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 South Carolina for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to South Carolina 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. South Carolina (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.

Carolina Bone & Joint Surgery Center (NPI 1316924632)

Field	Value
Entity Type	Organization
Organization	Carolina Bone & Joint Surgery Center
Address	101 Surgeons Dr
City	Myrtle Beach
State	SC
ZIP	29579
Taxonomy	Ambulatory Surgical Clinic/Center
NPI Enumerated	December 28, 2005

Payer Source	Total Paid
Medicare	$2.3M
Medicaid	$0

Key Findings

CAROLINA BONE & JOINT SURGERY CENTER presents as an orthopedic-focused ambulatory surgical clinic: its top Medicare procedures are 27447 (knee arthroplasty, $1M revenue), 27130 (hip arthroplasty, $480.6K revenue), and 29827 (arthroscopic rotator cuff repair, $130.1K revenue), indicating the operation primarily performs elective joint replacement and shoulder reconstruction in an ASC setting. These high-value operative codes align with an orthopedic service line rather than general ambulatory care.

Revenue is highly concentrated in a small number of procedures: the precomputed top 3 Medicare codes by revenue account for 71.8% of the provider’s total Medicare revenue. That concentration signals dependence on arthroplasty and major joint procedures for the bulk of the $2.3M Medicare lifetime revenue.

This provider is effectively single-payer at the state level: lifetime Medicare revenue is $2.3M while Medicaid is none (no Medicaid billing on file), so the center’s public-payer exposure is almost entirely Medicare-driven and it has no Medicaid billing footprint to evaluate.

Competitive standing is strong for specific orthopedic procedures. 27447 ranks #253 of 12089 providers nationally (98th percentile; notably above typical national volume for this code) and 29827 ranks #100 of 3445 providers nationally (97th percentile; notably above typical national volume for this code), indicating unusually high national volume in knee arthroplasty and rotator cuff repair; by contrast 27130 ranks #669 of 8062 providers nationally (91th percentile; typical, unremarkable volume), so hip replacement volume is closer to peer norms.

The practice shows unusually high outpatient hand and foot procedure volumes in addition to joint work: 64721 (carpal tunnel neuroplasty) accounted for $115.2K and ranks #16 of 3206 providers nationally (100th percentile; extreme outlier), and 28285 (hammertoe repair) contributed $57.6K and ranks #18 of 955 providers nationally (98th percentile; extreme outlier). These figures point to a parallel business line of high-volume hand and foot surgery within the ASC.

Drug or infusion billing is minimal relative to surgical revenue: C9145 appears 416 times but only represents $416 in revenue (0.0% of total Medicare revenue), confirming that the center’s Medicare income is driven by procedural surgery rather than medical oncology or high-cost drug administration.

The practice is well-established, with NPI enumeration on 2005-12-28 (~21 years ago), which supports the pattern of sustained specialty volume and may reflect long-standing referral relationships that supply high volumes of elective orthopedics. That tenure reinforces interpretation of the high-percentile rankings as repeatable operational strength rather than a short-term spike.

From a payer-management and network strategy perspective, the combination of concentrated revenue (71.8% from the top three codes), extreme outlier volumes in specific hand/foot codes, and no Medicaid billing suggests the center is a regional specialty leader for Medicare orthopedics but potentially underexposed to Medicaid populations; this creates both negotiating leverage on Medicare-driven orthopedic cases and a potential gap for plans seeking broader payer diversity or Medicaid access.

Medicare: Complete Services Breakdown

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

24 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…	150	$6,700	$1M
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…	70	$6,870	$480.6K
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…	60	$2,070	$130.1K
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…	200	$590	$115.2K
28299	The provider removes bone from a bunion, a foot deformity that causes a bump near where the big toe joins the foot. The procedure includes double osteotomy, cutting and realigning one or more toe…	20	$2,840	$62.4K
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…	20	$3,210	$57.8K
28285	The provider repairs a hammertoe deformity, a painful condition in which the toe remains permanently bent in a downward position.	90	$620	$57.6K
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…	130	$420	$54.8K
29881	The provider examines the inside of the knee joint with an arthroscope. She repairs the joint by removing the meniscus, a crescent shaped cartilage cushion, from either the medial or lateral…	40	$1,020	$38.9K
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…	50	$680	$36K

Showing 1–10 of 24

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 24 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. South Carolina Distribution

Carolina Bone & Joint Surgery Center — 7 of 24 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — South Carolina

Full comparison — all codes billed, vs. state median

24 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
27447	9	220	40	$1,090	$61.9K
27130	21	150	40	$1,060	$44.7K
28299	3	10	20	$1,330	$30.5K
25609	2	10	10	$1,640	$24.6K
64721	1	60	40	$400	$20.4K
29827	3	90	20	$880	$20.1K
29880	4	20	20	$710	$15.6K
29828	34	40	20	$710	$14.2K
29881	5	30	20	$620	$13.7K
28285	4	30	30	$350	$13.2K

Showing 1–10 of 24

Related Providers

Other providers that share a Tax Identification Number (TIN) with Carolina Bone & Joint Surgery Center, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
David Everman	SC	Orthopaedic Hand Surgery Physician	$167.4K	$0

Nearby Providers

Other providers in the same ZIP code as Carolina Bone & Joint Surgery Center, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Therapy Consortium Inc.	SC	Speech-Language Pathologist	$0	$18.9M
Little River Medical Center, Inc	SC	Federally Qualified Health Center (FQHC)	$0	$7.7M
Center Of Hope Of Myrtle Beach, LLC	SC	Substance Use Disorder Rehabilitation Clinic/Center	$258.9K	$5.6M
Conway Hospital Inc	SC	Pediatrics Physician	$0	$4.9M
Sawgrass Pediatric Dentistry, LLC	SC	Pediatric Dentistry	$0	$3.6M
Connections Pediatric Therapy	SC	Pediatric Occupational Therapist	$0	$2.9M
Coastal Carolina Oral Maxillofacial Surgery	SC	Oral and Maxillofacial Surgery (Dentist)	$0	$2M
Oceanic Counseling Group LLC	SC	Mental Health Counselor	$0	$1.6M
Michael Centilli	SC	Dermatology Physician	$925.1K	$7.5K
Scott Sauer	SC	Interventional Pain Medicine Physician	$650.6K	$0

Carolina Bone & Joint Surgery Center — Billing Profile & Reimbursement Data

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Carolina Bone & Joint Surgery Center — 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

Related Providers

Nearby Providers

Frequently Asked Questions

References