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NPI 1255303517 · Jackson, MS · Ambulatory Surgical Clinic/Center
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St Dominic Ambulatory Surgery Center L L C is a ambulatory surgical clinic/center provider located in Jackson, Mississippi. This profile covers 17 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 | St Dominic Ambulatory Surgery Center L L C |
| Address | 970 Lakeland Dr |
| City | Jackson |
| State | MS |
| ZIP | 39216 |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| NPI Enumerated | February 2, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $277.6K |
| Medicaid | $221.5K |
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
17 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 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). | 180 | $290 | $51.6K |
| 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)… | 170 | $230 | $40.2K |
| G0260 | Injection procedure for sacroiliac joint; provision of anesthetic, steroid and/or other therapeutic agent, with or without arthrography | 210 | $170 | $34.4K |
| 30140 | This CPT code is for a submucous resection of the inferior turbinate (partial or complete by any method). | 60 | $410 | $23.3K |
| 31276 | In this procedure, the provider inserts an endoscope into the frontal sinus to explore it for abnormalities. The provider may also remove bone, scar tissue, polyps, or other tissue from the frontal… | 20 | $1,030 | $19.6K |
| 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… | 80 | $240 | $19.3K |
| 31256 | In this procedure, the provider inserts an endoscope into the nasal cavity. He then gains access to the maxillary sinus through a cut in the uncinate process. The provider opens the maxillary sinus. | 40 | $470 | $18.8K |
| 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)… | 80 | $230 | $16.9K |
| 64635 | Under fluoroscopic or CT guidance, the provider applies an agent to a lower back joint to destroy nerve tissue. | 30 | $460 | $15K |
| 31257 | The provider performs a complete excision of the ethmoid air cells (anterior and posterior) and widens the opening of the sphenoid sinus cavity. The procedure is performed to treat chronic sinusitis. | 20 | $790 | $14.3K |
Showing 1–10 of 17
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 17 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
17 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| 64483 | 22 | 70 | 110 | $180 | $36.7K |
| 64635 | 48 | 70 | 60 | $340 | $31.3K |
| G0260 | 4 | 20 | 150 | $190 | $26.3K |
| 64493 | 44 | 70 | 90 | $170 | $24.6K |
| 31276 | 4 | 10 | 30 | $830 | $20.8K |
| 62323 | 19 | 70 | 60 | $140 | $19.5K |
| 52000 | 67 | 70 | 90 | $130 | $18.3K |
| 31257 | 1 | 10 | 20 | $790 | $14.3K |
| 31256 | 2 | 10 | 40 | $420 | $13.2K |
| 64490 | 37 | 50 | 50 | $170 | $12.1K |
Showing 1–10 of 17
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 |
|---|---|---|---|---|
| 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)… | 1,680 | $110 | $176.8K |
| 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… | 180 | $130 | $22.6K |
| 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)… | 90 | $110 | $10K |
| 64635 | Under fluoroscopic or CT guidance, the provider applies an agent to a lower back joint to destroy nerve tissue. | 30 | $240 | $7.6K |
| 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). | 20 | $160 | $2.4K |
| 20610 | In this procedure, the provider inserts a needle through the skin of a patient and into a major joint or bursa and then uses the syringe attachment to the needle to remove fluid or he may inject a… | 100 | $10 | $1.1K |
| 27096 | The provider performs an injection in the joint between the sacrum and ilium on one side of the body, with the aid of imaging equipment to locate the injection site. He injects an anesthetic to… | 20 | $20 | $400 |
| 64495 | In this add–on procedure, the provider injects a diagnostic or therapeutic substance into a lumbar or sacral paravertebral facet (zygapophyseal) joint, or into the nerves that supply that joint,… | 100 | $1 | $100 |
| 64494 | In this add–on procedure, 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… | 100 | $0 | $0 |
| 64636 | In this add on procedure, the provider destroys the facet joint nerve of a lumbar or sacral spinal segment using neurolytic agents like heat, electric current, or a chemical compound. He makes use of… | 40 | $0 | $0 |
Showing 1–10 of 13
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
13 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 64635 | Under fluoroscopic or CT guidance, the provider applies an agent to a lower back joint to destroy nerve tissue. | 11 | 20 | 40 | $420 | $105.7K |
| 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… | 17 | 40 | 160 | $170 | $90.1K |
| 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 | 30 | 110 | $120 | $55.7K |
| 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)… | 2 | 40 | 280 | $110 | $46.9K |
| 20610 | In this procedure, the provider inserts a needle through the skin of a patient and into a major joint or bursa and then uses the syringe attachment to the needle to remove fluid or he may inject a… | 46 | 70 | 210 | $30 | $25.3K |
| 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)… | 5 | 20 | 40 | $90 | $7.2K |
| 27096 | The provider performs an injection in the joint between the sacrum and ilium on one side of the body, with the aid of imaging equipment to locate the injection site. He injects an anesthetic to… | 8 | 10 | 40 | $60 | $5.8K |
| 64494 | In this add–on procedure, 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… | 18 | 30 | 120 | $10 | $2.7K |
| 64495 | In this add–on procedure, the provider injects a diagnostic or therapeutic substance into a lumbar or sacral paravertebral facet (zygapophyseal) joint, or into the nerves that supply that joint,… | 8 | 10 | 110 | $10 | $2.1K |
| 64636 | In this add on procedure, the provider destroys the facet joint nerve of a lumbar or sacral spinal segment using neurolytic agents like heat, electric current, or a chemical compound. He makes use of… | 7 | 10 | 40 | $10 | $1.6K |
Showing 1–10 of 13
Other providers in the same ZIP code as St Dominic Ambulatory Surgery Center L L C, ranked by combined Medicare and Medicaid revenue.
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