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NPI 1245450295 · Springfield, MA · Ambulatory Surgical Clinic/Center
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Mdsine, LLC is a ambulatory surgical clinic/center provider located in Springfield, Massachusetts. This profile covers 22 Medicare and 8 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 | Mdsine, LLC |
| Address | 55 Saint George Rd |
| City | Springfield |
| State | MA |
| ZIP | 01104 |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| NPI Enumerated | May 1, 2007 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $1.9M |
| Medicaid | $320.9K |
This facility’s Medicare billing is concentrated in a small set of procedure types: the top 3 Medicare codes account for 63.4% of its total Medicare revenue, led by 66984 (39.0% of Medicare revenue). The dominance of 66984 (cataract extraction with intraocular lens) plus other ophthalmic codes like 66982 and 66821 indicates the center operates significant ophthalmology surgical capacity alongside its other services.
Medicaid billing shows an even greater concentration: the top 3 Medicaid codes account for 80.8% of Medicaid revenue, with 66984 (29.2%), 64483 (25.9%), and 64490 (25.7%) together comprising most state Medicaid receipts. That mix — high shares for a cataract code and for image-guided spinal/facet injection codes — signals the center bills both ophthalmic surgery and interventional pain services to Medicaid in this state.
On payer scale the provider is far more active in Medicare than Medicaid in dollar terms: reported lifetime Medicare revenue is $1.9M versus $320.9K in Medicaid, so Medicare dominates the revenue base. While both payers are present, this is effectively Medicare-led in overall scale rather than a balanced dual-payer operation.
Competitive standing varies by service line: for Medicare the facility’s volume in 66984 ranks #2104 of 15965 (87th percentile) which is described as typical, unremarkable national volume for the code, while select interventional codes show unusually high standing — for example 64490 ranks #56 of 3759 (99th percentile) and is labeled an extreme outlier, far above typical national volume. This pattern suggests the provider is a routine contributor to cataract surgery nationally but an unusually large outlier for certain spinal/facet procedures.
State-level Medicaid rankings show the provider as a leading in-state source for some spine/interventional services: 64490 ranks #1 of 8 providers in-state (100th percentile; notably above typical state volume) and 64479 ranks #1 of 2 providers in-state (100th percentile; typical, unremarkable volume). These state rankings imply the center is a major local provider of facet-level injection services under Medicaid, even if its overall Medicaid revenue is modest.
Procedure mix aligns with an ambulatory surgical clinic that combines ophthalmology (high-volume cataract extractions and related laser/iris procedures) with interventional pain and spine services (facet/transforaminal injections, neurolytic procedures, and spinal cord stimulator work). Presence of codes such as 63650 (spinal cord stimulator lead placement) and multiple 64xxx series injections supports a dual specialty operational model rather than a narrow single-procedure ambulatory center.
Several individual codes are statistical outliers or unusually concentrated: Medicare 66761 ranks #2 of 671 (100th percentile; extreme outlier, far above typical national volume) indicating very high laser iridotomy activity for that code, and Medicare 64490 also carries the explicit label of "extreme outlier, far above typical national volume." These extreme-percentile observations point to programmatic emphasis or specialized throughput on those interventions relative to national peers.
The provider has an established tenure in the NPI file — enumerated on 2007-05-01 (~19 years ago) — indicating a long-running ambulatory surgical operation. That longevity, coupled with concentrated high-volume lines in both ophthalmology and interventional spine procedures, suggests an entrenched local service profile that mixes routine cataract work with higher-than-typical spine/interventional throughput in select codes.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
22 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… | 890 | $830 | $740.3K |
| 63650 | In this procedure, the provider places electrodes in the epidural space to relieve pain and reduce or eliminate spasms. | 70 | $3,720 | $245.3K |
| J1096 | Dexamethasone, lacrimal ophthalmic insert, 0.1 mg | 2,200 | $100 | $217.8K |
| 66982 | The provider inserts an intraocular lens prosthesis after extracapsular cataract extraction using complex techniques and devices. He may perform this by means of an iris expansion device, providing… | 140 | $830 | $116.6K |
| 0275T | N/A | 30 | $3,650 | $113K |
| 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… | 40 | $2,480 | $91.6K |
| 64635 | Under fluoroscopic or CT guidance, the provider applies an agent to a lower back joint to destroy nerve tissue. | 130 | $510 | $66.7K |
| 64490 | The provider injects a diagnostic or therapeutic substance into a single cervical or thoracic paravertebral facet (zygapophyseal) joint, or into the nerves that supply that joint, using imaging… | 200 | $270 | $53.7K |
| 67904 | The provider repairs a drooping eyelid by tightening the levator muscle that controls eyelid movement to improve cosmetic appearance or remove the obstruction to a patient’s vision. He accesses the… | 80 | $520 | $43.8K |
| 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). | 140 | $290 | $40.2K |
Showing 1–10 of 22
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 22 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
22 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| J1096 | 3 | 10 | 2,200 | $100 | $189.1K |
| 66984 | 78 | 330 | 170 | $200 | $143.2K |
| 63650 | 4 | 10 | 40 | $1,690 | $74.5K |
| 66991 | 16 | 50 | 30 | $1,640 | $70.7K |
| 0275T | 2 | 10 | 30 | $2,210 | $53K |
| 66982 | 10 | 140 | 30 | $680 | $36.9K |
| 15260 | 36 | 50 | 20 | $810 | $29.2K |
| 67904 | 1 | 20 | 40 | $650 | $27.3K |
| 15823 | 11 | 40 | 30 | $610 | $24.8K |
| 66821 | 24 | 240 | 40 | $210 | $17.4K |
Showing 1–10 of 22
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.
8 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… | 320 | $290 | $94K |
| 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). | 440 | $190 | $83.3K |
| 64490 | The provider injects a diagnostic or therapeutic substance into a single cervical or thoracic paravertebral facet (zygapophyseal) joint, or into the nerves that supply that joint, using imaging… | 600 | $140 | $82.5K |
| 64479 | 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 cervical or thoracic). | 200 | $200 | $41K |
| 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)… | 100 | $170 | $16.1K |
| 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)… | 10 | $170 | $2.2K |
| 64491 | In this add–on procedure, the provider injects a diagnostic or therapeutic substance into a single cervical or thoracic paravertebral facet (zygapophyseal) joint, or into the nerves that supply that… | 30 | $70 | $2.2K |
| 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… | 420 | $0 | $0 |
How this provider's Medicaid billing volume and revenue compare to other Massachusetts providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Massachusetts median
8 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average 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… | 33 | 60 | 330 | $380 | $352.9K |
| 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)… | 77 | 90 | 170 | $260 | $193.6K |
| 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). | 15 | 50 | 100 | $230 | $106.5K |
| 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 | 20 | 100 | $310 | $73.5K |
| 64479 | 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 cervical or thoracic). | 1 | 10 | 150 | $170 | $25.6K |
| 64490 | The provider injects a diagnostic or therapeutic substance into a single cervical or thoracic paravertebral facet (zygapophyseal) joint, or into the nerves that supply that joint, using imaging… | 1 | 10 | 50 | $140 | $20.5K |
| 64491 | In this add–on procedure, the provider injects a diagnostic or therapeutic substance into a single cervical or thoracic paravertebral facet (zygapophyseal) joint, or into the nerves that supply that… | 5 | 10 | 30 | $60 | $3.9K |
| 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… | 16 | 40 | 350 | $1 | $560 |
Other providers in the same ZIP code as Mdsine, LLC, ranked by combined Medicare and Medicaid revenue.
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