Loading...
NPI 1194913574 · Baltimore, MD · Ambulatory Surgical Clinic/Center
Customize your policy alerts
Get alerted when relevant policies change without checking for updates manually.
Monitor payer policy activity
Summit Ambulatory Surgical Center, LLC is a ambulatory surgical clinic/center provider located in Baltimore, Maryland. This profile covers 35 Medicare and 1 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 | Summit Ambulatory Surgical Center, LLC |
| Address | 6535 N Charles St |
| City | Baltimore |
| State | MD |
| ZIP | 21204 |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| NPI Enumerated | October 10, 2007 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $3.5M |
| Medicaid | $30.1K |
SUMMIT AMBULATORY SURGICAL CENTER, LLC is an established ambulatory surgical clinic/center in Baltimore, MD with an NPI enumerated on 2007-10-10 (~19 years ago), indicating long-term operation in the market and likely steady referral relationships that support procedural volume. The taxonomy and code mix are consistent with a urology- and endourology-focused ASCs offering cystoscopy, ureteroscopy, prostate procedures, and implantable devices.
Medicare dominates this provider’s public-payer footprint: lifetime Medicare revenue is $3.5M compared with total Medicaid revenue of $30.1K, making the entity effectively Medicare-driven in scale. Medicaid activity is narrowly concentrated — 100.0% of Medicaid revenue comes from a single code, 52000, suggesting limited participation in state programs outside this common cystoscopy service.
Revenue concentration within Medicare is also meaningful: the precomputed top 3 Medicare codes account for 33.0% of the provider’s total Medicare revenue. High-revenue, procedure-level codes (for example C9740, 55700, and 52000 among Medicare claims) indicate reliance on a relatively small set of therapeutic and diagnostic urologic procedures to drive a third of Medicare receipts.
The provider shows several national-level volume outliers on specific Medicare codes. Codes such as 55700, 52000, 52356, 52310, 52332, and 52648 are described as “extreme outlier” or at the 100th percentile, which signals substantially higher-than-typical national volume for those services relative to peers rather than incremental or routine outpatient work. This pattern suggests a focused procedural specialization—particularly endoscopic stone and prostate procedures—rather than a broad multispecialty ambulatory center.
Specific high-revenue Medicare procedures reinforce a specialty profile: C9740 ($511.7K, 93 claims) ranks #6 nationally and is notably above typical national volume; 55700 ($316K, 500 claims) ranks #7 and is an extreme outlier; and 52000 ($305.5K, 1.5K claims) ranks #9 and is an extreme outlier. These placements, together with substantial revenue from other urologic CPTs (e.g., 52356, 52648, 64590), point to a business centered on endoscopic urologic interventions and device implantation.
Competitive standing is mixed by code: for some high-value device and complex stone or implant procedures the center ranks very high nationally (top-10 or top-percentile positions), indicating it is a major national-volume contributor for those services. For many other CPTs the provider is in typical or unremarkable percentiles (for example 64561 at the 91st percentile and several generator/implant codes in the 60–90th percentiles), indicating the center also provides routine volumes typical of regional ASCs.
Medicaid-specific activity is narrowly concentrated on 52000 (274 claims, $30.1K revenue), where the provider ranks #5 of 21 in-state at the 80th percentile — a typical in-state volume for cystoscopy under Medicaid. This reinforces that Medicaid engagement appears limited to diagnostic/standard cystoscopy services rather than the higher-cost device and complex-procedure mix seen in Medicare.
Payer mix and operational implications: the disproportionate Medicare revenue versus minimal Medicaid receipts suggests contracting and referral patterns favor Medicare beneficiaries and fee-for-service procedural billing. For analysts assessing network adequacy or capacity for urology services, the center should be considered a concentrated outpatient surgical resource for urologic endoscopy, stone procedures, and implantable devices primarily serving Medicare patients.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
35 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| C9740 | Cystourethroscopy, with insertion of transprostatic implant; 4 or more implants | 90 | $5,500 | $511.7K |
| 55700 | Code deleted December 31, 2025. | 500 | $630 | $316K |
| 52000 | In this procedure, the provider performs an examination of the interior of the bladder, the urethra, and the ureteric openings by means of a cystourethroscope, a thin flexible or rigid tube with a… | 1,480 | $210 | $305.5K |
| 64561 | The provider, under imaging guidance, implants electrodes around nerves in the sacral region to reduce the pain along the path of the nerve. | 80 | $3,810 | $289.3K |
| 64590 | The provider inserts or replaces a peripheral, sacral, or gastric neurostimulator pulse generator or receiver. The system is one that requires surgical creation of a pocket for placement and that… | 20 | $14,750 | $280.3K |
| 50081 | The provider removes one or more stones from the kidney, renal pelvis, or ureter using an antegrade (“downhill”) percutaneous approach. The provider uses imaging guidance and may place a stent and… | 70 | $3,240 | $236.8K |
| 54405 | The provider inserts inflatable synthetic material for a multicomponent, inflatable penile prosthesis into the penis of the patient. The provider also places a pump, the cylinders, and a reservoir… | 20 | $11,930 | $226.7K |
| 52356 | The provider performs a cystourethroscopy, the inspection of the interior of the bladder, the urethra, prostatic urethra, and ureteric openings using a cystoscope passed through the urethra and into… | 140 | $1,630 | $220.6K |
| 52648 | Transurethral resection of the prostate is performed in cases of BPH (benign prostate hyperplasia) which commonly occurs in middle–aged and elderly men, often causing lower urinary symptoms, with… | 90 | $1,710 | $155.3K |
| 52310 | The provider performs a simple cystourethroscopy, the inspection of the interior of the bladder, the urethra, prostatic urethra, and ureteric openings using a cystoscope passed through the urethra… | 230 | $640 | $145.3K |
Showing 1–10 of 35
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 35 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
35 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| C9740 | 2 | 20 | 30 | $5,500 | $225.7K |
| 64590 | 10 | 20 | 20 | $7,550 | $151.1K |
| 54405 | 3 | 10 | 20 | $7,010 | $126.2K |
| 64561 | 3 | 30 | 40 | $2,550 | $104.4K |
| 50081 | 4 | 10 | 40 | $1,410 | $77.4K |
| J0585 | 5 | 80 | 8,130 | $1 | $49K |
| 50590 | 20 | 30 | 30 | $800 | $32.2K |
| 52648 | 1 | 40 | 20 | $1,160 | $31.4K |
| 52601 | 5 | 40 | 20 | $1,260 | $29.1K |
| 52000 | 3 | 200 | 120 | $140 | $25.8K |
Showing 1–10 of 35
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.
1 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 52000 | In this procedure, the provider performs an examination of the interior of the bladder, the urethra, and the ureteric openings by means of a cystourethroscope, a thin flexible or rigid tube with a… | 270 | $110 | $30.1K |
How this provider's Medicaid billing volume and revenue compare to other Maryland providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Maryland median
1 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 52000 | In this procedure, the provider performs an examination of the interior of the bladder, the urethra, and the ureteric openings by means of a cystourethroscope, a thin flexible or rigid tube with a… | 5 | 20 | 60 | $50 | $23.4K |
Other providers in the same ZIP code as Summit Ambulatory Surgical Center, LLC, ranked by combined Medicare and Medicaid revenue.
Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.