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

Why is the Medicaid comparison limited to Washington 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. Washington (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.

Proliance Surgery Center At Valley, LLC (NPI 1356965750)

Field	Value
Entity Type	Organization
Organization	Proliance Surgery Center At Valley, LLC
Address	4009 Talbot Road S
City	Renton
State	WA
ZIP	98055
Taxonomy	Ambulatory Surgical Clinic/Center
NPI Enumerated	June 1, 2020

Payer Source	Total Paid
Medicare	$3.3M
Medicaid	$0

Key Findings

PROLIANCE SURGERY CENTER AT VALLEY reports $3.3M in total Medicare revenue and has no Medicaid billing on file, making its public payer footprint effectively single-payer (Medicare-only) at the claims level. The absence of any Medicaid activity suggests the center’s revenue exposure and contracting relationships are concentrated on Medicare patients and payers, rather than a mixed Medicare/Medicaid caseload.

Revenue is highly concentrated in a small set of high-value procedures: the precomputed top 3 Medicare codes account for 66.6% of the provider’s total Medicare revenue. Those top three codes are 27447 ($1.1M, 32.8% of Medicare revenue, 139 claims), 27130 ($738.9K, 22.3% of Medicare revenue, 92 claims), and 63685 ($378.5K, 11.4% of Medicare revenue, 18 claims), indicating a heavy dependence on arthroplasty and select spine/neurostimulation services.

The code mix strongly indicates an orthopedic- and spine-focused ambulatory surgical practice: high-revenue joint replacements (27447, 27130) and spine/neurostimulation procedures (63685, 63650, 22551) dominate billed services. Supporting evidence includes 27447 (knee arthroplasty) at $1.1M and 139 claims and 27130 (hip arthroplasty) at $738.9K and 92 claims, alongside cervical fusion 22551 and neuromodulation codes, which together suggest the center operates as an ASC specializing in major joint and selected spine procedures.

For its highest-revenue arthroplasty services the center ranks well above peers nationally: 27447 ranks #333 of 12089 providers nationally (97th percentile) and is described as "notably above typical national volume for this code," while 27130 ranks #294 of 8062 providers nationally (96th percentile) and is also "notably above typical national volume for this code." These rankings characterize the center as a major national-volume participant for primary knee and hip replacement among Medicare-billing providers rather than a modest or occasional provider for those services.

By contrast, its spine/neurostimulation volumes are typical rather than exceptional: 63685 (spinal neurostimulator pulse generator) ranks #534 of 1281 (54th percentile; typical, unremarkable volume) and 63650 (epidural electrode placement) ranks #343 of 1371 (74th percentile; typical, unremarkable volume). This pattern indicates the center generates meaningful Medicare revenue from neuromodulation (63685 $378.5K) but does not stand out nationally as an outlier for those specific spine services.

There is a distinct pattern of high-volume, low-dollar ancillary procedures that supplement surgical revenue: 64483 shows 283 claims at $341 avg paid/claim for $96.5K in revenue and ranks #628 of 8202 providers nationally (92th percentile; typical, unremarkable volume). The high claim count but modest revenue share indicates a steady throughput of image-guided injections or peri-procedural pain-management services that likely support the surgical case mix.

The provider’s NPI was enumerated 2020-06-01 (~6 years ago), indicating it is a relatively recent entrant to the Medicare billing landscape but has achieved substantial volume in major arthroplasty codes in a short time. That tenure combined with high national percentiles for 27447 and 27130 suggests rapid development or alignment with referral pathways for joint replacement within the region.

Operational and payer-mix implications follow from the findings: with $3.3M concentrated in Medicare and no Medicaid billing on file, the center’s financial performance and negotiation leverage will be closely tied to Medicare reimbursement trends for high-value arthroplasty codes and any policy changes affecting outpatient joint replacement reimbursement. Analysts and network managers should treat this facility as a Medicare-focused, orthopedic/spine ASC with concentrated revenue drivers rather than a broad-based mixed-payer outpatient provider.

Medicare: Complete Services Breakdown

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

28 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…	140	$7,800	$1.1M
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…	90	$8,030	$738.9K
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	$21,030	$378.5K
63650	In this procedure, the provider places electrodes in the epidural space to relieve pain and reduce or eliminate spasms.	70	$4,130	$280.8K
22551	A cervical disc is removed through the front of the neck to help ease spinal pain and related symptoms. Fusion is performed to stabilize the vertebrae.	20	$7,770	$163.2K
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).	280	$340	$96.5K
27446	In this procedure, the provider reconstructs the diseased or damaged medial or lateral compartment of the knee along with the femoral condyles and tibial plateaus to relieve pain and improve the…	10	$7,830	$86.1K
63047	The provider performs a laminectomy (excision of the thin bony plate at the back of a vertebra), facetectomy (excision of an area of a vertebra characterized by its smooth surface), and foraminotomy…	30	$2,650	$71.5K
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…	100	$700	$67.7K
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	$3,500	$59.6K

Showing 1–10 of 28

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 28 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Washington Distribution

Proliance Surgery Center At Valley, LLC — 3 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Washington

Full comparison — all codes billed, vs. state median

28 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
63685	11	30	20	$8,250	$148.4K
63650	10	40	50	$1,960	$109.9K
27447	6	320	30	$1,190	$46.3K
27446	15	20	20	$2,200	$44K
27130	3	230	30	$1,060	$37.1K
22551	4	30	10	$1,900	$30.4K
29827	83	90	20	$1,130	$26.1K
63030	9	10	10	$1,250	$21.3K
23430	14	30	20	$920	$20.2K
G0260	14	20	60	$230	$19.8K

Showing 1–10 of 28

Nearby Providers

Other providers in the same ZIP code as Proliance Surgery Center At Valley, LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Public Hospital District 1 Of King County	WA	General Acute Care Hospital	$0	$120.6M
Valley Medical Group-renton	WA	General Acute Care Hospital	$0	$28.3M
Associated Emergency Room Physicians, Inc P.s.	WA	Emergency Medicine Physician	$0	$12M
Retina Institute, PLLC	WA	Retina Specialist (Ophthalmology) Physician	$0	$5.5M
Valley Children's Clinic	WA	Pediatric Adolescent Medicine Physician	$0	$5.2M
Vantage Radiology & Diagnostic Services, A Professional Services Corp	WA	Diagnostic Radiology Physician	$0	$2.6M
George Ko	WA	Retina Specialist (Ophthalmology) Physician	$1.7M	$0
Kenneth Fung	WA	Ophthalmology Physician	$1.6M	$0
Renton Regional Fire Authority	WA	Land Ambulance	$229.9K	$186.7K
Craig Fujisaki	WA	Dermatology Physician	$376.9K	$0

Proliance Surgery Center At Valley, LLC — Billing Profile & Reimbursement Data

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Proliance Surgery Center At Valley, LLC — 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

Nearby Providers

Frequently Asked Questions

References