	$0	$3.5M

Proliance Surgeons, Inc., P.s. — Billing Profile & Reimbursement Data

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Proliance Surgeons, Inc., P.s. — 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

Related Providers

Nearby Providers

Frequently Asked Questions

References