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NPI 1336149426 · Lone Tree, CO · Durable Medical Equipment & Medical Supplies
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Cochlear Americas is a durable medical equipment & medical supplies provider located in Lone Tree, Colorado. This profile covers 12 Medicare and 18 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 | Cochlear Americas |
| Address | 10350 Park Meadows Dr |
| City | Lone Tree |
| State | CO |
| ZIP | 80124 |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| NPI Enumerated | July 29, 2005 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $134.9M |
| Medicare | $27.4M |
COCHLEAR AMERICAS operates primarily as a supplier of cochlear implant external processors, replacement components, and related supplies: the dominant revenue drivers are device-replacement and accessory L-codes such as L8619 (cochlear implant external speech processor), L8691/L8694 (auditory osseointegrated device replacements), and battery/charger items. Medicare claims and Medicaid claims both concentrate on these product lines, indicating the organization functions more like a manufacturer/distributor of implant processors and consumable components than a broad DME generalist.
Revenue concentration is very high on a small set of codes for both payers: the top 3 Medicare codes account for 96.5% of Medicare revenue and the top 3 Medicaid codes account for 93.3% of Medicaid revenue. In particular, a single code L8619 makes up 85.5% of this provider's Medicare revenue and 71.2% of its Medicaid revenue, so most receipts are tied to replacement speech processors and integrated systems.
The provider’s payer mix is Medicaid-heavy in scale: total Medicaid revenue is $134.9M versus total Medicare revenue of $27.4M, so Medicaid constitutes the much larger revenue base for this entity. This profile suggests commercial/contracting attention should focus on state Medicaid reimbursement and channel access given the material concentration of dollars on Medicaid.
COCHLEAR AMERICAS demonstrates a dominant competitive position on its core cochlear implant lines within available peer datasets. For Medicare, L8619 ranks #1 of 4 providers nationally (100th percentile; typical, unremarkable volume), and L8691/L8694 also rank #1 nationally for their respective codes; for Medicaid, L8619, L8692, L8691 and multiple accessory codes all rank #1 of 1 providers in-state (0th percentile; no state peer volume comparison available), implying it is effectively the sole in-state supplier for many cochlear-specific codes.
The provider generates substantial recurring revenue from consumables and service work, which supports an aftermarket business model: battery L8624 appears with 5.5K Medicare claims ($735.5K Medicare revenue) and 18.4K Medicaid claims ($3.1M Medicaid revenue), and repair code L7510 has material Medicaid activity (6.4K claims, $1.3M). These volumes point to ongoing replacement and maintenance demand that supplements large device-replacement sales.
While multiple top codes are ranked #1, the supplied comparative labels indicate caution in interpretation: several Medicare and Medicaid top codes are described as "typical, unremarkable volume" even though the provider ranks first, and many in-state Medicaid ranks show "0th percentile; no state peer volume comparison available," so peer-comparison context is limited or shows the provider as the only reporter rather than indicating extreme outlier behavior. Analysts should treat percentile labels and single-provider state ranks as signaling limited peer data rather than definitive performance extremity.
The NPI has long tenure: enumerated 2005-07-29 (~21 years ago), which aligns with a sustained, established presence in the cochlear/DME market and supports the idea that current volumes reflect a mature supply channel rather than a new entrant spike. This longevity reinforces that the revenue concentration and code mix are stable operational characteristics rather than short-term anomalies.
From a risk and strategic perspective, the business is highly exposed to reimbursement, coverage, or supply changes for a narrow set of cochlear-related codes: because L8619 and the other top codes dominate revenue (top-3 shares of 96.5% Medicare and 93.3% Medicaid), any downward reimbursement pressure or competitive entry on those specific products could materially affect total revenue. Payers and network planners should therefore monitor policy changes for L8619/L869x codes and state Medicaid sourcing for cochlear processors.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
12 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| L8619 | Cochlear implant, external speech processor and controller, integrated system, replacement | 3,200 | $7,310 | $23.4M |
| L8691 | Auditory osseointegrated device, external sound processor, excludes transducer/actuator, replacement only, each | 1,280 | $1,530 | $2M |
| L8694 | Auditory osseointegrated device, transducer/actuator, replacement only, each | 1,270 | $820 | $1M |
| L8624 | Lithium ion battery for use with cochlear implant or auditory osseointegrated device speech processor, ear level, replacement, each | 5,490 | $130 | $735.5K |
| L9900 | Orthotic and prosthetic supply, accessory, and/or service component of another hcpcs "l" code | 1,360 | $80 | $101.7K |
| L8629 | Transmitting coil and cable, integrated, for use with cochlear implant device, replacement | 370 | $150 | $54.5K |
| L7520 | Repair prosthetic device, labor component, per 15 minutes | 860 | $30 | $23.1K |
| L8617 | Transmitting coil for use with cochlear implant device, replacement | 170 | $70 | $12.5K |
| L8628 | Cochlear implant, external controller component, replacement | 110 | $110 | $12.1K |
| L7510 | Repair of prosthetic device, repair or replace minor parts | 300 | $20 | $5.9K |
Showing 1–10 of 12
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 12 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
12 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| L8619 | 1 | 10 | 3,200 | $7,310 | $23.4M |
| L8691 | 1 | 10 | 1,280 | $1,530 | $2M |
| L8694 | 1 | 10 | 1,270 | $820 | $1M |
| L8624 | 1 | 10 | 5,490 | $130 | $733.9K |
| L9900 | 1 | 10 | 1,360 | $70 | $101.2K |
| L8629 | 1 | 10 | 370 | $150 | $54.4K |
| L7520 | 1 | 10 | 860 | $30 | $23.3K |
| L8617 | 1 | 10 | 170 | $70 | $12.5K |
| L8628 | 1 | 10 | 110 | $110 | $12.1K |
| L7510 | 1 | 10 | 300 | $20 | $6K |
Showing 1–10 of 12
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.
18 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| L8619 | Cochlear implant, external speech processor and controller, integrated system, replacement | 18,910 | $5,080 | $96.1M |
| L8692 | Auditory osseointegrated device, external sound processor, used without osseointegration, body worn, includes headband or other means of external attachment | 10,280 | $2,450 | $25.2M |
| L8691 | Auditory osseointegrated device, external sound processor, excludes transducer/actuator, replacement only, each | 3,680 | $1,250 | $4.6M |
| L8624 | Lithium ion battery for use with cochlear implant or auditory osseointegrated device speech processor, ear level, replacement, each | 18,400 | $170 | $3.1M |
| L8614 | Cochlear device, includes all internal and external components | 60 | $23,720 | $1.4M |
| L7510 | Repair of prosthetic device, repair or replace minor parts | 6,370 | $210 | $1.3M |
| L8694 | Auditory osseointegrated device, transducer/actuator, replacement only, each | 2,880 | $450 | $1.3M |
| L9900 | Orthotic and prosthetic supply, accessory, and/or service component of another hcpcs "l" code | 13,750 | $40 | $508.9K |
| E1399 | Durable medical equipment, miscellaneous | 1,500 | $330 | $500.8K |
| L8499 | Unlisted procedure for miscellaneous prosthetic services | 3,070 | $120 | $361.7K |
Showing 1–10 of 18
How this provider's Medicaid billing volume and revenue compare to other Colorado providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Colorado median
18 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| L8619 | Cochlear implant, external speech processor and controller, integrated system, replacement | 1 | 10 | 18,910 | $5,080 | $96.1M |
| L8692 | Auditory osseointegrated device, external sound processor, used without osseointegration, body worn, includes headband or other means of external attachment | 1 | 10 | 10,280 | $2,450 | $25.2M |
| L8691 | Auditory osseointegrated device, external sound processor, excludes transducer/actuator, replacement only, each | 1 | 10 | 3,680 | $1,250 | $4.6M |
| L8624 | Lithium ion battery for use with cochlear implant or auditory osseointegrated device speech processor, ear level, replacement, each | 1 | 10 | 18,400 | $170 | $3.1M |
| L8614 | Cochlear device, includes all internal and external components | 1 | 10 | 60 | $23,720 | $1.4M |
| L7510 | Repair of prosthetic device, repair or replace minor parts | 1 | 10 | 6,370 | $210 | $1.3M |
| L8694 | Auditory osseointegrated device, transducer/actuator, replacement only, each | 1 | 10 | 2,880 | $450 | $1.3M |
| L9900 | Orthotic and prosthetic supply, accessory, and/or service component of another hcpcs "l" code | 1 | 10 | 13,750 | $40 | $514.8K |
| L8499 | Unlisted procedure for miscellaneous prosthetic services | 1 | 10 | 3,070 | $120 | $361.6K |
| L8629 | Transmitting coil and cable, integrated, for use with cochlear implant device, replacement | 1 | 10 | 1,360 | $130 | $180.2K |
Showing 1–10 of 18
Other providers in the same ZIP code as Cochlear Americas, ranked by combined Medicare and Medicaid revenue.
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