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

Why is the Medicaid comparison limited to Puerto Rico 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. Puerto Rico (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.

Caguas Ambulatory Surgical Center, Inc (NPI 1396244877)

Field	Value
Entity Type	Organization
Organization	Caguas Ambulatory Surgical Center, Inc
Address	Carr 156 Km 60.1
City	Caguas
State	PR
ZIP	07256
Taxonomy	Ambulatory Surgical Clinic/Center
NPI Enumerated	February 9, 2018

Payer Source	Total Paid
Medicare	$107.1K
Medicaid	$0

Key Findings

CAGUAS AMBULATORY SURGICAL CENTER, INC operates as an ambulatory surgical center focused on high-reimbursement surgical procedures: its Medicare billing is concentrated in orthopedics (knee replacement 27447 and shoulder arthroscopy 29827) and ophthalmology (cataract extraction with lens 66984), consistent with an ASC service mix performing same-day invasive procedures. The three highest-revenue CPT codes on file correspond to total knee arthroplasty, cataract with intraocular lens, and rotator cuff repair, indicating the facility supports both joint replacement and specialty eye surgery workflows.

This provider’s Medicare revenue totals $107.1K and there is no Medicaid billing on file, so the entity is effectively single-payer in these claims records and derives all recorded public-payer revenue from Medicare. The absence of any Medicaid line items (“none (no Medicaid billing on file)”) should flag a materially different payer mix than dual-eligible or Medicaid-serving ASCs in the region.

Revenue concentration is extreme at the code level: the precomputed top 3 Medicare codes account for 100.0% of this provider’s total Medicare revenue. Those three codes break down as 27447 (66.5% of Medicare revenue), 66984 (20.9%), and 29827 (12.7%), showing the business is tightly dependent on a very small set of procedures.

27447 is the single largest revenue driver with 14 claims, $5084 avg paid/claim, and $71.2K revenue (66.5% of Medicare revenue). Despite its dominance for this provider, 27447 ranks #10557 of 12089 providers nationally (9th percentile) and is described as delivering "typical, unremarkable volume for this code," so the ASC is a modest-volume contributor for primary knee arthroplasty at the national level.

66984 (cataract with intraocular lens) accounts for $22.3K (20.9% of Medicare revenue) across 38 claims with a $588 avg paid/claim, and ranks #11912 of 15965 providers nationally (25th percentile). This placement and the accompanying label of "typical, unremarkable volume for this code" suggest the facility performs routine cataract work at modest scale compared with national peers.

29827 (arthroscopic rotator cuff repair) contributes $13.6K (12.7% of Medicare revenue) from 11 claims with a $1233 avg paid/claim, and ranks #3127 of 3445 providers nationally (0th percentile) while also noted as "typical, unremarkable volume for this code." The combination of lower claim count and low national rank indicates shoulder procedures are a secondary service line for this ASC rather than a primary volume driver.

Across the three reported codes the provider’s national competitive standing is modest: all codes are labeled "typical, unremarkable volume" and their national rank percentiles (9th, 25th, and 0th as reported) indicate this ASC is not a dominant player for these procedures at the national level. For payers and competitors, that pattern signals a provider with focused service offerings but limited market share in each specialty relative to national peers.

The NPI was enumerated on 2018-02-09 (~8 years ago), indicating the center has been active for several years but is not an incumbently long-tenured institution. Given the concentrated revenue mix and the tenure, analysts should consider whether growth would come from expanding existing orthopedics/ophthalmology capacity or from diversifying payers and procedure types; current Medicare records show concentrated procedure exposure without Medicaid participation.

Medicare: Complete Services Breakdown

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

3 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…	10	$5,080	$71.2K
66984	The provider inserts an artificial lens after removing an extracapsular cataract by aspiration or use of ultrasonic waves. This procedure is done without the use of an endoscopic laser probe to…	40	$590	$22.3K
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…	10	$1,230	$13.6K

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 3 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Puerto Rico Distribution

Caguas Ambulatory Surgical Center, Inc — 0 of 3 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Puerto Rico

Full comparison — all codes billed, vs. state median

3 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
27447	3	10	20	$1,610	$37.1K
66984	11	40	30	$500	$24.1K
29827	2	10	10	$980	$12.8K

Caguas Ambulatory Surgical Center, Inc — Billing Profile & Reimbursement Data

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Caguas Ambulatory Surgical Center, Inc — 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

Frequently Asked Questions

References