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NPI 1265401202 · Spokane, WA · Ambulatory Surgical Clinic/Center
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Northwest Orthopaedic Specialists, P.s. is a ambulatory surgical clinic/center provider located in Spokane, Washington. This profile covers 35 Medicare and 4 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 | Northwest Orthopaedic Specialists, P.s. |
| Address | 601 W 5th Ave Ste 500 |
| City | Spokane |
| State | WA |
| ZIP | 99204 |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| NPI Enumerated | March 14, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $4.1M |
| Medicaid | $252.1K |
Practice profile and service lines: NORTHWEST ORTHOPAEDIC SPECIALISTS, P.S. operates as an Ambulatory Surgical Clinic/Center delivering a mix of orthopedic joint replacement, arthroscopic surgery, spine interventions, and neuromodulation. Medicare top codes include 27447 (knee arthroplasty), 27130 (hip arthroplasty), and multiple arthroscopic shoulder and knee codes such as 29827 and 29828, while high-volume spine/pain codes (64483, 62323, 64635) and neuromodulation codes (63685, 63650) indicate a blended orthopedic-plus-pain-management service model rather than a single-procedure focus.
Medicare revenue concentration: the provider reports $4.1M in total Medicare revenue with its top 3 Medicare codes (27447, 27130, 63685) accounting for 48.4% of that Medicare revenue. Individually, 27447 generated $945.5K (23.8% of Medicare revenue) and 27130 generated $636K (16.0%), highlighting joint arthroplasty as principal Medicare revenue drivers.
Medicaid revenue concentration and composition: total Medicaid revenue is $252.1K and the top 3 Medicaid codes account for 100.0% of Medicaid revenue, led overwhelmingly by L8699 (Prosthetic implant) at $225.9K (89.6% of Medicaid revenue). The remainder of Medicaid revenue is driven by two image-guided spine injection codes, 64483 ($13.7K, 5.4%) and 62323 ($12.5K, 5.0%), showing Medicaid volume is concentrated in prosthetic implant billing plus a small amount of spine injections.
Payer mix and scale: Medicare ($4.1M) is materially larger than Medicaid ($252.1K) for this provider, indicating the clinic is predominantly dependent on Medicare fee-for-service volume rather than Medicaid. Medicaid activity is present but represents a much smaller portion of lifetime public-payer revenue, consistent with an ambulatory surgical practice that serves Medicare-aged patients at scale.
Competitive standing on high-cost procedures: the provider ranks well above peers on several national measures for Medicare procedures—27447 ranks #404 of 12089 providers (97th percentile) and 27130 ranks #403 of 8062 providers (95th percentile)—signaling notably above-typical national volume for major joint arthroplasty. By contrast, neuromodulation insertion 63685 ranks in a mid-range position (#590 of 1281, 48th percentile), indicating typical national volume for that specific service.
High-volume outpatient spine/pain procedural footprint: multiple image-guided injection and facet denervation codes show extreme or notable outlier status nationally—64483 ranks #36 of 8202 (100th percentile; extreme outlier), 62323 ranks #9 of 7397 (100th percentile; extreme outlier), and 64493, 64635 also appear in very high percentiles. This pattern suggests the center delivers a disproportionately high volume of outpatient spine and pain procedures relative to national peers.
Mix of device-driven and procedural revenue: Medicare average paid per-claim figures and code mix indicate significant device- and implant-related revenue (e.g., 27447 avg paid/claim $7163 and 27130 avg paid/claim $7571) alongside high-frequency lower-unit injections (e.g., 64483 avg paid/claim $286). On Medicaid the dominant L8699 prosthetic billing ($225.9K) further underscores reliance on implant-related revenue streams on that payer.
Tenure and market presence: the NPI was enumerated on 2006-03-14 (~20 years ago), indicating long-standing presence in the Spokane market. Combined with the facility’s high percentile ranks on multiple Medicare codes, the tenure supports an interpretation of an established regional orthopedic surgery and pain management center rather than a newly originated clinic.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
35 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… | 130 | $7,160 | $945.5K |
| 27130 | In this procedure, the provider surgically replaces the hip joint by prosthesis, or artificial hip joint. He replaces both the femoral and acetabular components with or without using an autograft or… | 80 | $7,570 | $636K |
| 63685 | The provider inserts or replaces a spinal neurostimulator pulse generator or receiver. The system is one that requires surgical creation of a pocket for placement and that requires a connection… | 20 | $20,090 | $341.4K |
| 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). | 920 | $290 | $261.7K |
| 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)… | 900 | $260 | $233.4K |
| 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… | 110 | $1,960 | $218K |
| 63650 | In this procedure, the provider places electrodes in the epidural space to relieve pain and reduce or eliminate spasms. | 50 | $3,990 | $211.2K |
| 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… | 50 | $2,550 | $132.6K |
| 64635 | Under fluoroscopic or CT guidance, the provider applies an agent to a lower back joint to destroy nerve tissue. | 230 | $540 | $126.3K |
| 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… | 170 | $660 | $114K |
Showing 1–10 of 35
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 35 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
35 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| 63685 | 12 | 30 | 20 | $8,250 | $148.4K |
| 63650 | 20 | 40 | 50 | $1,960 | $109.9K |
| 28297 | 2 | 10 | 10 | $3,730 | $52.2K |
| 27447 | 7 | 320 | 30 | $1,190 | $46.3K |
| 27130 | 6 | 230 | 30 | $1,060 | $37.1K |
| 28750 | 3 | 10 | 20 | $2,020 | $36.3K |
| 29828 | 3 | 30 | 20 | $1,240 | $28.4K |
| 29827 | 2 | 90 | 20 | $1,130 | $26.1K |
| 29862 | 1 | 10 | 20 | $1,340 | $22.8K |
| 64635 | 3 | 90 | 30 | $400 | $21.2K |
Showing 1–10 of 35
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.
4 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| L8699 | Prosthetic implant, not otherwise specified | 230 | $1,000 | $225.9K |
| 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). | 60 | $220 | $13.7K |
| 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)… | 60 | $200 | $12.5K |
| 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… | 50 | $0 | $0 |
How this provider's Medicaid billing volume and revenue compare to other Washington providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Washington median
4 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| L8699 | Prosthetic implant, not otherwise specified | 8 | 10 | 250 | $250 | $138.2K |
| 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). | 22 | 40 | 80 | $210 | $63.2K |
| 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)… | 12 | 20 | 60 | $160 | $52.2K |
| 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… | 34 | 50 | 90 | $1 | $1 |
Other providers in the same ZIP code as Northwest Orthopaedic Specialists, P.s., ranked by combined Medicare and Medicaid revenue.
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