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NPI 1518129576 · Sioux Falls, SD · Ambulatory Surgical Clinic/Center
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Usc Ambulatory Surgical Center Prof LLC is a ambulatory surgical clinic/center provider located in Sioux Falls, South Dakota. This profile covers 10 Medicare and 4 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 | Usc Ambulatory Surgical Center Prof LLC |
| Address | 201 West 69th Street |
| City | Sioux Falls |
| State | SD |
| ZIP | 57108 |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| NPI Enumerated | June 30, 2008 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $1.1M |
| Medicaid | $44.2K |
USC AMBULATORY SURGICAL CENTER PROF LLC in SIOUX FALLS is an ambulatory surgical clinic/center that has been NPI‑enumerated since 2008-06-30 (~18 years ago). Its reported lifetime Medicare revenue is $1.1M compared with $44.2K in Medicaid, indicating a Medicare‑dominant revenue profile rather than balanced dual‑payer scale. Analysts should treat Medicare as the primary revenue stream when modeling payer exposure.
The provider’s procedure mix is strongly urology‑focused: Medicare top codes include 52310, 52000 and 55700, all cystoscopy/cystourethroscopy–related procedures, and the presence of codes such as 64561 (sacral nerve electrode implantation), J0585 (onabotulinumtoxina injections), and C9740 (transprostatic implants) points to additional services for bladder dysfunction and neuromodulation. This mix aligns with the Ambulatory Surgical Clinic/Center taxonomy and suggests onsite endoscopic and interventional urology capacity rather than primarily diagnostic outpatient care.
Medicare revenue is highly concentrated: the precomputed top 3 Medicare codes (52310, 52000, 55700) account for 54.1% of this provider’s total Medicare revenue. Individually, 52310 generated $197.5K (18.2%), 52000 generated $196.7K (18.1%), and 55700 generated $194.1K (17.9%), making those three procedures the dominant drivers of Medicare dollars at this facility. This concentration implies that changes in reimbursement or utilization for these specific cystoscopic procedures would materially affect overall Medicare revenue.
On the Medicaid side the top codes are even more concentrated: the precomputed top 3 Medicaid codes account for 100.0% of this provider’s Medicaid revenue, with 52000 contributing $30.5K (69.1%) and 52310 contributing $13.6K (30.9%). The remaining listed Medicaid codes (G8907, G8918) show $0 revenue and appear to be administrative/safety reporting codes rather than contributors to billed revenue. For state‑level Medicaid planning, this center behaves as a near‑pure provider of a narrow set of cystoscopic services.
This facility is a national high‑volume outlier for several Medicare codes: 52310 ranks #3 of 2547 providers, 52000 ranks #17 of 8548, and 55700 ranks #18 of 4425 — each labeled an "extreme outlier" compared with national peers. Additional Medicare codes such as 52287 and 76872 also rank at the 99th percentile nationally, reinforcing that the center operates at an unusually high procedural volume for endoscopic urology relative to most providers. Payers and competitors should interpret these rankings as evidence the site is a specialty volume leader for these services on a national basis.
In the state Medicaid competitive frame the center is a dominant listed provider for cystoscopy: 52000 ranks #1 of 3 in‑state (100th percentile) and 52310 ranks #1 of 1 in‑state (no peer comparison available). These in‑state rankings indicate that for the Medicaid population the facility is a primary destination for these specific procedures, which has implications for network access and utilization management at the state level.
Operational signals support a high‑throughput ambulatory model: Medicare claims volumes include 1.1K claims for 52000 and 332 claims for 52310, while Medicaid shows 210 claims for 52000 and 62 claims for 52310; J0585 also records 20.4K claims on Medicare despite lower per‑claim payment ($5 avg paid/claim), suggesting frequent administration of botulinum toxin injections. Together, these counts and the low average paid/claim on certain injectable codes are consistent with repetitive procedural throughput and procedure‑based revenue rather than episodic high‑cost inpatient care.
Two monitoring points for analysts: the heavy Medicare revenue concentration in three cystoscopic codes (54.1% of Medicare revenue) creates sensitivity to utilization and coding changes for those services, and the code 55700 is flagged as deleted effective December 31, 2025, which may shift future revenue mix or require code mapping. Given multiple codes labeled "extreme outlier" at national rank, payers should prioritize clinical and utilization benchmarking for these high‑volume procedures before making network or reimbursement changes.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
10 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 52310 | The provider performs a simple cystourethroscopy, the inspection of the interior of the bladder, the urethra, prostatic urethra, and ureteric openings using a cystoscope passed through the urethra… | 330 | $600 | $197.5K |
| 52000 | In this procedure, the provider performs an examination of the interior of the bladder, the urethra, and the ureteric openings by means of a cystourethroscope, a thin flexible or rigid tube with a… | 1,080 | $180 | $196.7K |
| 55700 | Code deleted December 31, 2025. | 320 | $600 | $194.1K |
| 64561 | The provider, under imaging guidance, implants electrodes around nerves in the sacral region to reduce the pain along the path of the nerve. | 50 | $3,560 | $192.1K |
| J0585 | Injection, onabotulinumtoxina, 1 unit | 20,400 | $10 | $102K |
| 52287 | The provider performs an examination of the interior of the bladder, the urethra, and the ureteric openings by means of a cystoscope. He then inserts a needle and injects a neurolytic drug into the… | 160 | $590 | $94.1K |
| C9740 | Cystourethroscopy, with insertion of transprostatic implant; 4 or more implants | 10 | $5,130 | $61.6K |
| 52281 | The provider uses a cystoscope to view inside the urethra and bladder of a male or female patient. The procedure must include calibrating or dilating a urethral stricture or stenosis. The procedure… | 40 | $570 | $21.1K |
| 52224 | The provider inspects the urethra, prostatic urethra (in men), the interior of the bladder, and ureteric openings using a cystoscope passed through the urethra and into the bladder; he destroys… | 20 | $1,020 | $16.4K |
| 76872 | The provider inserts an ultrasound probe into the rectum and performs a transrectal ultrasound to assess disorders of the prostate, rectum, and surrounding tissues. | 320 | $40 | $11.6K |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 10 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.
4 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 52000 | In this procedure, the provider performs an examination of the interior of the bladder, the urethra, and the ureteric openings by means of a cystourethroscope, a thin flexible or rigid tube with a… | 210 | $150 | $30.4K |
| 52310 | The provider performs a simple cystourethroscopy, the inspection of the interior of the bladder, the urethra, prostatic urethra, and ureteric openings using a cystoscope passed through the urethra… | 60 | $220 | $13.6K |
| 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 |
| G8918 | Patient without preoperative order for iv antibiotic surgical site infection (ssi) prophylaxis | 20 | $0 | $0 |
How this provider's Medicaid billing volume and revenue compare to other South Dakota providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. South Dakota median
4 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 52000 | In this procedure, the provider performs an examination of the interior of the bladder, the urethra, and the ureteric openings by means of a cystourethroscope, a thin flexible or rigid tube with a… | 1 | 10 | 100 | $120 | $15.2K |
| 52310 | The provider performs a simple cystourethroscopy, the inspection of the interior of the bladder, the urethra, prostatic urethra, and ureteric openings using a cystoscope passed through the urethra… | 1 | 10 | 60 | $220 | $13.7K |
| 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 | 20 | $0 | $0 |
| G8918 | Patient without preoperative order for iv antibiotic surgical site infection (ssi) prophylaxis | 2 | 10 | 20 | $0 | $0 |
Other providers in the same ZIP code as Usc Ambulatory Surgical Center Prof LLC, ranked by combined Medicare and Medicaid revenue.
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