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NPI 1205845740 · Cincinnati, OH · Ambulatory Surgical Clinic/Center
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The Urology Center LLC is a ambulatory surgical clinic/center provider located in Cincinnati, Ohio. This profile covers 39 Medicare and 9 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 | The Urology Center LLC |
| Address | 2000 Joseph E Sanker Blvd |
| City | Cincinnati |
| State | OH |
| ZIP | 45212 |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| NPI Enumerated | August 5, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $4.3M |
| Medicaid | $808.9K |
THE UROLOGY CENTER LLC presents a procedure-heavy ambulatory surgical clinic profile dominated by endoscopic urology and implantable-device work: Medicare top procedures include cystourethroscopy/ureteroscopy codes (52000, 52332, 52356) and implant codes (64590, 54405), while Medicaid billing is concentrated in cystourethroscopy (52000) and ESWL (50590). The presence of high‑avg‑paid implant procedures such as 64590 ($14601 avg paid/claim) and 54405 ($12462 avg paid/claim) indicates the practice performs higher-intensity, device-based surgeries in addition to high-volume diagnostic and stone procedures.
Revenue concentration differs materially by payer: for Medicare the precomputed top‑3 codes account for 31.9% of total Medicare revenue, while for Medicaid the top‑3 codes account for 85.5% of total Medicaid revenue. This indicates a more diversified Medicare code mix and a heavily concentrated Medicaid profile driven largely by a single service line.
Medicare scale is larger than Medicaid for this provider: Total Medicare revenue is $4.3M compared with Total Medicaid revenue of $808.9K, making Medicare the dominant source of reported public-payer revenue. Both payers are on file, so the provider is not single‑payer, but Medicare represents the primary revenue base in absolute terms.
The provider occupies nationally top-tier positions on several CPTs: C9740 accounts for 14.9% of the provider's Medicare revenue and ranks #3 of 162 nationally (99th percentile; extreme outlier), 55700 accounts for 8.6% and ranks #4 of 4425 (100th percentile; extreme outlier), and 52332 accounts for 6.1% and ranks #1 of 3938 (100th percentile; extreme outlier). These rank/percentile labels indicate THE UROLOGY CENTER LLC is a high-volume, highly ranked national outlier for multiple cystoscopy- and implant-related services rather than a modest participant.
Medicaid competitive standing is concentrated and state-leading for key services: 52000 represents $468.7K and 58.0% of this provider's total Medicaid revenue and ranks #2 of 50 in-state (98th percentile; extreme outlier), while 50590 contributes $151.6K and 18.8% and ranks #1 of 3 in-state (100th percentile; typical, unremarkable volume). These positions show the provider is a dominant statewide source of Medicaid billing for cystourethroscopy and a principal ESWL provider in-state.
High-volume, lower-intensity cystoscopy work is a major operational driver: Medicare shows 52000 with 1.4K claims and $273.4K revenue (6.8% of Medicare revenue) and Medicaid shows 52000 with 1.7K claims and $468.7K revenue (58.0% of Medicaid revenue). The combination of thousands of cystoscopy claims across both payers signals a steady throughput of diagnostic and stone-management cases forming the backbone of the ambulatory surgical center.
Device and implant procedures are significant revenue contributors and raise operational complexity: codes with large per-claim payments such as 64590 ($14601 avg paid/claim, $335.8K Medicare revenue) and 54405 ($12462 avg paid/claim, $299.1K Medicare revenue) indicate the facility staffs for surgical implants and postoperative device management in addition to endoscopy and lithotripsy. Reliance on these higher-cost, lower‑frequency procedures means reimbursement for implants materially influences Medicare revenue composition.
The practice has long tenure in the NPI registry, which supports an established ambulatory presence: NPI enumerated (registered) on 2006-08-05 (~20 years ago). Note also that 55700 is listed as Code deleted December 31, 2025, which could require operational coding adjustments or alternative CPT utilization for services historically billed under that code.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
39 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| C9740 | Cystourethroscopy, with insertion of transprostatic implant; 4 or more implants | 110 | $5,420 | $601.1K |
| 55700 | Code deleted December 31, 2025. | 550 | $630 | $344.3K |
| 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 | $14,600 | $335.8K |
| 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… | 180 | $1,640 | $302.5K |
| 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 | $12,460 | $299.1K |
| 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… | 1,370 | $200 | $273.4K |
| 52332 | The provider performs 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… | 270 | $930 | $246.1K |
| 50590 | Extracorporeal shock wave lithotripsy (ESWL) is a procedure used to destroy calculus (kidney stones) in the kidneys and ureters. | 150 | $1,050 | $160.8K |
| 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… | 260 | $610 | $158.5K |
| 64561 | The provider, under imaging guidance, implants electrodes around nerves in the sacral region to reduce the pain along the path of the nerve. | 40 | $3,770 | $147K |
Showing 1–10 of 39
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 39 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
39 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| C9740 | 1 | 10 | 80 | $5,440 | $424.4K |
| 64581 | 1 | 10 | 20 | $4,020 | $88.5K |
| 54405 | 1 | 10 | 20 | $4,170 | $66.7K |
| J0585 | 14 | 100 | 7,600 | $1 | $52.1K |
| 64590 | 2 | 10 | 20 | $3,020 | $51.4K |
| C2638 | 1 | 10 | 1,620 | $30 | $48.3K |
| C9761 | 1 | 10 | 10 | $3,130 | $37.5K |
| 52354 | 1 | 10 | 20 | $1,660 | $34.9K |
| 64561 | 2 | 20 | 20 | $1,400 | $32.1K |
| 52353 | 1 | 10 | 10 | $1,350 | $27.1K |
Showing 1–10 of 39
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.
9 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… | 1,690 | $280 | $468.7K |
| 50590 | Extracorporeal shock wave lithotripsy (ESWL) is a procedure used to destroy calculus (kidney stones) in the kidneys and ureters. | 190 | $800 | $151.6K |
| 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… | 210 | $340 | $71K |
| 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… | 50 | $1,070 | $54.4K |
| 55700 | Code deleted December 31, 2025. | 130 | $330 | $42K |
| 52332 | The provider performs 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… | 90 | $230 | $20.7K |
| G8907 | Patient documented not to have experienced any of the following events: a burn prior to discharge; a fall within the facility; wrong site/side/patient/procedure/implant event; or a hospital transfer… | 330 | $0 | $0 |
| G8915 | Patient documented not to have experienced a hospital transfer or hospital admission upon discharge from asc | 150 | $0 | $0 |
| G8918 | Patient without preoperative order for iv antibiotic surgical site infection (ssi) prophylaxis | 140 | $0 | $0 |
How this provider's Medicaid billing volume and revenue compare to other Ohio providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Ohio median
9 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… | 2 | 50 | 90 | $360 | $91.9K |
| 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… | 2 | 10 | 30 | $580 | $86K |
| 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… | 4 | 10 | 40 | $1,810 | $83.1K |
| 55700 | Code deleted December 31, 2025. | 2 | 10 | 130 | $580 | $83.1K |
| 50590 | Extracorporeal shock wave lithotripsy (ESWL) is a procedure used to destroy calculus (kidney stones) in the kidneys and ureters. | 1 | 10 | 20 | $990 | $75.3K |
| 52332 | The provider performs 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… | 1 | 10 | 30 | $290 | $12.7K |
| G8915 | Patient documented not to have experienced a hospital transfer or hospital admission upon discharge from asc | 2 | 10 | 200 | $30 | $5.5K |
| G8918 | Patient without preoperative order for iv antibiotic surgical site infection (ssi) prophylaxis | 11 | 40 | 40 | $1 | $100 |
| G8907 | Patient documented not to have experienced any of the following events: a burn prior to discharge; a fall within the facility; wrong site/side/patient/procedure/implant event; or a hospital transfer… | 11 | 50 | 90 | $1 | $60 |
Other providers in the same ZIP code as The Urology Center LLC, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Dialysis Access Center Of Cincinnati, Inc. | OH | Ambulatory Surgical Clinic/Center | $1M | $2.6M |
| Fresenius Vascular Care Cincinnati Asc LLC | OH | Ambulatory Surgical Clinic/Center | $533.5K | $1.1M |
| Norwood Endoscopy Center, LLC | OH | Ambulatory Surgical Clinic/Center | $715.2K | $455.2K |
| Michelle Bowman | OH | Neurology Physician | $794.1K | $0 |
| Baber Khan | OH | Neurology Physician | $727.8K | $0 |
| Michael Schmerler | OH | Neurology Physician | $460.5K | $0 |
| Cynthia Westermann | OH | Anatomic Pathology & Clinical Pathology Physician | $432.2K | $0 |
| Eli Cianciolo | OH | Pain Medicine (Anesthesiology) Physician | $338.7K | $0 |
| Stephen Bennett | OH | Urology Physician | $323K | $0 |
| Shon Michael | OH | Neurology Physician | $300.3K | $0 |
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