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

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

Macon Outpatient Surgery, LLC (NPI 1386652667)

Key Findings

Field	Value
Entity Type	Organization
Organization	Macon Outpatient Surgery, LLC
Address	3708 Northside Dr
City	Macon
State	GA
ZIP	31210
Taxonomy	Ambulatory Surgical Clinic/Center
NPI Enumerated	August 3, 2006

Payer Source	Total Paid
Medicare	$2.2M
Medicaid	$0

This entity reports $2.2M in total Medicare revenue and has no Medicaid billing on file, so its publicly visible payer activity is effectively single-payer Medicare in scale. The absence of any Medicaid claims suggests the provider’s billed population or contracting footprint does not include Medicaid, or that Medicaid services are routed elsewhere.

Revenue is highly concentrated: the precomputed top three Medicare codes account for 67.8% of this provider’s Medicare revenue. Those codes are 27447 ($914.5K, 42.0%), 63685 ($364.7K, 16.8%), and 27130 ($197.3K, 9.1%), indicating that a small set of procedures drives most billings.

The code mix points to a surgical practice focused on major orthopedic joint replacement and neuromodulation services rather than general outpatient procedures. High-revenue codes 27447 (knee arthroplasty) and 27130 (hip arthroplasty) combined with spinal neurostimulator implantation (63685) suggest the operation performs implant-heavy, procedure-based services consistent with an Ambulatory Surgical Clinic/Center taxonomy.

Several specific CPTs show statistically notable national standing: 27447 ranks #353 of 12089 providers nationally (97th percentile) and is described as notably above typical national volume, making the provider a major national-volume participant for knee arthroplasty. Similarly, 29848 ranks #22 of 1333 (98th percentile) and 64718 ranks #12 of 739 (99th percentile), labeled respectively as notably above typical national volume and an extreme outlier, which together indicate unusually high volumes in selected upper-extremity and nerve-decompression procedures.

By contrast, the other top revenue drivers show typical or unremarkable volume compared with peers: 63685 ranks #458 of 1281 (61th percentile) and 27130 ranks #3396 of 8062 (56th percentile), both characterized as typical, unremarkable volumes. This mix means the provider is a dominant outlier for a few specific procedures while otherwise operating at modal volumes for other major implant codes.

The economics reflect dependence on a few high-cost, implant or device-driven services: average paid/claim for 63685 is $18236 and for 27447 is $6675, indicating that a small number of device-intensive procedures materially shape revenue. Operationally, that concentration can make total revenue sensitive to reimbursement or utilization changes for those specific high-cost codes.

Several other high-percentile codes point to a broader surgical scope beyond large joint arthroplasty: 26055 (121 claims, $449 avg paid/claim, ranks in the 97th percentile) and 29848 (141 claims, $436 avg paid/claim, 98th percentile) show notable volumes in hand and wrist procedures, suggesting the practice captures substantial upper-extremity surgical volume in addition to hip/knee and spinal services.

The provider has an established operational history, with its NPI enumerated on 2006-08-03 (~20 years ago), which supports interpretation of the observed billing profile as a stable, long-standing pattern rather than a short-term anomaly. Analysts should treat the combination of long tenure and concentrated, high-volume procedure lines as key context when evaluating competitive positioning or contracting discussions.

Medicare: Complete Services Breakdown

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

29 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	$6,680	$914.5K
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	$18,240	$364.7K
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…	30	$6,800	$197.3K
63655	In this procedure, the provider removes a portion of the vertebra called the lamina and places a permanent plate/paddle electrode in the epidural space, or area between the dura membrane and the wall…	10	$13,240	$158.9K
63650	In this procedure, the provider places electrodes in the epidural space to relieve pain and reduce or eliminate spasms.	20	$3,620	$68.9K
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…	30	$1,930	$63.5K
29848	The provider inserts an endoscope into the wrist joint to divide the transverse carpal ligament and reduce compression on the median nerve in the carpal tunnel that results in pain and numbness.	140	$440	$61.5K
26055	Trigger finger, or stenosing tenosynovitis, is when a finger remains in a bent position. It is painful to open or close the finger. A swollen tendon or formation of knots or nodules in the tendon may…	120	$450	$54.3K
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).	150	$310	$45.6K
62323	The provider injects a diagnostic or a therapeutic substance, such as pain medication or a steroid, into the space around the spinal nerves of the lumbar (lower back) or sacral (caudal, or tailbone)…	140	$240	$32.4K

Showing 1–10 of 29

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Primary Pediatrics, PC	GA	Specialist	$0	$32.9M
Cogent Healthcare Of Georgia PC	GA	Internal Medicine Physician	$0	$4.6M
Bradley Sumrall	GA	Medical Oncology Physician	$3.1M	$0
Harry Moore	GA	Medical Oncology Physician	$2.9M	$0
Tara Adams	GA	Nurse Practitioner	$2.9M	$0
Georgia Em-i Medical Services PC	GA	Physician Assistant	$0	$1.9M
Steven Allee	GA	Ophthalmology Physician	$1.7M	$0
Norman Nelson	GA	Ophthalmology Physician	$1.5M	$0
Central Georgia Cancer Care	GA	Specialist	$0	$1.2M
Arpan Bachhawat	GA	Retina Specialist (Ophthalmology) Physician	$1.2M	$0

Macon Outpatient Surgery, LLC — Billing Profile & Reimbursement Data

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Macon Outpatient Surgery, 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

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
63685	9	40	10	$7,580	$121.3K
63655	7	10	10	$5,170	$87.9K
63650	52	50	40	$1,890	$81.4K
27447	8	360	30	$1,500	$61.5K
27130	82	210	30	$1,450	$49.4K
64483	92	360	70	$200	$23.7K
G0260	77	90	70	$200	$23.2K
29827	14	110	20	$1,100	$22.1K
64493	240	320	60	$190	$16.8K
29848	1	50	30	$380	$16.1K