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NPI 1235240813 · Tupelo, MS · Ambulatory Surgical Clinic/Center
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North Mississippi Ambulatory Surgery Center LLC is a ambulatory surgical clinic/center provider located in Tupelo, Mississippi. This profile covers 30 Medicare and 12 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 | North Mississippi Ambulatory Surgery Center LLC |
| Address | 589 Garfield St |
| City | Tupelo |
| State | MS |
| ZIP | 38801 |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| NPI Enumerated | August 31, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $7.1M |
| Medicare | $1.5M |
This facility is effectively Medicaid-dominant by scale: Total Medicaid revenue is $7.1M versus Total Medicare revenue of $1.5M, so Medicaid is the primary payer by dollar volume for this ambulatory surgical center. That payer mix indicates the center’s overall business footprint is driven more by pediatric and state-covered cases than by Medicare beneficiaries.
Top-line revenue concentration differs sharply by payer: the precomputed top 3 Medicare codes by revenue account for 53.0% of this provider's total Medicare revenue, while the precomputed top 3 Medicaid codes by revenue account for 94.5% of this provider's total Medicaid revenue. For Medicare the highest contributors are 66984 (26.3% of Medicare revenue), 27447 (16.0%), and J1097 (10.7%), signaling concentration in ophthalmology and major joint procedures. For Medicaid the revenue is heavily concentrated in pediatric ENT procedures: 42820 (56.6%), 69436 (31.1%), and 42830 (6.8%).
Medicaid procedural mix points to a high-volume pediatric ENT focus: large Medicaid claims counts and dollar volumes for 42820 (2.6K claims, $4M revenue) and 69436 (6.2K claims, $2.2M revenue) indicate routine tonsil/adenoid and tympanostomy workflows. Both 42820 and 69436 rank #2 in-state (97th and 98th percentiles respectively), a comparator signal that this center is a major in-state provider for these pediatric ENT services.
Medicare case mix indicates a blended ambulatory specialty operation: the single largest Medicare line is cataract surgery 66984 (535 claims, $391.1K revenue) and high-revenue contributions from orthopedic joint replacement 27447 (38 claims, $238.8K) plus the ophthalmic supply J1097 ($158.8K). This pattern—ophthalmology procedures alongside elective orthopedics and outpatient ENT/hand cases—supports classification as an ambulatory surgical clinic that serves both eye and musculoskeletal specialties.
Competitive standing is uneven across codes: for some high-revenue Medicare services the facility is a typical national participant (for example 66984 ranks in the 82nd percentile and is described as typical/unremarkable), while for several ENT and orthopedic codes it is well above peers—29827 (rotator cuff) ranks in the 96th percentile and is labeled notably above typical national volume, 30140 (inferior turbinate resection) sits in the 93rd percentile, and 30520 (septoplasty) is an extreme outlier at the 98th percentile. This indicates pockets of regional or procedural strength despite otherwise typical national volumes for core cataract work.
High Medicaid concentration into a few procedure codes creates potential revenue vulnerability: with 42820 alone representing 56.6% of Medicaid revenue and the top three Medicaid codes totaling 94.5% of Medicaid revenue, changes in pediatric referral patterns, state reimbursement, or bundled payment policy for those specific ENT procedures could materially affect facility revenue. The concentrated Medicaid footprint also means payer-specific operational capacity (OR schedules, anesthesia resources) is likely configured around high pediatric case volumes.
Operational and billing signals: several Medicaid-reported codes show $0 avg paid/claim (for example G8916 with 203 claims $0 and G8907 with 389 claims $0), and supply/prosthetic entries like L8699 and J1097 are present in the Medicaid billing stream with $0 paid. These items are consistent with reported quality/process or supply-supply claims that may be handled outside fee-for-service payment (e.g., bundled or administrative reporting) and suggest routine capture of registry/quality codes and device supply entries in the Medicaid dataset.
Long tenure in the data set supports a stable operating presence: the NPI was enumerated on 2006-08-31 (~20 years ago), indicating the ambulatory surgery center has been established for approximately two decades which aligns with the concentrated, repeat procedural volumes observed in both pediatric ENT and select Medicare specialty lines.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
30 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 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… | 540 | $730 | $391.1K |
| 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… | 40 | $6,280 | $238.8K |
| J1097 | phenylephrine 10.16 mg/ml and ketorolac 2.88 mg/ml ophthalmic irrigation solution, 1 ml | 2,090 | $80 | $158.8K |
| 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 | $1,640 | $98.4K |
| 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… | 30 | $2,110 | $52.8K |
| 31267 | In this procedure, the provider inserts an endoscope into the nasal cavity. She then gains access to the maxillary sinus through a cut in the uncinate process. The provider opens the maxillary sinus… | 50 | $1,020 | $47.7K |
| 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. | 100 | $470 | $45.2K |
| 25609 | The provider surgically repairs a fracture of the lower radius, the larger of the two lower arm bones, beyond the joint or a separation of the radius from the joint through an incision and fixes… | 20 | $2,980 | $44.7K |
| 66991 | The provider inserts an intraocular lens prosthesis during the same session as extracapsular cataract extraction. The provider also inserts one or more anterior segment aqueous drainage devices in… | 20 | $2,200 | $44K |
| 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 | $370 | $39.4K |
Showing 1–10 of 30
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 30 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
30 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| J1097 | 8 | 10 | 3,040 | $80 | $244.1K |
| 27447 | 52 | 90 | 50 | $2,160 | $164.5K |
| 66984 | 25 | 240 | 70 | $470 | $90.5K |
| 66991 | 24 | 20 | 40 | $1,300 | $62.6K |
| 25609 | 6 | 10 | 20 | $1,850 | $35.1K |
| 29827 | 5 | 50 | 20 | $1,020 | $33.6K |
| 29848 | 5 | 10 | 80 | $400 | $32.2K |
| 31254 | 1 | 10 | 40 | $860 | $30.2K |
| 29828 | 6 | 30 | 20 | $1,070 | $27.7K |
| 15823 | 19 | 40 | 40 | $460 | $25.2K |
Showing 1–10 of 30
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.
12 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 42820 | The provider removes the tonsils and adenoids in a patient younger than 12 years old. | 2,560 | $1,580 | $4M |
| 69436 | This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia. | 6,170 | $360 | $2.2M |
| 42830 | The provider performs an initial adenoidectomy in a patient who is less than 12 years old. | 690 | $710 | $487K |
| 41899 | Use this code to report a procedure on the teeth and adjoining alveolar structures for which there is no specific code available. | 530 | $560 | $296.9K |
| 42821 | The provider removes the tonsils and adenoids of a patient age 12 or older. | 120 | $720 | $86.9K |
| 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… | 10 | $270 | $3.5K |
| 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. | 10 | $290 | $3.5K |
| 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… | 390 | $0 | $0 |
| G8916 | Patient with preoperative order for iv antibiotic surgical site infection (ssi) prophylaxis, antibiotic initiated on time | 200 | $0 | $0 |
| G8918 | Patient without preoperative order for iv antibiotic surgical site infection (ssi) prophylaxis | 10 | $0 | $0 |
Showing 1–10 of 12
How this provider's Medicaid billing volume and revenue compare to other Mississippi providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Mississippi median
12 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 42820 | The provider removes the tonsils and adenoids in a patient younger than 12 years old. | 2 | 30 | 70 | $1,790 | $891.2K |
| 42830 | The provider performs an initial adenoidectomy in a patient who is less than 12 years old. | 2 | 10 | 440 | $1,090 | $571.7K |
| 69436 | This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia. | 2 | 50 | 300 | $510 | $483.3K |
| 41899 | Use this code to report a procedure on the teeth and adjoining alveolar structures for which there is no specific code available. | 7 | 20 | 150 | $250 | $158.9K |
| 42821 | The provider removes the tonsils and adenoids of a patient age 12 or older. | 1 | 10 | 110 | $1,170 | $96K |
| J1097 | phenylephrine 10.16 mg/ml and ketorolac 2.88 mg/ml ophthalmic irrigation solution, 1 ml | 11 | 10 | 190 | $20 | $12.9K |
| 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… | 3 | 10 | 10 | $320 | $11.2K |
| 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. | 1 | 10 | 10 | $290 | $3.5K |
| L8699 | Prosthetic implant, not otherwise specified | 2 | 10 | 100 | $1 | $760 |
| G8918 | Patient without preoperative order for iv antibiotic surgical site infection (ssi) prophylaxis | 34 | 40 | 140 | $1 | $590 |
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Other providers in the same ZIP code as North Mississippi Ambulatory Surgery Center LLC, ranked by combined Medicare and Medicaid revenue.
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