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    OpenPayerNPI Medicare & MedicaidProliance Surgeons Inc Ps
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    Proliance Surgeons Inc Ps — Billing Profile & Reimbursement Data

    NPI 1326094491 · Seattle, WA · Ambulatory Surgical Clinic/Center

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    Proliance Surgeons Inc Ps is a ambulatory surgical clinic/center provider located in Seattle, Washington. This profile covers 9 Medicare and 0 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

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    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeOrganization
    OrganizationProliance Surgeons Inc Ps
    Address515 Minor Ave Ste 130
    CitySeattle
    StateWA
    ZIP98104
    TaxonomyAmbulatory Surgical Clinic/Center
    NPI EnumeratedMay 26, 2006

    Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)

    Payer SourceTotal Paid
    Medicare$1.4M
    Medicaid$0

    Key Findings

    PROLIANCE SURGEONS INC PS is an ambulatory surgical clinic/center in SEATTLE, WA with an NPI enumerated 2006-05-26 (~20 years ago). Its lifetime Medicare revenue on file is $1.4M and there is no Medicaid billing on file, making Medicare the effectively exclusive payer represented in this dataset.

    Revenue is highly concentrated: the precomputed top three Medicare codes (69930, 64582, 31267) account for 92.4% of this provider’s total Medicare revenue. Specifically, 69930 generated $793.9K (55.8% of Medicare revenue), 64582 generated $492.8K (34.6%), and 31267 generated $29.5K (2.1%).

    The code mix indicates a specialized otolaryngology practice with a strong focus on implantable device procedures. High-revenue procedures include cochlear implantation (69930) and hypoglossal nerve neurostimulator implantation (64582), while additional sinus and turbinate codes (31267, 30140, 31253) show concurrent rhinology/airway surgery capability rather than a purely diagnostic clinic.

    For cochlear implantation (69930) the provider ranks #14 of 176 nationally and sits in the 91th percentile, described as notably above typical national volume for this code; this positions the clinic as a high-volume national participant for that specific implant service.

    For hypoglossal nerve neurostimulator implantation (64582) the provider ranks #40 of 190 nationally and is in the 76th percentile with a characterization of typical, unremarkable volume; this suggests a moderate national presence in sleep apnea implant procedures but not a dominant share.

    Several lower-revenue ENT procedures are present and reinforce a broad procedural scope: 30140 (62 claims, $28.3K) is reported as typical, unremarkable volume, while 30520 (34 claims, $21.3K) is at the 94th percentile and described as notably above typical national volume, indicating above-average activity in septoplasty within the peer set.

    The provider has no Medicaid billing on file (“none below”), so its documented patient/payer mix in this dataset is effectively single-payer Medicare. That concentration exposes the practice’s revenue profile to Medicare policy and reimbursement changes and suggests limited engagement with Medicaid-covered populations in this data extract.

    Clinical and business implications of the concentration are clear: device-based implant procedures (69930 and 64582) drive the majority of revenue, creating both margin and volume sensitivity to device adoption, referrals, and coding/payer policies. The mix of high-volume implant work alongside routine rhinology and airway surgeries points to a hybrid model—specialized implant programs supported by a base of general ENT procedures—which could be an opportunity to diversify payer relationships or expand non-implant service lines to mitigate concentration risk.

    Medicare: Total Revenue Breakdown by CPT/HCPCS Code

    Medicare revenue breakdown by CPT/HCPCS procedure code.

    View: Bar Chart1 / 2

    Medicare: Complete Services Breakdown

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

    9 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    69930The external parts include microphone, speech processor, and a transmitter. The implant is surgically placed under the skin behind the ear. The internal parts are a receiver and stimulator which are…30$25,610$793.9K
    64582The provider uses an open approach to implant a hypoglossal nerve neurostimulator electrode array and also implants a programmable pulse generator and one or more distal respiratory sensor…20$21,420$492.8K
    31267In this procedure, the provider inserts an endoscope into the nasal cavity. She then gains access to the maxillary sinus through a cut in the uncinate process. The provider opens the maxillary sinus…30$1,020$29.5K
    30140This CPT code is for a submucous resection of the inferior turbinate (partial or complete by any method).60$460$28.3K
    42870During this procedure, the provider removes or destroys the lingual tonsils located on the dorsal surface of the base of the tongue. When enlarged, the tonsils can restrict the airway passage.10$2,170$28.2K
    30520Septoplasty is most often performed for a deviated septum which can be either C–shaped, S–shaped, or a cartilaginous deviation.30$630$21.3K
    31253The provider performs a complete excision of the ethmoid air cells (anterior and posterior) with exploration of the frontal sinus; he may or may not remove tissue from frontal sinus. The procedure is…20$1,060$21.3K
    31525The provider uses a laryngoscope to look directly inside the larynx, which is the voice box, to detect any abnormality. He may or may not perform tracheoscopy to visualize the trachea, which is the…20$330$7.5K
    42975After the patient receives sedation and is asleep, the provider uses an endoscope to assess the throat and check the palate and tongue areas. The goal is to determine where airway obstruction is…20$40$920

    Medicare: Competitive Analysis & Benchmarks

    How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 9 CPT/HCPCS codes.

    View: State1 / 2

    Full comparison — all codes billed, vs. state median

    9 rows

    CPT/HCPCS CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    6993021020$9,270$213.2K
    6458221020$5,970$131.3K
    4287011010$1,220$15.8K
    3014022030$390$14.1K
    3126722020$680$13.5K
    3125311020$720$11.5K
    3052012020$520$10.9K
    3152521020$200$4.8K
    4297531020$50$1.2K

    Related Providers

    Other providers that share a Tax Identification Number (TIN) with Proliance Surgeons Inc Ps, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Proliance Surgeons Inc P SWAAmbulatory Surgical Clinic/Center$2.4M$680
    Proliance Surgeons, Inc., P.s.WAAmbulatory Surgical Clinic/Center$1.7M$0
    Proliance Surgeons, Inc., P.s.WAAmbulatory Surgical Clinic/Center$1.3M$0
    Proliance Surgeons, Inc., P.s.WAAmbulatory Surgical Clinic/Center$1.1M$24.2K
    The Retina Surgery Center LLCWAAmbulatory Surgical Clinic/Center$1.1M$0
    Proliance Surgeons Inc P SWAAmbulatory Surgical Clinic/Center$830.4K$0
    Proliance Surgeons Inc P SWAAmbulatory Surgical Clinic/Center$793.8K$0
    Proliance Surgeons Inc P SWAAmbulatory Surgical Clinic/Center$617.8K$0
    Stacia SmithWAOrthopaedic Surgery Physician$324.7K$0
    Timothy AltonWAOrthopaedic Surgery Physician$313.4K$0

    Nearby Providers

    Other providers in the same ZIP code as Proliance Surgeons Inc Ps, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Harborview Medical CenterWAGeneral Acute Care Hospital$0$128.2M
    Seattle-king County Dept Of Public HealthWACase Manager/Care Coordinator$0$74M
    The Association Of University PhysiciansWAAnesthesiology Physician$0$66.3M
    Seattle-king County Dept Of Public HealthWADental Clinic/Center$0$62.9M
    BloodworksWACommunity/Retail Pharmacy$0$56.8M
    Swedish Health ServicesWAInternal Medicine Physician$0$21.1M
    International Community Health ServicesWADentist$0$16M
    Swedish Health ServicesWAFamily Medicine Physician$0$11.1M
    Northwest Kidney CentersWAEnd-Stage Renal Disease (ESRD) Treatment Clinic/Center$0$7.2M
    King County FinanceWAState or Local Public Health Clinic/Center$0$5.7M

    Frequently Asked Questions

    References

    1. 1.Medicare Physician & Other Practitioner by Provider and Service. CMS.gov.Provider-level Medicare Part B utilization and payment data.
    2. 2.NPPES NPI Registry. CMS.gov.National Provider Identifier registry used for provider enumeration and taxonomy metadata.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

    Medicare Revenue by CPT/HCPCS Code
    Claims Volume vs. Washington Distribution
    Proliance Surgeons Inc Ps — 1 of 9 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Washington