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 Wyoming for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Wyoming 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. Wyoming (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.

Gem City Bone & Joint PC (NPI 1518947589)

Field	Value
Entity Type	Organization
Organization	Gem City Bone & Joint PC
Address	1909 Vista Dr
City	Laramie
State	WY
ZIP	82070
Taxonomy	Ambulatory Surgical Clinic/Center
NPI Enumerated	January 18, 2006

Payer Source	Total Paid
Medicare	$1.3M
Medicaid	$0

Key Findings

This provider is effectively single‑payer: total Medicare revenue is $1.3M and there is no Medicaid billing on file, indicating GEM CITY BONE & JOINT PC relies on Medicare as its primary public payer and has little to no Medicaid participation. This payer mix will shape contracting leverage, patient access, and revenue stability toward the Medicare population rather than low‑reimbursement Medicaid volumes.

Revenue is highly concentrated in a small set of procedures: the top 3 Medicare codes account for 70.5% of total Medicare revenue. Those top drivers are 27447 ($466.8K, 36.0%), 27130 ($346.2K, 26.7%), and 29827 ($101.2K, 7.8%), so a majority of revenue comes from major joint arthroplasty and shoulder arthroscopy.

The code mix and taxonomy (Ambulatory Surgical Clinic/Center) indicate an outpatient orthopedic surgery center focused on high‑value joint procedures: 27447 and 27130 are total knee and total hip replacement procedures with high average payment amounts ($7072 and $7213 avg paid/claim respectively), consistent with a facility performing complex joint arthroplasty in an ambulatory setting. 29827 and 29823 show a clear shoulder arthroscopy component, signaling combined arthroplasty and arthroscopic service lines.

Competitive standing for the top joint replacement codes is above median but not dominant: 27447 ranks #2167 of 12089 providers nationally (82th percentile) and 27130 ranks #1630 of 8062 providers nationally (79th percentile), both labeled in the benchmarks as "typical, unremarkable volume for this code," which suggests the practice is an established regional participant in joint replacement without being a national leader. Conversely, shoulder procedure 29823 ranks #80 of 1675 (95th percentile) and is described as "notably above typical national volume," identifying the provider as relatively high‑volume for that specific arthroscopic shoulder procedure.

Service mix shows breadth beyond arthroplasty: the profile includes high‑volume transforaminal lumbar injections (64483, 174 claims, $49.8K revenue) and multiple hand/wrist procedures (64721, 26055, 29848), indicating the clinic performs both procedural pain management and smaller orthopaedic surgeries in addition to joint replacements. These lower‑reimbursement, higher‑volume codes add procedural throughput and may support steady same‑day or short‑stay case flow even if they generate modest revenue per claim.

Certain codes are statistically characterized as routine across peers: many of the listed codes (including 27447, 27130, 29827, 64483, and 64721) are described in the benchmark notes as "typical, unremarkable volume for this code," which points to a practice profile that aligns with common outpatient orthopedic surgery patterns rather than anomalous billing behavior. The notable exception is 29823, which the benchmarks flag as "notably above typical national volume," highlighting a potential specialty strength in arthroscopic shoulder debridement.

Operationally, average paid amounts for the two largest revenue lines are high (27447 at $7072 avg paid/claim and 27130 at $7213 avg paid/claim), so revenue sensitivity is concentrated in reimbursement levels and case mix for major joint replacement. Given that the top three codes generate the bulk of revenue, changes in reimbursement, referral patterns, or surgical volume for those procedures would materially affect overall Medicare revenue.

The provider has an established presence with an NPI enumerated on 2006-01-18 (~20 years ago), suggesting long tenure in the market. That longevity, combined with a Medicare‑centered payer mix and a concentrated set of high‑value orthopedic procedures, frames this entity as a stable, Medicare‑focused ambulatory orthopedics clinic with a particular strength in certain shoulder procedures and typical national standing in major joint arthroplasty.

Medicare: Complete Services Breakdown

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

23 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…	70	$7,070	$466.8K
27130	In this procedure, the provider surgically replaces the hip joint by prosthesis, or artificial hip joint. He replaces both the femoral and acetabular components with or without using an autograft or…	50	$7,210	$346.2K
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…	50	$2,150	$101.2K
27446	In this procedure, the provider reconstructs the diseased or damaged medial or lateral compartment of the knee along with the femoral condyles and tibial plateaus to relieve pain and improve the…	10	$6,980	$90.8K
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).	170	$290	$49.8K
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	$590	$35.3K
29823	The provider examines the tissue inside the shoulder joint with an arthroscope. He inserts additional instruments and excises extensive damaged tissues in the shoulder joint caused by trauma to the…	50	$540	$26K
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…	60	$440	$25.1K
29880	In this procedure, the provider performs arthroscopic examination of the knee joint. She removes the damaged and torn meniscus from the medial and lateral compartments of the knee joint along with…	20	$1,050	$24.2K
20902	A bone graft restores structural integrity and natural osseous, or bony, tissue to the site of a bony defect, which increases its strength so it will last over a period of time. The provider…	20	$1,330	$22.6K

Showing 1–10 of 23

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 23 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Wyoming Distribution

Gem City Bone & Joint PC — 4 of 23 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Wyoming

Full comparison — all codes billed, vs. state median

23 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
27446	2	10	10	$2,800	$39.2K
27447	6	50	20	$1,010	$32.5K
27130	3	30	30	$1,190	$30.8K
64483	9	20	90	$200	$29.3K
20902	1	10	20	$1,330	$22.6K
29827	1	10	20	$970	$19.4K
64635	8	10	30	$400	$18.1K
45380	30	40	40	$210	$17K
67974	1	10	20	$790	$16.6K
64493	9	20	50	$190	$15.1K

Showing 1–10 of 23

Related Providers

Other providers that share a Tax Identification Number (TIN) with Gem City Bone & Joint PC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
John Horberg	WY	Orthopaedic Trauma Physician	$301.5K	$270
Trevin Thurman	FL	Pain Medicine (Physical Medicine & Rehabilitation) Physician	$246.3K	$0
Eric Harris	WY	Orthopaedic Surgery of the Spine Physician	$207.3K	$0
Premier Surgical Center, LLC	WY	Ambulatory Surgical Clinic/Center	$120.8K	$85.5K
Matthew Fournier	WY	Orthopaedic Surgery Physician	$196.9K	$0
Mark Mckenna	WY	Orthopaedic Surgery Physician	$193.5K	$0
Daniel Levene	WY	Orthopaedic Surgery Physician	$163.6K	$0
Thomas Bienz	WY	Orthopaedic Hand Surgery Physician	$139K	$0
Todd Hammond	WY	Interventional Pain Medicine Physician	$134.3K	$0
Brandon Roy-garland	CO	Vascular Surgery Physician	$117.8K	$0

Nearby Providers

Other providers in the same ZIP code as Gem City Bone & Joint PC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Care United Medical Center Of Laramie, LLC	WY	Multi-Specialty Clinic/Center	$0	$3.2M
Quality Home Health Care Inc	WY	Home Health Agency	$0	$2.6M
Elite Medical Supplies, LLC	WY	Durable Medical Equipment & Medical Supplies	$0	$1.3M
James A Boucher & Sue E Lowe Ptr	WY	Optometrist	$0	$444.4K
Martha Nesslinger	WY	Counselor	$0	$415.2K
Step-by-step Family Therapy A Professional Corporation	WY	Multi-Specialty Clinic/Center	$0	$333.8K
Grand Avenue Urgent Care, LLC	WY	Urgent Care Clinic/Center	$0	$264.3K
Samuel Ecker	WY	Dermatology Physician	$206.2K	$0
Leah Rasmussen	WY	Psychiatric/Mental Health Nurse Practitioner	$23.3K	$170.7K
Kristina Rutherford	WY	Case Manager/Care Coordinator	$0	$159.2K

Gem City Bone & Joint PC — 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

Related Providers

Nearby Providers

Frequently Asked Questions

References