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NPI 1255339628 · Bismarck, ND · Ambulatory Surgical Clinic/Center
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Bismarck Surgical Associates, LLC is a ambulatory surgical clinic/center provider located in Bismarck, North Dakota. This profile covers 39 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 | Bismarck Surgical Associates, LLC |
| Address | 106 E Greenfield Ln |
| City | Bismarck |
| State | ND |
| ZIP | 58503 |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| NPI Enumerated | July 11, 2005 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $2.2M |
| Medicaid | $0 |
BISMARCK SURGICAL ASSOCIATES, LLC has essentially all billed volume coming from Medicare: total Medicare revenue is $2.2M while reported Medicaid revenue is $0, making the practice effectively single-payer in the available data. That concentration has direct implications for reimbursement risk and contract negotiation leverage, since Medicaid does not appear in the reported payer mix.
Revenue concentration within Medicare is high: the precomputed top 3 Medicare codes account for 52.5% of this provider's total Medicare revenue, driven primarily by 27447 (26.5%), 66984 (17.2%), and 62323 (8.8%). This degree of concentration means a relatively small set of procedures—knee arthroplasty, cataract extraction with IOL, and lumbar epidural injections—drive the majority of Medicare dollars for the site.
The code mix indicates a multi-specialty ambulatory surgery profile anchored in orthopedics, ophthalmology, and spine/pain services. High-revenue codes include 27447 (knee arthroplasty) and 66984 (cataract extraction with lens insertion), while large claim counts for codes such as J1097 (2K claims, $154.1K revenue) and J2403 (71.2K claims, $71.2K revenue) point to routine ophthalmic supply usage that supports a busy eye surgery stream.
Competitive standing varies by service line: for major orthopedics, 27447 ranks #1453 of 12089 providers nationally (88th percentile; typical, unremarkable volume for this code), indicating modest national footprint for knee arthroplasty. By contrast, the practice is a clear national outlier in lumbar epidural injections: 62323 ranks #12 of 7397 providers nationally (100th percentile; extreme outlier, far above typical national volume for this code), showing outsized scale in image-guided spinal injections relative to peers.
Several codes signal specialty strength beyond the top three: 62321 (cervical/thoracic injection) ranks #77 of 4493 providers nationally (98th percentile; extreme outlier, far above typical national volume for this code), and 64721 (carpal tunnel release) ranks #57 of 3206 providers nationally (98th percentile; notably above typical national volume for this code). These high-percentile ranks across spine and hand surgery/nerve procedures suggest focused capacity and throughput in procedural pain management and upper-extremity surgery.
Procedure-level revenue and utilization detail further supports a mixed surgical and injection-oriented ASCs model: high average paid/claim items such as 27447 ($6793 avg paid/claim) and 66991 ($2385 avg paid/claim) coexist with large-volume, low-unit items like J2403 ($1 avg paid/claim, 71.2K claims) and C9290 ($1 avg paid/claim, 21.5K claims). This mix implies revenue drivers come from both high-reimbursement operative cases and high-frequency ancillary supplies/medications used in ambulatory procedures.
Tenure and market presence: the provider’s NPI was enumerated on 2005-07-11 (~21 years ago), indicating long-standing operation in the market. Combined with the outlier volumes on several therapeutic injection and hand-surgery codes, the longevity supports a stable, procedure-focused ambulatory surgery business rather than a recent startup.
Concentration risk and operational implications: because the top three Medicare codes account for 52.5% of Medicare revenue, shifts in reimbursement or referral patterns for 27447, 66984, or 62323 could materially affect revenue. Payers and analysts should monitor utilization trends for these specific codes—particularly 62323 and 62321, where national-rank outlier status points to local dominance in spinal injection services.
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 |
|---|---|---|---|---|
| 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… | 80 | $6,790 | $550.2K |
| 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… | 450 | $790 | $356.1K |
| 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)… | 790 | $230 | $183.4K |
| J1097 | phenylephrine 10.16 mg/ml and ketorolac 2.88 mg/ml ophthalmic irrigation solution, 1 ml | 2,030 | $80 | $154.1K |
| 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… | 40 | $1,960 | $84.3K |
| 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… | 30 | $2,390 | $81.1K |
| 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… | 130 | $570 | $72.3K |
| J2403 | Chloroprocaine hcl ophthalmic, 3% gel, 1 mg | 71,200 | $1 | $71.2K |
| 23430 | In this procedure, the provider surgically cleans the long tendon of the biceps from its damaged fragment and fixes the tendon to the upper end of the humerus to improve the stability of the joint.… | 20 | $3,000 | $57.1K |
| 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). | 170 | $280 | $48.3K |
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 |
|---|---|---|---|---|---|
| J1097 | 5 | 10 | 3,660 | $80 | $272.3K |
| 66984 | 10 | 100 | 50 | $350 | $61.2K |
| 66991 | 6 | 10 | 30 | $1,320 | $50.1K |
| 27447 | 8 | 60 | 40 | $1,110 | $47.9K |
| J2403 | 1 | 10 | 71,200 | $1 | $39.6K |
| 66982 | 8 | 20 | 40 | $590 | $29.4K |
| G0260 | 2 | 10 | 100 | $220 | $27.9K |
| 66821 | 6 | 30 | 80 | $230 | $27.3K |
| 62323 | 1 | 20 | 160 | $110 | $22.3K |
| 63047 | 6 | 10 | 20 | $570 | $21.2K |
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.
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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 |
|---|---|---|---|---|
| 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… | 10 | $0 | $0 |
How this provider's Medicaid billing volume and revenue compare to other North Dakota providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. North Dakota median
1 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 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… | 2 | 10 | 50 | $0 | $0 |
Other providers in the same ZIP code as Bismarck Surgical Associates, LLC, ranked by combined Medicare and Medicaid revenue.
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