Loading...
NPI 1396342838 · Columbia, SC · Ambulatory Surgical Clinic/Center
Customize your policy alerts
Get alerted when relevant policies change without checking for updates manually.
Monitor payer policy activity
Lexington Health Inc is a ambulatory surgical clinic/center provider located in Columbia, South Carolina. This profile covers 15 Medicare and 2 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 | Lexington Health Inc |
| Address | 7035 Saint Andrews Rd |
| City | Columbia |
| State | SC |
| ZIP | 29212 |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| NPI Enumerated | October 7, 2020 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $792.7K |
| Medicaid | $22.3K |
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
15 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 64590 | The provider inserts or replaces a peripheral, sacral, or gastric neurostimulator pulse generator or receiver. The system is one that requires surgical creation of a pocket for placement and that… | 30 | $13,790 | $427.5K |
| 64561 | The provider, under imaging guidance, implants electrodes around nerves in the sacral region to reduce the pain along the path of the nerve. | 20 | $3,500 | $80.4K |
| 28285 | The provider repairs a hammertoe deformity, a painful condition in which the toe remains permanently bent in a downward position. | 120 | $670 | $77.8K |
| 28750 | In this procedure, the provider surgically immobilizes the metatarsophalangeal joint of the great toe. A metatarsophalangeal joint is a joint between the first metatarsal of the foot and the first… | 20 | $3,200 | $48K |
| 28297 | The provider removes bone from a bunion, a foot deformity that causes a bump near where the big toe joins the foot. The procedure includes fusing the joint between the foot’s first metatarsal bone… | 10 | $3,310 | $36.4K |
| 49650 | The provider performs laparoscopic repair of an initial inguinal hernia. | 10 | $1,780 | $24.9K |
| 57288 | The provider places a sling made of fascia or synthetic material under the urethra to support it in the correct position to treat urinary stress incontinence. The procedure can be performed… | 10 | $1,900 | $24.7K |
| 57260 | The provider repairs the vaginal tissues over the weakened spots to support the area and return the bladder and rectum to their correct positions. This is a vaginal approach procedure. The provider… | 10 | $1,170 | $12.9K |
| 45385 | The provider examines the colon and rectum using a colonoscope, a long, thin flexible tubular instrument with a light source and camera. He removes one or more tumors, polyps, or other lesions with a… | 30 | $400 | $12.1K |
| 45380 | The provider examines the rectum and colon using a flexible colonoscope, a tubular instrument with a light source and camera, to look for the cause of a patient's symptoms, which may include… | 30 | $360 | $11.9K |
Showing 1–10 of 15
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 15 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
15 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| 64590 | 2 | 10 | 20 | $5,830 | $110.8K |
| 64561 | 8 | 20 | 20 | $2,150 | $64.5K |
| 45385 | 203 | 270 | 90 | $270 | $36.9K |
| 28297 | 2 | 10 | 20 | $1,490 | $22.4K |
| 28750 | 4 | 10 | 20 | $1,350 | $21.6K |
| 45380 | 188 | 260 | 60 | $170 | $18.9K |
| 43239 | 221 | 270 | 90 | $120 | $16.1K |
| 14060 | 26 | 40 | 20 | $510 | $14.4K |
| 28285 | 3 | 30 | 30 | $350 | $13.2K |
| 57260 | 5 | 10 | 30 | $530 | $12.7K |
Showing 1–10 of 15
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.
2 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| D2930 | N/A | 120 | $160 | $18.3K |
| D2392 | Post 2 surface resin‑based composite | 30 | $140 | $4K |
How this provider's Medicaid billing volume and revenue compare to other South Carolina providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. South Carolina median
2 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| D2930 | N/A | 107 | 130 | 1,060 | $150 | $371.1K |
| D2392 | Post 2 surface resin‑based composite | 316 | 350 | 520 | $100 | $175.3K |
Other providers in the same ZIP code as Lexington Health Inc, ranked by combined Medicare and Medicaid revenue.
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.