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NPI 1467511899 · Grimes, IA · Ambulatory Surgical Clinic/Center
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Mercy Terrace Hill Surgery Center, LLC is a ambulatory surgical clinic/center provider located in Grimes, Iowa. This profile covers 24 Medicare and 7 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 | Mercy Terrace Hill Surgery Center, LLC |
| Address | 3201 Se 37th Street |
| City | Grimes |
| State | IA |
| ZIP | 50111 |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| NPI Enumerated | December 8, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $922.8K |
| Medicaid | $149K |
MER CY TERRACE HILL SURGERY CENTER, LLC is listed as an Ambulatory Surgical Clinic/Center and its CPT mix is consistent with an orthopedic/pain-management focused ASC: high-revenue Medicare codes include facet joint neurolysis (64635), knee arthroplasty (27447), and arthroscopic rotator cuff repair (29827), while Medicaid volume is concentrated in carpal tunnel surgery (64721) and spinal injection/neurolysis codes. This blend of codes suggests the facility performs a mixture of outpatient orthopedic procedures (upper and lower extremity arthroplasty and arthroscopy) alongside image-guided spine/pain interventions.
Medicare revenue is concentrated: the top 3 Medicare codes account for 36.0% of this provider’s total Medicare revenue, driven by 64635, 27447, and 29827. Those codes represent high-value procedural work (spine neurolysis, joint replacement, and arthroscopic shoulder repair) and indicate a focused set of services that disproportionately contribute to the $922.8K in Medicare revenue.
Medicaid revenue is highly concentrated: the top 3 Medicaid codes account for 96.2% of total Medicaid revenue, led by 64721 which alone represents $122.7K or 82.4% of the provider’s $149K Medicaid revenue. This indicates the provider’s Medicaid business is effectively dominated by carpal tunnel surgery and related spine injection/neurolysis services rather than a broad mix of outpatient procedures.
Payer mix is skewed toward Medicare in scale: Medicare revenue ($922.8K) is substantially larger than Medicaid revenue ($149K), so the facility is Medicare-dominant in overall dollars while maintaining targeted Medicaid activity in a few high-volume procedure lines. Analysts should treat Medicaid as a concentrated, code-specific part of the practice rather than a proportional reflection of its overall revenue base.
The provider shows national-level concentration on several Medicare codes: 64635 ranks #101 of 5957 nationally (98th percentile; labeled an extreme outlier), 29827 ranks #130 of 3445 (96th percentile; notably above typical), and 64721 ranks #66 of 3206 (98th percentile; notably above typical). These rank/percentile positions signal that the facility performs unusually large volumes of specific procedures compared with national peers, consistent with a specialized referral or procedural focus.
At the state level the provider is a leading Medicaid performer for its top codes: 64721 ranks #1 of 3 in-state (100th percentile) and 64635 ranks #1 of 2 in-state (100th percentile), while 64636 is listed as #1 of 1 in-state with no peer comparison available. These state rankings indicate the facility is one of the primary in-state sources for these hand and spine procedures in the Medicaid population.
Billing patterns show a mix of high-claim, low-dollar items and zero-paid implant/supply claims on Medicaid and Medicare: Medicare records C9290 with 11.2K claims at $1 avg paid/claim ($11.2K revenue), and Medicaid shows large claim counts for implant codes like C1713 (276 claims) and L8699 (88 claims) with $0 avg paid/claim. This combination suggests routine reporting of many small-unit supply items and implants where payment may be minimal or bundled, and it is an operational detail payers should validate against contract/bundle rules.
The provider has long tenure: NPI enumerated on 2006-12-08 (~20 years ago), consistent with an established ambulatory surgery operation that has likely developed referral relationships and procedural specialization over time. Longevity plus concentrated code volumes supports the interpretation of an established specialty ASC rather than a new entrant or transient practice.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
24 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 64635 | Under fluoroscopic or CT guidance, the provider applies an agent to a lower back joint to destroy nerve tissue. | 240 | $470 | $113.5K |
| 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… | 20 | $6,810 | $108.9K |
| 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… | 60 | $1,880 | $108.9K |
| 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… | 120 | $600 | $74.4K |
| 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… | 30 | $2,290 | $57.3K |
| 25609 | The provider surgically repairs a fracture of the lower radius, the larger of the two lower arm bones, beyond the joint or a separation of the radius from the joint through an incision and fixes… | 20 | $3,220 | $54.7K |
| 25607 | The provider surgically repairs a fracture of the lower radius, the larger of the two lower arm bones, beyond the joint or a separation of the radius from the joint through an incision and fixes the… | 20 | $3,220 | $51.5K |
| 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 | $51.2K |
| 28285 | The provider repairs a hammertoe deformity, a painful condition in which the toe remains permanently bent in a downward position. | 60 | $640 | $36.1K |
| 64633 | In this procedure, the provider destroys the facet joint nerve of a cervical or thoracic spinal segment using neurolytic agents like heat, electric current, or a chemical compound. He makes use of… | 60 | $610 | $35.5K |
Showing 1–10 of 24
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 24 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
24 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| 25607 | 1 | 10 | 20 | $3,220 | $51.5K |
| 25609 | 2 | 10 | 20 | $2,460 | $44.3K |
| 27447 | 166 | 190 | 40 | $870 | $41.7K |
| 28750 | 7 | 10 | 20 | $1,790 | $37.5K |
| 64635 | 2 | 40 | 40 | $340 | $21.8K |
| 64721 | 4 | 50 | 30 | $430 | $20.5K |
| 29827 | 1 | 40 | 20 | $950 | $18.1K |
| 28285 | 4 | 20 | 30 | $430 | $17.6K |
| 29881 | 2 | 10 | 20 | $790 | $14.9K |
| C9290 | 4 | 10 | 11,170 | $1 | $14.2K |
Showing 1–10 of 24
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.
7 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 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… | 410 | $300 | $122.7K |
| 64635 | Under fluoroscopic or CT guidance, the provider applies an agent to a lower back joint to destroy nerve tissue. | 50 | $250 | $13.5K |
| 64636 | In this add on procedure, the provider destroys the facet joint nerve of a lumbar or sacral spinal segment using neurolytic agents like heat, electric current, or a chemical compound. He makes use of… | 40 | $190 | $7K |
| 62321 | 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 cervical (neck) or thoracic (upper and middle back)… | 30 | $190 | $5.6K |
| C1713 | Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) | 280 | $0 | $0 |
| G8907 | Patient documented not to have experienced any of the following events: a burn prior to discharge; a fall within the facility; wrong site/side/patient/procedure/implant event; or a hospital transfer… | 20 | $0 | $0 |
| L8699 | Prosthetic implant, not otherwise specified | 90 | $0 | $0 |
How this provider's Medicaid billing volume and revenue compare to other Iowa providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Iowa median
7 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 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… | 1 | 10 | 30 | $300 | $45.4K |
| 64635 | Under fluoroscopic or CT guidance, the provider applies an agent to a lower back joint to destroy nerve tissue. | 1 | 10 | 40 | $220 | $8.8K |
| 64636 | In this add on procedure, the provider destroys the facet joint nerve of a lumbar or sacral spinal segment using neurolytic agents like heat, electric current, or a chemical compound. He makes use of… | 1 | 10 | 40 | $190 | $7K |
| 62321 | 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 cervical (neck) or thoracic (upper and middle back)… | 1 | 10 | 20 | $190 | $4K |
| L8699 | Prosthetic implant, not otherwise specified | 5 | 10 | 120 | $1 | $1 |
| C1713 | Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) | 2 | 10 | 160 | $0 | $0 |
| G8907 | Patient documented not to have experienced any of the following events: a burn prior to discharge; a fall within the facility; wrong site/side/patient/procedure/implant event; or a hospital transfer… | 10 | 10 | 50 | $0 | $0 |
Other providers in the same ZIP code as Mercy Terrace Hill Surgery Center, LLC, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Hy-vee Inc | IA | Community/Retail Pharmacy | $167.7K | $33.5K |
| Dennis Bussey | IA | Family Medicine Physician | $134.1K | $0 |
| Paul Otteson | IA | Physician Assistant | $86.3K | $0 |
| Heidi Curtis | IA | Family Nurse Practitioner | $56.4K | $440 |
| Mirnes Kadic | IA | Family Medicine Physician | $33.1K | $0 |
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