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NPI 1538195169 · Indianapolis, IN · Ambulatory Surgical Clinic/Center
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Center For Special Surgery LLC is a ambulatory surgical clinic/center provider located in Indianapolis, Indiana. This profile covers 18 Medicare and 10 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 | Center For Special Surgery LLC |
| Address | 8805 N Meridian St |
| City | Indianapolis |
| State | IN |
| ZIP | 46260 |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| NPI Enumerated | June 24, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $1.6M |
| Medicaid | $120.4K |
CENTER FOR SPECIAL SURGERY LLC is operating as an Ambulatory Surgical Clinic/Center with a code mix that aligns with interventional pain management and spinal neuromodulation services. Its top Medicare procedures include device-focused codes such as 63685 (spinal neurostimulator pulse generator implantation), 63650 (epidural electrode placement), and 62362 (implantable programmable pump), which together indicate the facility performs both implanted neuromodulation therapies and related imaging-guided spine procedures.
Medicare revenue is highly concentrated in implant and device procedures: the top three Medicare codes (63685, 63650, 62362) account for 63.4% of the provider's total Medicare revenue, with individual shares reported as 63685 at 31.7%, 63650 at 21.3%, and 62362 at 10.4%. This concentration shows the business is substantially driven by higher-paid implantable device services on the Medicare side.
Medicaid billing is even more concentrated in image-guided injection services: the top three Medicaid codes (62323, 64493, 64483) account for 91.9% of the provider's total Medicaid revenue, with 62323 alone representing 65.2% and 64493 representing 22.5%. These Medicaid line items are high-volume, lower-paid episodes (for example, 62323 has 1.2K claims at $66 avg paid/claim), indicating routine injection workflows dominate Medicaid activity.
The provider's payer mix is Medicare-dominant in scale: reported total Medicare revenue is $1.6M versus total Medicaid revenue of $120.4K, so Medicare is the primary revenue source while Medicaid represents a much smaller share of dollars despite high Medicaid claim counts. Operationally this suggests the center derives its revenue base from higher-paid Medicare device procedures while Medicaid contributes volume and recurring injection encounters.
National competitive standing on Medicare is mixed: 63650 ranks #198 of 1371 (85th percentile) and 63685 ranks #287 of 1281 (77th percentile), which indicates above-median national activity for key neuromodulation codes, while 62362 is more middle-of-market at the 50th percentile (rank #57 of 138). Additionally, 64490 is specifically noted as "notably above typical" (94th percentile) for injections, so the center demonstrates pockets of relatively high national activity without being a dominant national leader across all its device codes.
Within the state Medicaid market the facility is a major participant for certain injection services: 62323 ranks #4 of 83 in-state (96th percentile) and 64493 ranks #17 of 73 (78th percentile), reflecting a strong statewide presence for lumbar/sacral injection services. Conversely, G8907 appears as an "extreme outlier, far above typical state volume" (rank #1 of 66) with 2.2K claims and $0 revenue, representing an anomalously high volume of a $0-paid reporting code compared with peers.
Operational pattern across payers shows divergent roles: on Medicare the center generates material revenue from higher-dollar device implants and pump procedures (e.g., 63685 average paid/claim $19151, 62362 average paid/claim $10224), whereas on Medicaid the business is driven by high-frequency, lower-paid image-guided injections (e.g., 1.2K claims for 62323 at $66 avg paid/claim). This split suggests the center functions both as a surgical implant hub for Medicare beneficiaries and as a high-throughput injection clinic for Medicaid patients.
The provider has long-established market presence, with NPI enumeration dated 2006-06-24 (~20 years ago), indicating sustained operations in Indianapolis. Tenure combined with the specialized code mix—device implants, programmable pumps, and extensive fluoroscopy-guided injections—supports a stable, procedure-focused ambulatory surgery operation that has developed both device implantation and high-volume injection lines of business.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
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… | 30 | $19,150 | $497.9K |
| 63650 | In this procedure, the provider places electrodes in the epidural space to relieve pain and reduce or eliminate spasms. | 90 | $3,800 | $334.8K |
| 62362 | The provider implants or replaces a programmable pump under the skin used for intrathecal or epidural infusion of medication. This service allows the continuous infusion of medications such as… | 20 | $10,220 | $163.6K |
| 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… | 40 | $4,340 | $156.2K |
| 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. | 10 | $7,650 | $91.8K |
| 0275T | N/A | 10 | $3,740 | $48.6K |
| 64635 | Under fluoroscopic or CT guidance, the provider applies an agent to a lower back joint to destroy nerve tissue. | 80 | $570 | $45.6K |
| 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… | 150 | $260 | $38.7K |
| 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… | 60 | $590 | $36K |
| 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)… | 130 | $250 | $31.7K |
Showing 1–10 of 18
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
Full comparison — all codes billed, vs. state median
18 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| 63685 | 10 | 50 | 20 | $8,700 | $174.1K |
| 64555 | 6 | 10 | 50 | $2,650 | $135.1K |
| 63650 | 7 | 50 | 50 | $1,870 | $110.5K |
| 62362 | 6 | 10 | 20 | $4,350 | $95.6K |
| 64628 | 1 | 10 | 10 | $7,650 | $91.8K |
| 0275T | 14 | 20 | 20 | $2,530 | $55.6K |
| 62350 | 4 | 10 | 20 | $1,070 | $21.4K |
| 64483 | 63 | 190 | 60 | $180 | $17.8K |
| G0260 | 4 | 30 | 70 | $210 | $16.7K |
| 64635 | 19 | 150 | 30 | $360 | $16.1K |
Showing 1–10 of 18
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.
10 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 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)… | 1,200 | $70 | $79.1K |
| 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… | 600 | $50 | $27.4K |
| 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). | 80 | $60 | $5.1K |
| 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)… | 50 | $80 | $3.7K |
| 64494 | In this add–on procedure, 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… | 590 | $1 | $2.4K |
| G0260 | Injection procedure for sacroiliac joint; provision of anesthetic, steroid and/or other therapeutic agent, with or without arthrography | 130 | $20 | $2.2K |
| 77002 | The provider uses fluoroscopic guidance to place a needle for biopsy, aspiration, injection, or localization of a device to detect any lesions in any area of the body, except for the spine, or to… | 20 | $50 | $1.1K |
| 27096 | The provider performs an injection in the joint between the sacrum and ilium on one side of the body, with the aid of imaging equipment to locate the injection site. He injects an anesthetic to… | 90 | $10 | $450 |
| 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… | 2,200 | $0 | $0 |
| G8918 | Patient without preoperative order for iv antibiotic surgical site infection (ssi) prophylaxis | 630 | $0 | $0 |
How this provider's Medicaid billing volume and revenue compare to other Indiana providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Indiana median
10 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 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). | 39 | 50 | 310 | $140 | $94.7K |
| 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… | 17 | 70 | 90 | $120 | $62K |
| 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)… | 4 | 80 | 80 | $160 | $45.3K |
| 27096 | The provider performs an injection in the joint between the sacrum and ilium on one side of the body, with the aid of imaging equipment to locate the injection site. He injects an anesthetic to… | 16 | 30 | 80 | $70 | $24.3K |
| 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)… | 11 | 20 | 50 | $100 | $22.4K |
| 64494 | In this add–on procedure, 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… | 16 | 70 | 110 | $40 | $21.5K |
| 77002 | The provider uses fluoroscopic guidance to place a needle for biopsy, aspiration, injection, or localization of a device to detect any lesions in any area of the body, except for the spine, or to… | 21 | 30 | 100 | $30 | $13.2K |
| G0260 | Injection procedure for sacroiliac joint; provision of anesthetic, steroid and/or other therapeutic agent, with or without arthrography | 3 | 10 | 100 | $50 | $5.3K |
| 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… | 1 | 70 | 320 | $0 | $0 |
| G8918 | Patient without preoperative order for iv antibiotic surgical site infection (ssi) prophylaxis | 9 | 40 | 240 | $0 | $0 |
Other providers in the same ZIP code as Center For Special Surgery LLC, ranked by combined Medicare and Medicaid revenue.
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