Why are Medicare and Medicaid shown separately instead of combined?

They come from two different CMS data sources with no shared claim identifier, so they can't be reconciled into one number without double-counting or guessing. Every table and chart on this page keeps them fully separate.

Why is there no private/commercial revenue figure?

Private and commercial payer data comes from Transparency in Coverage files, which only publish negotiated rates — not claims or utilization volume. Without a volume figure, no revenue number can be computed for any provider from that data.

What does "Rank" mean in the Competitive Analysis & Benchmarks tables?

For a given CPT/HCPCS code, it's this provider's position by claims volume among all providers billing that same code at that geography level (State, National, or Ohio for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Ohio only?

Medicaid is administered per-state with no single national fee schedule, so a state or national comparison the way Medicare has one isn't available. Ohio (this provider's own state) is the only grouping that's conceptually meaningful.

Why are the numbers rounded to the nearest 10?

To avoid implying more precision than the underlying data supports at a single-provider level. Ratios are kept precise since they're a relative comparison, not a volume or dollar figure.

How current is this data?

The Medicare and Medicaid tables are both single current snapshots, not refreshed on a recurring schedule yet.

Ohio Orthopedic Surgery Institute LLC (NPI 1285639062)

Key Findings

Field	Value
Entity Type	Organization
Organization	Ohio Orthopedic Surgery Institute LLC
Address	4605 Sawmill Rd
City	Columbus
State	OH
ZIP	43220
Taxonomy	Ambulatory Surgical Clinic/Center
NPI Enumerated	June 17, 2005

Payer Source	Total Paid
Medicare	$2.6M
Medicaid	$0

Service mix is focused on high-acuity musculoskeletal care consistent with an Ambulatory Surgical Clinic/Center: the provider’s largest Medicare revenue contributors are joint arthroplasty and spine/interventional procedures, led by 27447 (total knee), 27130 (hip replacement), and 64483 (transforaminal epidural injection). The presence of both major joint replacement codes and high-volume injection codes suggests the operation performs inpatient-intensity orthopedic procedures and supports perioperative or nonoperative pain management on the same billing footprint.

Revenue is highly concentrated in a very small set of Medicare codes: the top 3 Medicare codes by revenue account for 79.8% of total Medicare revenue, with 27447 contributing $1.3M (51.2%), 27130 contributing $559.9K (21.3%), and 64483 contributing $191.5K (7.3%). This level of concentration indicates the business is heavily dependent on a narrow mix of high-revenue procedures.

Payer mix is effectively single-payer Medicare at scale: lifetime Medicare revenue is $2.6M and there is no Medicaid billing on file (none). The absence of Medicaid activity means the practice’s outpatient and surgical business is materially exposed to Medicare reimbursement and referral patterns rather than a broader dual-payer mix.

For national competitive standing the provider is a clear high-volume outlier on several headline services: 27447 ranks #106 of 12089 providers nationally (99th percentile; extreme outlier, far above typical national volume for this code) and 64483 ranks #98 of 8202 providers nationally (99th percentile; extreme outlier, far above typical national volume for this code). These rankings indicate the clinic punches well above typical national volume for total knee arthroplasty and lumbar transforaminal epidural injections despite its ambulatory taxonomy.

27130 (hip replacement) is also a notable contributor and ranks #487 of 8062 providers nationally (94th percentile; notably above typical national volume for this code), which together with the 27447 ranking signals a regional or niche referral role in major joint replacement. The joint-arthroplasty rankings suggest the provider is a significant, above-typical-volume participant in hip and knee replacement relative to national peers.

The provider shows above-typical volume in certain ambulatory and upper-extremity procedures beyond arthroplasty: 64721 (carpal tunnel neuroplasty) produced $56.2K (2.1% of Medicare revenue) and ranks #178 of 3206 providers nationally (94th percentile; notably above typical national volume for this code), while shoulder and hand codes (29827, 29828) contribute additional but smaller Medicare revenue lines. This mix implies a broader orthopedics practice that includes both major joint replacement and focused hand/shoulder surgery.

Use of long-acting local anesthetic/analgesic products is unusually prominent relative to peers: C9290 shows 48K claims at $1 avg paid/claim for $48K revenue and ranks #13 of 451 providers nationally (97th percentile; notably above typical national volume for this code), and C9088 records 15.2K claims at $1 avg for $15.2K revenue. High-ranked utilization of these HCPCS products suggests standardized perioperative or procedural analgesic protocols that are materially more common here than among most peers.

Operational implications: with an NPI enumerated 2005-06-17 (~21 years ago) the provider is an established entity, but its Medicare revenue profile is highly dependent on a small set of high-revenue orthopedic procedures (79.8% from the top three codes). That concentration creates sensitivity to changes in Medicare coverage, reimbursement, or referral flows for arthroplasty and spinal injection services and should be a focus for payer contracting and utilization management discussions.

Medicare: Complete Services Breakdown

The CPT/HCPCS codes generating the most Medicare revenue for this provider.

28 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…	190	$7,030	$1.3M
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	$7,180	$559.9K
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).	650	$300	$191.5K
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	$1,540	$59.9K
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…	90	$600	$56.2K
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…	20	$2,400	$50.3K
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…	190	$260	$48.3K
C9290	Injection, bupivacaine liposome, 1 mg	48,010	$1	$48K
25609	The provider surgically repairs a fracture of the lower radius, the larger of the two lower arm bones, beyond the joint or a separation of the radius from the joint through an incision and fixes…	10	$3,190	$35.1K
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…	80	$450	$34.3K

Showing 1–10 of 28

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Advanced Home Health Care Inc	OH	Home Health Agency	$0	$10.9M
Pure Health Care, LLC	OH	Home Health Agency	$0	$9.4M
Upper Arlington Surgery Center, Ltd.	OH	Ambulatory Surgical Clinic/Center	$725K	$0
Elizabeth Owens	OH	Physical Therapist	$461.7K	$0
Milan Herceg	OH	Orthopaedic Surgery of the Spine Physician	$363K	$0
Robert Ryu	OH	Orthopaedic Surgery of the Spine Physician	$330.6K	$0
Vivek Sahai	OH	Adult Reconstructive Orthopaedic Surgery Physician	$314.3K	$0
Rahul Biyani	OH	Orthopaedic Surgery Physician	$257.9K	$0
Andrew Campbell	OH	Adult Reconstructive Orthopaedic Surgery Physician	$254.2K	$0
Jeffrey Oehler	OH	Ophthalmology Physician	$252.3K	$0

Ohio Orthopedic Surgery Institute LLC — Billing Profile & Reimbursement Data

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Ohio Orthopedic Surgery Institute LLC — Billing Profile & Reimbursement Data

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Key Findings

Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
27447	6	540	30	$1,280	$52.4K
27130	13	340	20	$1,250	$38.8K
25609	7	10	10	$1,930	$32.9K
C9290	2	10	15,410	$1	$27.4K
29827	7	120	20	$950	$19K
64483	4	270	50	$170	$17.7K
G0260	18	30	40	$200	$17.5K
64635	42	210	30	$310	$14.8K
29828	5	30	20	$800	$14.4K
64721	6	130	30	$400	$13.9K