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NPI 1497759955 · Billings, MT · Ambulatory Surgical Clinic/Center
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Yellowstone Surgery Center, LLC is a ambulatory surgical clinic/center provider located in Billings, Montana. This profile covers 19 Medicare and 11 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 | Yellowstone Surgery Center, LLC |
| Address | 1144 N 28th St |
| City | Billings |
| State | MT |
| ZIP | 59101 |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| NPI Enumerated | June 10, 2005 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $2.2M |
| Medicare | $629.2K |
Medicaid dominates this facility’s payer mix: total Medicaid revenue is $2.2M compared with total Medicare revenue of $629.2K, indicating the center’s overall commercial scale is largely driven by Medicaid-covered procedures rather than Medicare. This makes the provider effectively Medicaid-weighted in lifetime revenue.
Medicaid billing is extremely concentrated in a small set of pediatric ENT procedures: the precomputed top-3 Medicaid codes account for 94.5% of the provider’s Medicaid revenue, with 42820 (tonsil/adenoid) at $1.4M (65.1%) and 69436 (tympanostomy) at $453.4K (20.8%). Those two codes alone constitute the bulk of Medicaid dollars and signal that Medicaid volume is highly dependent on routine outpatient pediatric airway/ENT surgery.
Medicare revenue is more diversified but still concentrated: the precomputed top-3 Medicare codes account for 47.5% of Medicare revenue, led by 27447 at $110.1K (17.6%), 64635 at $97.9K (15.6%), and 29827 at $89.1K (14.2%). This mix shows Medicare dollars come primarily from adult musculoskeletal and interventional procedures rather than the pediatric ENT work dominating Medicaid.
State-level competitive standing for the Medicaid service lines is dominant: 42820 ranks #1 of 16 providers in-state (100th percentile; notably above typical state volume) and 69436 ranks #1 of 18 providers in-state (100th percentile; extreme outlier, far above typical state volume). These rankings indicate the center is a statewide leader for pediatric tonsil/adenoid and ear tube procedures.
Nationally the provider shows above-typical volumes for select Medicare spine and pain codes: 64635 ranks #155 of 5957 providers nationally (97th percentile; notably above typical national volume) and 62323 ranks #461 of 7397 (94th percentile). While overall Medicare revenue is modest, these percentiles suggest the ASC performs interventional pain and certain arthroscopic procedures at volumes well above many peers.
The code mix implies two distinct outpatient service lines co-located at this ASC: high-volume pediatric ENT on the Medicaid side (42820, 69436) and an adult-focused orthopedics/pain suite on the Medicare side (27447, 29827, multiple epidural/facet injection codes). Operationally, that pattern is consistent with an ambulatory surgical center that treats both routine pediatric ENT cases and higher-volume adult musculoskeletal/pain interventions.
C9290 (bupivacaine liposome) appears on both payers and contributes meaningfully to analgesia billing: Medicare shows $32.5K (5.2% of Medicare revenue) with a national rank of #35 of 451 (92nd percentile) and Medicaid shows $70.8K (3.3% of Medicaid revenue) with an in-state rank of #3 of 7 (67th percentile). Its presence across both payers signals routine use of long-acting local analgesia in the center’s procedures and suggests standardized perioperative pain management practices.
The provider has long tenure and an ASC taxonomy: NPI enumerated 2005-06-10 (~21 years ago) and is classified as an Ambulatory Surgical Clinic/Center in Billings, MT. The combination of long-standing operation and concentrated, high-ranking Medicaid ENT volumes points to a stable, specialty-focused outpatient surgical operation in-state.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
19 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… | 20 | $6,880 | $110.1K |
| 64635 | Under fluoroscopic or CT guidance, the provider applies an agent to a lower back joint to destroy nerve tissue. | 200 | $480 | $97.9K |
| 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… | 40 | $2,070 | $89.1K |
| 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)… | 250 | $250 | $60.5K |
| 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… | 180 | $250 | $44.1K |
| 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… | 60 | $580 | $34K |
| C9290 | Injection, bupivacaine liposome, 1 mg | 32,450 | $1 | $32.5K |
| 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). | 110 | $310 | $32.3K |
| 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… | 30 | $480 | $15.5K |
| 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… | 30 | $510 | $15.2K |
Showing 1–10 of 19
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 19 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
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.
11 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 42820 | The provider removes the tonsils and adenoids in a patient younger than 12 years old. | 640 | $2,230 | $1.4M |
| 69436 | This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia. | 760 | $600 | $453.4K |
| 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)… | 960 | $200 | $188.1K |
| C9290 | Injection, bupivacaine liposome, 1 mg | 770 | $90 | $70.8K |
| 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… | 60 | $210 | $12.7K |
| 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)… | 70 | $190 | $12.2K |
| 42826 | The provider performs an initial, recurrent, or secondary tonsillectomy procedure in a patient who is 12 years of age or older. | 10 | $930 | $12.1K |
| 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). | 30 | $270 | $8.2K |
| L8699 | Prosthetic implant, not otherwise specified | 1,490 | $1 | $3K |
| 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… | 160 | $0 | $0 |
Showing 1–10 of 11
How this provider's Medicaid billing volume and revenue compare to other Montana providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Montana median
11 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 42820 | The provider removes the tonsils and adenoids in a patient younger than 12 years old. | 1 | 20 | 40 | $1,180 | $169.3K |
| 69436 | This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia. | 1 | 20 | 30 | $400 | $56.1K |
| 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). | 7 | 20 | 30 | $180 | $28.5K |
| 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)… | 3 | 10 | 90 | $60 | $18.9K |
| C9290 | Injection, bupivacaine liposome, 1 mg | 3 | 10 | 720 | $30 | $16K |
| 42826 | The provider performs an initial, recurrent, or secondary tonsillectomy procedure in a patient who is 12 years of age or older. | 1 | 10 | 10 | $930 | $12.1K |
| 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)… | 2 | 10 | 50 | $140 | $8.2K |
| 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… | 2 | 10 | 30 | $110 | $5.4K |
| L8699 | Prosthetic implant, not otherwise specified | 1 | 10 | 60 | $10 | $2.3K |
| 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… | 3 | 10 | 140 | $0 | $0 |
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Other providers in the same ZIP code as Yellowstone Surgery Center, LLC, ranked by combined Medicare and Medicaid revenue.
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