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NPI 1275642480 · Lewes, DE · Ambulatory Surgical Clinic/Center
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Egnm LLC is a ambulatory surgical clinic/center provider located in Lewes, Delaware. This profile covers 32 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 | Egnm LLC |
| Address | 17015 Old Orchard Road |
| City | Lewes |
| State | DE |
| ZIP | 19958 |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| NPI Enumerated | August 30, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $2.2M |
| Medicaid | $13.6K |
EGNM LLC is overwhelmingly Medicare‑facing: lifetime Medicare revenue is $2.2M compared with only $13.6K in Medicaid revenue, so Medicare drives virtually all clinical volume and revenue. The Medicaid footprint is minimal in scale relative to Medicare, making the provider effectively Medicare‑dominant for payer mix and growth considerations.
Revenue concentration on Medicare is high: the top three Medicare codes together account for 50.8% of the provider’s total Medicare revenue, led by 66984 at 38.1% of Medicare revenue, with 62323 at 8.0% and 64493 at 4.6%. This level of concentration means a small set of procedures disproportionately determine financial performance and utilization metrics for the practice.
The code mix and the Ambulatory Surgical Clinic/Center taxonomy indicate a multi‑specialty ambulatory surgical operation. High Medicare revenue from 66984 (cataract extraction/IOL insertion), paired with substantial billing for spinal injection codes such as 62323 and 64493, plus orthopaedic and soft‑tissue procedures (for example 29827, 27447, 28285), suggest the ASC supports ophthalmology, interventional pain management, and orthopedics rather than a single narrow specialty.
Several Medicare codes are statistical outliers nationally, signaling unusually high national volume in specific services: 62323 ranks #20 of 7397 providers nationally (100th percentile; extreme outlier, far above typical national volume for this code) and 64493 ranks #116 of 7519 (98th percentile; extreme outlier). By contrast, 66984 ranks #1968 of 15965 (88th percentile; typical, unremarkable volume), indicating the center is especially prominent in certain interventional pain and musculoskeletal procedures even though its cataract volume is more typical at the national level.
Within Medicaid billing the activity is narrowly focused: 62323 makes up 100.0% of the provider’s total Medicaid revenue ($13.6K from 96 claims) and the provider ranks #4 of 9 in‑state for that code (63th percentile; typical, unremarkable volume). This pattern shows the provider’s Medicaid participation is effectively limited to lumbar epidural injections rather than a broader set of outpatient procedures.
Beyond the headline outliers, other individual Medicare codes show elevated standing regionally and nationally — for example 28285 (hammertoe repair) ranks #11 of 955 providers nationally (99th percentile; extreme outlier) and 20680 (removal of skeletal fixation) ranks #8 of 601 (99th percentile; notably above typical national volume). These multiple high‑percentile codes point to concentrated procedural strengths across a few specific service lines rather than evenly distributed ambulatory surgery activity.
EGNM’s NPI was enumerated on 2006-08-30 (~20 years ago), indicating an established presence in the market. That tenure, combined with concentrated high volumes in select procedures, is consistent with an ASC that has built stable referral streams for particular specialties over time.
From an operational and contracting perspective, dependence on a few high‑revenue codes (top three Medicare codes = 50.8% of Medicare revenue; top three Medicaid codes = 100.0% of Medicaid revenue) means reimbursement changes, utilization management, or shifts in referral patterns for those specific services could have outsized effects on the facility’s revenue and capacity planning. The mix also suggests payer negotiations and resource allocation should prioritize the facility’s pain‑management and key surgical lines where it shows national‑level volume strength.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
32 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… | 1,010 | $810 | $816.9K |
| 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)… | 700 | $240 | $171.8K |
| 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… | 400 | $250 | $99.4K |
| 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). | 340 | $290 | $99.1K |
| 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 | $2,280 | $98K |
| 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… | 120 | $810 | $97.8K |
| 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… | 10 | $6,960 | $76.5K |
| 66821 | The provider removes the haziness from the capsule of the eye using a laser for a patient with a secondary membranous cataract. | 370 | $200 | $74.7K |
| 28750 | In this procedure, the provider surgically immobilizes the metatarsophalangeal joint of the great toe. A metatarsophalangeal joint is a joint between the first metatarsal of the foot and the first… | 20 | $3,370 | $67.5K |
| 28285 | The provider repairs a hammertoe deformity, a painful condition in which the toe remains permanently bent in a downward position. | 110 | $600 | $67K |
Showing 1–10 of 32
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 32 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
32 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| J1097 | 2 | 10 | 2,720 | $80 | $207.4K |
| 66984 | 5 | 50 | 70 | $590 | $163.6K |
| V2785 | 2 | 10 | 30 | $3,250 | $90.9K |
| 64483 | 11 | 40 | 170 | $220 | $62.4K |
| 15823 | 4 | 10 | 60 | $550 | $60.3K |
| 66982 | 7 | 20 | 60 | $700 | $60K |
| 27447 | 51 | 50 | 50 | $810 | $52K |
| 66821 | 2 | 30 | 140 | $230 | $37.1K |
| G0260 | 3 | 10 | 80 | $210 | $31.6K |
| 64721 | 18 | 20 | 40 | $470 | $29.4K |
Showing 1–10 of 32
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 |
|---|---|---|---|---|
| 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)… | 100 | $140 | $13.6K |
How this provider's Medicaid billing volume and revenue compare to other Delaware providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Delaware median
1 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average 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)… | 4 | 10 | 70 | $90 | $56.9K |
Other providers in the same ZIP code as Egnm LLC, ranked by combined Medicare and Medicaid revenue.
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