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NPI 1275515157 · Bozeman, MT · Ambulatory Surgical Clinic/Center
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Rocky Mountain Surgical Center, LLC is a ambulatory surgical clinic/center provider located in Bozeman, Montana. This profile covers 17 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 | Rocky Mountain Surgical Center, LLC |
| Address | 1450 Ellis St |
| City | Bozeman |
| State | MT |
| ZIP | 59715 |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| NPI Enumerated | November 16, 2005 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $316.4K |
| Medicaid | $0 |
ROCKY MOUNTAIN SURGICAL CENTER, LLC operates as an ambulatory surgical clinic/center whose Medicare billing pattern centers on upper‑extremity surgery and image‑guided pain procedures. The top Medicare CPT codes are 23430 (20 claims, $2965 avg paid/claim, $59.3K revenue), 64721 (73 claims, $586 avg paid/claim, $42.8K revenue), and 64635 (80 claims, $466 avg paid/claim, $37.3K revenue), and the remainder of the reported CPT mix includes additional hand/wrist procedures (29827, 29848, 26480, 26055) and multiple facet/epidural injections (64490, 64479, 64493). This combination of codes indicates a blended service line focused on elective hand/shoulder surgery plus interventional spine/pain care delivered in an outpatient surgical setting.
Revenue concentration is meaningful: the top 3 Medicare codes by revenue account for 44.0% of this provider's total Medicare revenue, with 23430 contributing $59.3K (18.7%), 64721 contributing $42.8K (13.5%), and 64635 contributing $37.3K (11.8%) of the $316.4K total Medicare revenue. That level of concentration implies that changes in referral patterns or reimbursement for these few services could materially affect overall Medicare revenue for the center.
This provider is effectively single‑payer in the dataset: total Medicare revenue is $316.4K while reported Medicaid revenue is $0, indicating Medicaid does not appear in the center’s billing profile. For payers and network analysts this implies contracting and utilization negotiations will hinge largely on Medicare volumes and reimbursement trends rather than a two‑payer mix.
Competitive standing by code is mixed but shows cluster strength in interventional pain and carpal tunnel work. For example, 64721 ranks #336 of 3206 providers nationally (89th percentile) and 64635 ranks #1105 of 5957 providers nationally (81th percentile), while facet injection code 64490 ranks #328 of 3759 providers nationally (91th percentile), indicating above‑typical national volume for several pain and nerve‑decompression services; by contrast, 23430 sits at #295 of 811 (60th percentile), a more typical national footprint for that shoulder procedure.
The provider has long tenure in claims data with NPI enumeration dated 2005-11-16 (~21 years ago), suggesting an established local presence and likely stable referral relationships in the Bozeman, MT market. Longstanding enrollment combined with a concentrated set of procedural services supports the impression of a stable specialty ambulatory surgical practice rather than a recently opened or transient operation.
Procedure-level utilization shows both higher‑priced surgical episodes and frequent lower‑priced injections: 23430 posts a high average payment per claim ($2965 avg paid/claim) while common pain injections and neurolytic procedures have lower avg paid/claim values (for example, 64635 $466 avg paid/claim, 64490 $259 avg paid/claim). This mix suggests revenue is driven by a small number of higher‑unit‑price surgeries complemented by higher‑frequency, lower‑unit‑price interventional procedures.
Operational focus is reflected in claim counts: several codes have substantial claim volumes consistent with routine throughput in an ASC—for example, 64721 has 73 claims, 64635 has 80 claims, and 64490 has 92 claims—indicating consistent procedural flow for carpal tunnel and spine/pain interventions. Payers assessing network adequacy should note these routine volumes for common hand and pain procedures when modeling capacity and access in the Bozeman area.
There are selective low‑volume or below‑typical national positions in some areas, which suggest a narrow scope of services rather than broad procedural breadth. Examples include 20680 (12 claims, $772 avg paid/claim) which ranks #507 of 601 providers nationally (8th percentile) and lumbar facet code 64493 (29 claims, $242 avg paid/claim) which ranks #5661 of 7519 providers nationally (23th percentile); these lower percentiles indicate limited activity in those specific service lines compared with national peers.
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 |
|---|---|---|---|---|
| 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 | $2,970 | $59.3K |
| 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… | 70 | $590 | $42.8K |
| 64635 | Under fluoroscopic or CT guidance, the provider applies an agent to a lower back joint to destroy nerve tissue. | 80 | $470 | $37.3K |
| 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… | 90 | $260 | $23.8K |
| 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… | 20 | $1,440 | $23.1K |
| 26480 | In this procedure, the provider transfers or transplants a tendon in the carpometacarpal area or the back of the hand. The carpometacarpal area is the articulation of the wrist’s carpal bones with… | 20 | $1,020 | $21.4K |
| 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). | 50 | $280 | $13.9K |
| 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… | 40 | $390 | $13.6K |
| 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. | 30 | $510 | $13.2K |
| 25447 | The provider performs arthroplasty (joint replacement) of the intercarpal joints (between the small bones in the wrist) or carpometacarpal joints (where the carpal bones of the wrist meet the… | 20 | $510 | $12.2K |
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
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.
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… | 230 | $0 | $0 |
How this provider's Medicaid billing volume and revenue compare to other Montana providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Montana 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 | 140 | $0 | $0 |
Other providers in the same ZIP code as Rocky Mountain Surgical Center, LLC, ranked by combined Medicare and Medicaid revenue.
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