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NPI 1538100649 · Provo, UT · Ambulatory Surgical Clinic/Center
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Riverwoods Surgery Center, LLC is a ambulatory surgical clinic/center provider located in Provo, Utah. This profile covers 6 Medicare and 1 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 | Riverwoods Surgery Center, LLC |
| Address | 320 River Park Dr Ste 125 |
| City | Provo |
| State | UT |
| ZIP | 84604 |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| NPI Enumerated | June 9, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $5M |
| Medicare | $737.9K |
RIVERWOODS SURGERY CENTER, LLC is an ambulatory surgical clinic/center in PROVO, UT with its NPI enumerated (registered) on 2006-06-09 (~20 years ago), indicating a long-tenured operation that has been billing Medicare and Medicaid for roughly two decades. The taxonomy and tenure are consistent with a stable, established outpatient surgical provider rather than a newly formed entity.
The provider’s payer mix is heavily skewed toward Medicaid in scale: total Medicare revenue is $737.9K while total Medicaid revenue is $5M, so Medicaid represents the substantially larger share of lifetime public-payer revenue on file. This makes the entity effectively Medicaid-dominant in dollar terms, despite continuing Medicare activity.
Medicare revenue is highly concentrated: the precomputed top-3 Medicare codes account for 90.3% of this provider’s Medicare revenue. Those three codes are 27447 (43.2%, $318.5K), 66984 (32.4%, $239.2K), and 27130 (14.7%, $108.3K), showing that total Medicare dollars are driven primarily by a small set of high-value procedures.
The Medicare code mix points to two principal service lines: major joint arthroplasty (27447 and 27130) and ophthalmology/cataract surgery (66984 and related cataract codes such as 66982). The presence of high-revenue joint replacement codes alongside high-volume cataract work suggests the ASC bills both orthopedic and ophthalmic procedures rather than a single procedural focus.
Competitive standing for the top Medicare codes is modest rather than dominant nationally: 27447 ranks #3822 of 12089 providers (67th percentile) and is characterized as "typical, unremarkable volume," 66984 ranks #4106 of 15965 providers (74th percentile, "typical, unremarkable volume"), and 27130 ranks #6312 of 8062 providers (18th percentile, "typical, unremarkable volume"). These percentiles indicate the center performs routine volumes of these procedures relative to national peers and is not a national outlier.
Medicaid billing is extremely concentrated and state-dominant on a single code: code 41899 accounts for $5M and 100.0% of the provider’s Medicaid revenue (5.4K claims, $911 avg paid/claim), and it ranks #2 of 23 providers in-state (95th percentile; notably above typical state volume). This makes the provider a major in-state biller for this unspecified dental/adjoining-alveolar procedure and creates a single-code dependency for Medicaid revenue.
The statistical characterizations reported for key codes bear out different risk profiles: Medicare top codes are described as "typical, unremarkable volume," indicating no national outlier behavior for those procedure lines, whereas the Medicaid code 41899 is described as "notably above typical state volume," indicating a clear in-state concentration of activity. Analysts should therefore treat Medicaid revenue as a potential point of exposure to state-level policy, coverage, or utilization shifts that would disproportionately affect overall revenue.
Given the mix and concentration, operational implications are twofold: on the Medicare side the center appears to sustain revenue through established orthopedic and ophthalmic surgical services, while on the Medicaid side the center derives nearly all Medicaid dollars from a single dental/adjoining-alveolar procedure (41899). For payer/provider analysts this suggests monitoring code-level utilization trends and Medicaid contract coverage for 41899 as a priority, and verifying that Medicare joint and cataract volumes align with facility capacity and credentialing for those specialties.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
6 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… | 50 | $7,080 | $318.5K |
| 66984 | The provider inserts an artificial lens after removing an extracapsular cataract by aspiration or use of ultrasonic waves. This procedure is done without the use of an endoscopic laser probe to… | 290 | $820 | $239.2K |
| 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… | 20 | $7,220 | $108.3K |
| 66982 | The provider inserts an intraocular lens prosthesis after extracapsular cataract extraction using complex techniques and devices. He may perform this by means of an iris expansion device, providing… | 70 | $810 | $53.3K |
| 67311 | The provider realigns an imbalance in the eye muscles by either recession, which weakens the eye muscle or resection, which strengthens the muscles so as to restore normal vision. This procedure is… | 20 | $540 | $10.3K |
| 66821 | The provider removes the haziness from the capsule of the eye using a laser for a patient with a secondary membranous cataract. | 40 | $200 | $8.2K |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 6 CPT/HCPCS codes.
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.
1 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 41899 | Use this code to report a procedure on the teeth and adjoining alveolar structures for which there is no specific code available. | 5,440 | $910 | $5M |
How this provider's Medicaid billing volume and revenue compare to other Utah providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Utah median
1 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 41899 | Use this code to report a procedure on the teeth and adjoining alveolar structures for which there is no specific code available. | 2 | 20 | 630 | $750 | $1.2M |
Other providers in the same ZIP code as Riverwoods Surgery Center, LLC, ranked by combined Medicare and Medicaid revenue.
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