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NPI 1346403854 · Atlanta, GA · Ambulatory Surgical Clinic/Center
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The Emory Clinic Inc is a ambulatory surgical clinic/center provider located in Atlanta, Georgia. This profile covers 25 Medicare and 345 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 | The Emory Clinic Inc |
| Address | 21 Ortho Ln |
| City | Atlanta |
| State | GA |
| ZIP | 30329 |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| NPI Enumerated | July 3, 2008 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $26.6M |
| Medicare | $1.4M |
The provider’s Medicare billing is concentrated in interventional pain and neuromodulation procedures: 64555, 64483, and 64493 are the largest Medicare revenue drivers, and the top three Medicare codes together account for 48.2% of this provider's total Medicare revenue. Individual Medicare claims show high per-claim payments for device implantation and radiofrequency/neurolytic procedures, indicating a significant clinical focus on pain-management interventions and spinal procedures within the ambulatory surgical clinic taxonomy.
Medicare competitive standing is elevated for multiple pain-intervention codes: 64483 and 64493 are described as "extreme outlier, far above typical national volume" and 64635 is also flagged as an "extreme outlier, far above typical national volume," while 64555 sits at a typical volume (83th percentile). These national rankings indicate THE EMORY CLINIC INC performs pain-interventional services at volumes well above most peers nationally, suggesting regional leadership in these specific service lines.
Although Medicare totals $1.4M, Medicaid dominates this provider’s lifetime revenue at $26.6M, so the organization is effectively Medicaid‑weighted in scale. This payer mix implies that financial performance and operational footprint are driven primarily by Medicaid service volumes rather than Medicare.
Medicaid billing is heavily concentrated in evaluation/management and hospital/ED care: 99214, 99233 and 99284 are the top three Medicaid codes and — per the precomputed figure — the top three Medicaid codes together account for 40.4% of the provider's total Medicaid revenue. The raw Medicaid volumes for those codes (e.g., 99214 with $3.6M and 99233 with $2.8M) point to large outpatient and inpatient E/M throughput that likely supports broad ambulatory and hospital-based care operations.
State-level competitive standing on Medicaid is dominant across many core services: the provider ranks at or near #1 in-state for multiple high-volume codes (for example 71045, 71046, 93306, 93010 and 01967 are each listed as #1 in-state and labeled "extreme outlier" or equivalent). These in-state rankings indicate THE EMORY CLINIC INC is a major provider of imaging, echocardiography, radiography, and obstetric anesthesia services within Georgia’s Medicaid population.
The Medicaid code mix also shows substantial ancillary and specialty services beyond E/M — high revenue items include J0475 (baclofen injections), 93306 (echocardiography), 76819 (biophysical profile), 90960 (ESRD monthly management), and pathology codes 88307/88305. Together these suggest the organization operates a broad multispecialty platform with integrated imaging, procedural, obstetric, renal, and pathology capabilities that capture large Medicaid volumes across outpatient and inpatient settings.
Tenure and presence: the NPI was enumerated on 2008-07-03 (~18 years ago), signaling an established provider with a long operational history that aligns with the breadth of high-volume services reported across both payers. Longevity combined with high in-state ranks supports interpretation of a mature clinical operation rather than a recent entrant.
While many Medicare procedure codes are extreme outliers for volume, several listed Medicare codes (for example 23430, 64721, 29828) are described as having typical or unremarkable volumes compared with national peers. This mixed profile suggests the provider’s exceptional national standing is concentrated in specific interventional-pain and spinal procedure lines rather than uniformly across all surgical or orthopedic services.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
25 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 64555 | A neurostimulator includes electrodes which are inserted under the skin and induced by a generator to stimulate the nerve tissue. Use of this stimulator involves implantation of electrodes around a… | 60 | $4,260 | $247K |
| 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). | 840 | $290 | $243.6K |
| 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… | 630 | $270 | $166.8K |
| 64635 | Under fluoroscopic or CT guidance, the provider applies an agent to a lower back joint to destroy nerve tissue. | 320 | $510 | $165.2K |
| 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… | 50 | $1,680 | $87.5K |
| 23430 | In this procedure, the provider surgically cleans the long tendon of the biceps from its damaged fragment and fixes the tendon to the upper end of the humerus to improve the stability of the joint.… | 20 | $3,020 | $63.5K |
| 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… | 70 | $620 | $41K |
| 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 | $2,250 | $40.5K |
| 22513 | The provider performs a percutaneous vertebral augmentation of the thoracic spine, such as kyphoplasty, a surgical procedure that treats compression fractures of the spine. He also may perform a… | 20 | $2,380 | $40.5K |
| 64490 | The provider injects a diagnostic or therapeutic substance into a single cervical or thoracic paravertebral facet (zygapophyseal) joint, or into the nerves that supply that joint, using imaging… | 140 | $280 | $40.3K |
Showing 1–10 of 25
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 25 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
25 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| 64555 | 1 | 10 | 30 | $3,430 | $123.4K |
| 64635 | 7 | 270 | 50 | $380 | $27.7K |
| 22514 | 8 | 10 | 20 | $1,270 | $25.4K |
| 64483 | 4 | 360 | 70 | $200 | $23.7K |
| G0260 | 56 | 90 | 70 | $200 | $23.2K |
| 22513 | 5 | 10 | 20 | $1,250 | $22.5K |
| 29827 | 3 | 110 | 20 | $1,100 | $22.1K |
| 29828 | 10 | 30 | 20 | $1,110 | $21.1K |
| 64493 | 2 | 320 | 60 | $190 | $16.8K |
| 29848 | 44 | 50 | 30 | $380 | $16.1K |
Showing 1–10 of 25
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.
345 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 99214 | The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the… | 86,700 | $40 | $3.6M |
| 99233 | The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the… | 76,840 | $40 | $2.8M |
| 99284 | The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making. | 28,840 | $60 | $1.8M |
| 99213 | The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the… | 29,510 | $30 | $914.9K |
| 99285 | The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making. | 9,350 | $90 | $869.5K |
| J0475 | Injection, baclofen, 10 mg | 1,210 | $690 | $839K |
| 71045 | In this diagnostic procedure, the provider performs a single radiological view of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and nearby… | 157,900 | $10 | $789.5K |
| 93306 | The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent… | 22,550 | $30 | $676.6K |
| 99203 | The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the provider… | 9,730 | $70 | $642.2K |
| 99215 | The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the… | 9,770 | $60 | $615.6K |
Showing 1–10 of 345
How this provider's Medicaid billing volume and revenue compare to other Georgia providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Georgia median
345 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 99285 | The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making. | 22 | 140 | 200 | $280 | $1.9M |
| 72197 | In this diagnostic procedure, the provider performs magnetic resonance imaging (MRI) of the pelvis first without using contrast and again after injecting contrast material. | 3 | 10 | 290 | $1,900 | $1.2M |
| D7240 | N/A | 4 | 10 | 580 | $240 | $1M |
| 99284 | The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making. | 18 | 230 | 120 | $170 | $937.5K |
| 70553 | In this procedure, the provider performs a magnetic resonance imaging, or MRI, study of the brain including the brain stem. He performs this procedure without using contrast material. He then follows… | 2 | 20 | 310 | $900 | $893.2K |
| 70551 | The provider uses magnetic resonance imaging, or MRI, to examine the brain and brain stem. The provider does not administer contrast for this exam. | 12 | 30 | 550 | $540 | $834.8K |
| J0586 | Injection, abobotulinumtoxina, 5 units | 4 | 10 | 860 | $960 | $818.4K |
| 99283 | The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making. | 44 | 240 | 170 | $120 | $779.3K |
| 74183 | The provider performs magnetic resonance imaging of the structures and organs of the abdomen, initially without control and then with additional sequences after injection of contrast. | 1 | 10 | 460 | $950 | $722.3K |
| 93303 | The provider performs a complete transthoracic echocardiography to obtain images of the heart structures through the chest wall in patients born with heart defects. This study includes visualization… | 5 | 10 | 250 | $130 | $636K |
Showing 1–10 of 345
Other providers in the same ZIP code as The Emory Clinic Inc, ranked by combined Medicare and Medicaid revenue.
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