Loading...
NPI 1336180173 · Carmel, IN · Ambulatory Surgical Clinic/Center
Customize your policy alerts
Get alerted when relevant policies change without checking for updates manually.
Monitor payer policy activity
Beltway Surgery Centers LLC is a ambulatory surgical clinic/center provider located in Carmel, Indiana. This profile covers 44 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 | Beltway Surgery Centers LLC |
| Address | 151 Pennsylvania Pkwy |
| City | Carmel |
| State | IN |
| ZIP | 46280 |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| NPI Enumerated | June 10, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $1.7M |
| Medicaid | $0 |
This entity reports total Medicare revenue of $1.7M and total Medicaid revenue of $0, making it effectively a single‑payer operation in the public programs on file. The absence of Medicaid billing suggests limited exposure to the Medicaid population and that Medicare payment policy and utilization trends will disproportionately affect this provider’s public‑payer revenue profile.
Revenue is concentrated in a small set of procedures: the precomputed top 3 Medicare codes account for 42.6% of Medicare revenue, led by 63685 ($325.8K, 21.3%), followed by 15823 ($166.8K, 10.9%) and 27447 ($159K, 10.4%). This concentration indicates that a handful of high‑revenue procedures drive a large share of the center’s Medicare receipts and creates sensitivity to changes in reimbursement or referral patterns for those services.
The code mix and high volumes point to a strong ophthalmic/oculoplastic and retina service line: 15823 (327 claims, $166.8K) ranks #13 of 1718 (99th percentile) and is flagged as an "extreme outlier, far above typical national volume," while 67917 (120 claims, $63.6K) ranks #9 of 596 (99th percentile; "extreme outlier, far above typical national volume"). Multiple retina and eyelid codes including 67042 (89 claims, $135.5K; #34 of 1087, 97th percentile; "notably above typical national volume") and 67108 (48 claims, $72.7K; #39 of 706, 94th percentile; "notably above typical national volume") further support the interpretation that the center functions as a high‑volume ambulatory hub for ophthalmic surgery.
At the same time the center bills notable spine and orthopedic procedures but at more typical volumes: 63685 (spinal neurostimulator pulse generator) is the single largest Medicare revenue source at $325.8K but ranks #590 of 1281 (48th percentile; "typical, unremarkable volume"), and 27447 (knee joint resurfacing) accounts for $159K and ranks #8050 of 12089 (31st percentile; "typical, unremarkable volume"). These patterns suggest that while spine and orthopedics are present in the portfolio, they do not show the same competitive outlier status as the ophthalmic services.
Competitive standing is therefore mixed: the provider is a major national outlier on specific ophthalmic/eyelid and retina codes (e.g., 15823 and 67917 labeled "extreme outlier, far above typical national volume," and several other eye codes at the 90th+ percentiles), but for its largest single revenue code 63685 and for 27447 it is a modest or typical participant nationally. For payers and analysts, this implies careful scrutiny of the ophthalmology referral network and capacity, while spine/ortho exposure looks operationally present but not dominant.
The NPI was enumerated on 2006-06-10 (~20 years ago), indicating the provider has an established, long‑tenured presence in the market. That tenure, combined with concentrated Medicare revenue ($1.7M) and strong ophthalmic volumes, is consistent with an established ambulatory surgical center that has built sustained referral relationships in select surgical specialties.
The large count and revenue for select eyelid codes further underline service specialization: 15823 has 327 claims, 67904 has 136 claims, 67917 has 120 claims, and 67924 has 60 claims, each contributing materially to Medicare revenue and many ranking at or near the national top percentiles (several at the 94th–99th percentiles). This pattern reinforces that oculoplastic procedures are a core operational focus and a key driver of the center’s Medicare performance.
Given that the top 3 Medicare codes account for 42.6% of Medicare revenue and Medicaid is $0, the provider faces concentrated financial exposure: changes in utilization, referral relationships, or Medicare reimbursement for those few high‑impact codes could materially affect overall revenue. Analysts should prioritize monitoring reimbursement trends and referral stability for 63685, 15823, and 27447 when assessing financial risk and contracting strategy.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
44 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 63685 | The provider inserts or replaces a spinal neurostimulator pulse generator or receiver. The system is one that requires surgical creation of a pocket for placement and that requires a connection… | 20 | $19,170 | $325.8K |
| 15823 | In this procedure, the provider surgically trims excessive skin that weighs down the upper eyelid, typically to improve the cosmetic appearance of the face and due to the interference of the tissue… | 330 | $510 | $166.8K |
| 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… | 20 | $7,230 | $159K |
| 67042 | In this procedure, the provider removes vitreous humor, the gelatinous material that gives shape to the eye, using a mechanical cutting tool. He removes the internal limiting membrane of the retina… | 90 | $1,520 | $135.5K |
| 63650 | In this procedure, the provider places electrodes in the epidural space to relieve pain and reduce or eliminate spasms. | 20 | $3,790 | $87.2K |
| 0275T | N/A | 20 | $3,740 | $85.9K |
| 67108 | The provider repairs a detached retina using heat produced by a laser beam or by freezing the tissues. He may attach a scleral buckle to simplify the passage of fluid through and behind the retina or… | 50 | $1,510 | $72.7K |
| 67904 | The provider repairs a drooping eyelid by tightening the levator muscle that controls eyelid movement to improve cosmetic appearance or remove the obstruction to a patient’s vision. He accesses the… | 140 | $530 | $72.6K |
| 67917 | During this procedure, the provider performs an extensive repair of an ectropion, which is an outward turning of the lower eyelid and eyelashes, which can lead to excessive tearing and irritation of… | 120 | $530 | $63.6K |
| 67924 | During this procedure, the provider performs an extensive repair of an entropion, which is an inward turning of the lower eyelid and eyelashes toward the eye, which can lead to excessive tearing and… | 60 | $630 | $37.6K |
Showing 1–10 of 44
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 44 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
44 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| 63685 | 22 | 50 | 20 | $8,700 | $174.1K |
| 63650 | 47 | 50 | 50 | $1,870 | $110.5K |
| 0275T | 6 | 20 | 20 | $2,530 | $55.6K |
| 27447 | 254 | 340 | 40 | $1,130 | $51.1K |
| 67042 | 2 | 20 | 20 | $1,310 | $47K |
| 67113 | 2 | 10 | 20 | $1,400 | $44.8K |
| 67904 | 3 | 20 | 50 | $560 | $37.8K |
| 67036 | 12 | 10 | 30 | $1,040 | $37.4K |
| 67039 | 4 | 10 | 20 | $1,280 | $34.5K |
| 67108 | 3 | 20 | 20 | $1,150 | $32.2K |
Showing 1–10 of 44
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 |
|---|---|---|---|---|
| G8907 | Patient documented not to have experienced any of the following events: a burn prior to discharge; a fall within the facility; wrong site/side/patient/procedure/implant event; or a hospital transfer… | 10 | $0 | $0 |
How this provider's Medicaid billing volume and revenue compare to other Indiana providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Indiana median
1 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| G8907 | Patient documented not to have experienced any of the following events: a burn prior to discharge; a fall within the facility; wrong site/side/patient/procedure/implant event; or a hospital transfer… | 62 | 70 | 320 | $0 | $0 |
Other providers in the same ZIP code as Beltway Surgery Centers LLC, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Blair Boehmer | IN | Ophthalmology Physician | $1.3M | $0 |
| Jerwana Laster | IN | Primary Podiatric Medicine Podiatrist | $276.3K | $1.1K |
| Brian Paquette | IN | Neurology Physician | $262.6K | $0 |
| Hui Bae Lee | IN | Ophthalmic Plastic and Reconstructive Surgery Physician | $193.5K | $0 |
| Dmitry Arbuck | IN | Specialist | $175.6K | $0 |
| Donald Hulsey | IN | Optometrist | $100.8K | $0 |
| Amber Fleming | IN | Rehabilitation Psychologist | $53.1K | $0 |
| Lauren Baker | IN | Endocrinology, Diabetes & Metabolism Physician | $51.6K | $0 |
| Russell Swann | IN | Orthopaedic Surgery Physician | $38.7K | $0 |
| Monica Schrader | IN | Physical Therapist | $38.1K | $0 |
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.