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NPI 1194790592 · Erie, PA · Ambulatory Surgical Clinic/Center
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Upmc Hamot Surgery Center, LLC is a ambulatory surgical clinic/center provider located in Erie, Pennsylvania. This profile covers 26 Medicare and 13 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 | Upmc Hamot Surgery Center, LLC |
| Address | 200 State St |
| City | Erie |
| State | PA |
| ZIP | 16507 |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| NPI Enumerated | February 20, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $871.5K |
| Medicaid | $719.9K |
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
26 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… | 440 | $360 | $155.7K |
| 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… | 240 | $410 | $97.5K |
| G0105 | Colorectal cancer screening; colonoscopy on individual at high risk | 240 | $370 | $87.9K |
| 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. | 360 | $220 | $79.5K |
| 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… | 250 | $230 | $57.8K |
| 43248 | The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum; then through the scope, he passes a guidewire over which he passes dilators through the… | 190 | $260 | $49.3K |
| 64635 | Under fluoroscopic or CT guidance, the provider applies an agent to a lower back joint to destroy nerve tissue. | 90 | $450 | $42.3K |
| 66984 | The provider inserts an artificial lens after removing an extracapsular cataract by aspiration or use of ultrasonic waves. This procedure is done without the use of an endoscopic laser probe to… | 50 | $680 | $31.2K |
| G0121 | Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk | 80 | $370 | $30.3K |
| 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 | $550 | $29.8K |
Showing 1–10 of 26
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 26 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
26 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| 66984 | 428 | 670 | 80 | $530 | $97.8K |
| 45385 | 47 | 860 | 50 | $290 | $24.3K |
| 66982 | 83 | 200 | 30 | $640 | $23.2K |
| 15823 | 34 | 70 | 30 | $520 | $20.7K |
| 64483 | 107 | 340 | 60 | $190 | $18.6K |
| G0260 | 30 | 40 | 60 | $210 | $18.4K |
| 64721 | 40 | 160 | 30 | $420 | $17.1K |
| 64635 | 23 | 230 | 30 | $360 | $16.1K |
| 62323 | 140 | 360 | 60 | $140 | $14.2K |
| 45380 | 8 | 840 | 40 | $180 | $12.5K |
Showing 1–10 of 26
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.
13 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 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. | 1,120 | $150 | $172.3K |
| 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… | 500 | $250 | $123.5K |
| 43248 | The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum; then through the scope, he passes a guidewire over which he passes dilators through the… | 200 | $590 | $114.7K |
| 45378 | The provider examines the colon and rectum using a colonoscope, a flexible tube with a camera at its inserted end. If he sees any areas of abnormal mucosa or tissue, he takes samples using a brush… | 250 | $420 | $102.6K |
| 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)… | 120 | $650 | $79.4K |
| 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… | 160 | $410 | $65.5K |
| 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… | 100 | $350 | $35.6K |
| 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). | 30 | $560 | $17.3K |
| 62321 | 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 cervical (neck) or thoracic (upper and middle back)… | 10 | $460 | $5.5K |
| 69436 | This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia. | 20 | $220 | $4.5K |
Showing 1–10 of 13
How this provider's Medicaid billing volume and revenue compare to other Pennsylvania providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Pennsylvania median
13 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 69436 | This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia. | 39 | 50 | 70 | $620 | $190.6K |
| L8699 | Prosthetic implant, not otherwise specified | 2 | 10 | 240 | $690 | $167K |
| 45378 | The provider examines the colon and rectum using a colonoscope, a flexible tube with a camera at its inserted end. If he sees any areas of abnormal mucosa or tissue, he takes samples using a brush… | 13 | 60 | 40 | $640 | $98K |
| 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. | 22 | 290 | 90 | $290 | $85.6K |
| 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… | 27 | 80 | 40 | $580 | $76.9K |
| 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… | 9 | 120 | 60 | $440 | $67.2K |
| 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)… | 37 | 70 | 120 | $240 | $61.7K |
| 43248 | The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum; then through the scope, he passes a guidewire over which he passes dilators through the… | 2 | 10 | 40 | $470 | $46K |
| 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). | 35 | 60 | 50 | $270 | $36.9K |
| 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… | 11 | 40 | 60 | $150 | $20.6K |
Showing 1–10 of 13
Other providers in the same ZIP code as Upmc Hamot Surgery Center, LLC, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Gaudenzia Inc | PA | Community/Behavioral Health Agency | $0 | $40M |
| Dr Gertrude A Barber Center Inc | PA | Clinic/Center | $0 | $18.7M |
| Robert Baldwin | PA | Ophthalmology Physician | $2.3M | $145.9K |
| Laboratory Associates Of Erie LLC | PA | Clinical Medical Laboratory | $60.1K | $2.2M |
| Ryan Constantine | PA | Retina Specialist (Ophthalmology) Physician | $2M | $0 |
| David Almeida | PA | Ophthalmology Physician | $1.3M | $520.5K |
| Douglas Babel | PA | Ophthalmology Physician | $742.6K | $63.8K |
| Edward Zimm | PA | Ophthalmology Physician | $422.7K | $380 |
| Ellen Dailey | PA | Obstetrics & Gynecology Physician | $72.4K | $276.7K |
| Paul Demjanenko | PA | Cardiovascular Disease Physician | $165.6K | $116.6K |
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