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.

Pain & Spine Physicians Surgery Center LLC (NPI 1477047199)

Field	Value
Entity Type	Organization
Organization	Pain & Spine Physicians Surgery Center LLC
Address	3333 Old Milton Pkwy Ste 430
City	Alpharetta
State	GA
ZIP	30005
Taxonomy	Ambulatory Surgical Clinic/Center
NPI Enumerated	June 16, 2018

Payer Source	Total Paid
Medicare	$1.9M
Medicaid	$0

Key Findings

This facility reports $1.9M in lifetime Medicare revenue and has no Medicaid billing on file, which makes it effectively a single‑payer (Medicare) billing entity for the data available. The provider’s NPI was enumerated 2018-06-16 (~8 years ago), indicating roughly eight years of Medicare presence during which this revenue was accumulated.

Revenue is highly concentrated in a small set of procedures: the precomputed top three Medicare codes account for 52.1% of the provider’s total Medicare revenue. Those top three codes are 63685 ($396K, 20.9% of total Medicare revenue), 63650 ($343.1K, 18.1%), and 64628 ($246.8K, 13.0%), signaling that a majority of dollars come from implantable neurostimulator work and basivertebral nerve ablation.

The code mix indicates a specialized interventional spine/pain practice with both device implantation and targeted neurolytic procedures: 63685 and 64555 document spinal neurostimulator generator and electrode implantation, while 63650 and multiple 646xx and 644/623 series codes reflect epidural electrode placement, radiofrequency/thermal neurolysis (including basivertebral ablation 64628), and fluoroscopically guided facet and epidural injections. This mix is consistent with an ambulatory surgical clinic/center taxonomy that performs implant procedures and high-volume image‑guided pain interventions.

Competitive standing varies by service line. For high-revenue implant and ablation codes the provider appears a capable but not dominant national participant—63685 ranks #422 of 1281 (64th percentile, labeled typical), 63650 ranks #177 of 1371 (87th percentile, labeled typical), and 64628 ranks #38 of 247 (84th percentile, labeled typical). These positions suggest respectable national activity for those device and ablation services but not market leadership.

By contrast, the practice is an extreme/high outlier on volume for several neurolytic/injection codes, implying very high procedural throughput in certain interventions. Notably, 64635 (292 claims, $142.5K revenue) ranks #71 of 5957 (99th percentile; extreme outlier) and 64633 (113 claims, $55.7K revenue) ranks #42 of 2262 (98th percentile; extreme outlier), while multiple injection codes such as 62323, 64493, 62321, 64490 and G0260 are described as "notably above typical" in national rank—this pattern points to disproportionately high utilization of image‑guided injections and radiofrequency neurolysis relative to peers.

Some mid‑range and niche procedures also contribute materially to revenue and indicate diversification within spine care. For example, 0775T generated $185.6K (9.8% of Medicare revenue) and 64555 generated $123.5K (6.5%), showing that less common or device‑related codes are meaningful contributors beyond routine injections. These items broaden the clinical footprint beyond simple injection therapy into implant and advanced procedure lines.

From a payer/contracting perspective the lack of Medicaid activity simplifies payer mix but concentrates commercial/operational exposure around Medicare reimbursement and device/procedure economics. With $1.9M concentrated in a few device and ablation codes (top 3 = 52.1% of Medicare revenue) and marked outlier volumes in several neurolysis/injection codes, reimbursement changes or shifts in clinical referral patterns for those high‑volume services could disproportionately affect the center’s revenue base.

Operationally, the combination of high counts for low‑unit‑value injection codes (e.g., 62323: 385 claims, $92K revenue; 64493: 319 claims, $81K revenue) alongside fewer high‑value device claims suggests a workflow that pairs high throughput of repeat image‑guided interventions with episodic surgical implant cases. This mix is consistent with an ASC‑style operation that manages both ambulatory implant procedures and frequent interventional pain clinic throughput.

Medicare: Complete Services Breakdown

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

18 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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	$18,860	$396K
63650	In this procedure, the provider places electrodes in the epidural space to relieve pain and reduce or eliminate spasms.	90	$3,730	$343.1K
64628	The provider uses a thermal (heat) method under imaging guidance to destroy an intraosseous basivertebral nerve. Use this code for the first two lumbar or sacral vertebral bodies treated at a session.	30	$7,480	$246.8K
0775T	N/A	20	$10,310	$185.6K
64635	Under fluoroscopic or CT guidance, the provider applies an agent to a lower back joint to destroy nerve tissue.	290	$490	$142.5K
64555	A neurostimulator includes electrodes which are inserted under the skin and induced by a generator to stimulate the nerve tissue. Use of this stimulator involves implantation of electrodes around a…	30	$4,260	$123.5K
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)…	390	$240	$92K
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).	300	$280	$82.6K
64493	The provider injects a diagnostic or therapeutic substance into a single lumbar or sacral paravertebral facet (zygapophyseal) joint, or into the nerves that supply that joint, using imaging guidance…	320	$250	$81K
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…	110	$490	$55.7K

Showing 1–10 of 18

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 18 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Georgia Distribution

Pain & Spine Physicians Surgery Center LLC — 8 of 18 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Georgia

Full comparison — all codes billed, vs. state median

18 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
0775T	3	10	30	$9,830	$314.7K
64555	2	10	30	$3,430	$123.4K
63685	5	40	10	$7,580	$121.3K
64628	1	10	20	$4,670	$93.4K
63650	2	50	40	$1,890	$81.4K
64635	8	270	50	$380	$27.7K
64483	29	360	70	$200	$23.7K
G0260	8	90	70	$200	$23.2K
64493	9	320	60	$190	$16.8K
64633	3	130	30	$400	$13.9K

Showing 1–10 of 18

Nearby Providers

Other providers in the same ZIP code as Pain & Spine Physicians Surgery Center LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Bakotic Pathology Associates, LLC	GA	Clinical Medical Laboratory	$101.5K	$13.3M
Modify Health Inc	GA	Community Health Worker	$0	$5M
Scott Acker	GA	Dermatopathology (Pathology) Physician	$3.8M	$0
Tots, Inc.	GA	Pediatric Occupational Therapist	$0	$3M
Darren Harris	GA	Anatomic Pathology & Clinical Pathology Physician	$1.4M	$0
William Betsill	GA	Clinical Medical Laboratory	$1.3M	$0
John Grimwood	GA	Anatomic Pathology & Clinical Pathology Physician	$1.2M	$0
Carolina Montes	GA	Anatomic Pathology & Clinical Pathology Physician	$1.1M	$0
Eli Piatigorsky	GA	Dermatopathology Physician	$1.1M	$0
Wiles Therapy Services Inc	GA	Pediatric Occupational Therapist	$0	$985.5K

Pain & Spine Physicians Surgery Center LLC — Billing Profile & Reimbursement Data

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Pain & Spine Physicians Surgery Center 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