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

Why is the Medicaid comparison limited to Puerto Rico 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. Puerto Rico (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.

Surgical Solutions-j.a. Puerto Rico, Inc (NPI 1538475348)

Field	Value
Entity Type	Organization
Organization	Surgical Solutions-j.a. Puerto Rico, Inc
Address	#1 Electro Biology Blvd.
City	Guaynabo
State	PR
ZIP	00969
Taxonomy	Durable Medical Equipment & Medical Supplies
NPI Enumerated	August 31, 2010

Payer Source	Total Paid
Medicaid	$7.1M
Medicare	$0

Key Findings

Business/service-line profile: The provider is classified in Durable Medical Equipment & Medical Supplies and its Medicaid activity is concentrated entirely in L8699 (prosthetic implant, not otherwise specified), indicating an operational focus on implantable prosthetic devices rather than a broader DME product mix. This revenue mix suggests the organization functions principally as a prosthetic implant supplier or intermediary rather than a general medical-supply vendor, with clinical and billing workflows aligned to high-value implant claims.

Revenue concentration: The precomputed top-3 Medicaid codes account for 100.0% of this provider's total Medicaid revenue, and in practice that concentration is entirely captured by a single code, L8699 (3.1K claims, $2263 avg paid/claim, $7.1M revenue). This extreme concentration means nearly all Medicaid receipts derive from one clinical product line, making the provider’s Medicaid topline highly dependent on continued reimbursement and utilization of that code.

Payer mix and scale: The provider has no Medicare billing on file while reporting $7.1M in lifetime Medicaid revenue, making it effectively a single-payer (Medicaid) operation in the available data. This asymmetric payer footprint implies limited exposure to Medicare fee schedules and beneficiary mixes and a revenue profile closely tied to state Medicaid policy and contracting.

Competitive standing in-state: For L8699 the provider ranks #7 of 23 providers in-state and sits at the 73th percentile, described in the source as a "typical, unremarkable volume for this code." That placement characterizes the provider as a modest but established participant in the statewide prosthetic implant market—neither a dominant market leader nor a fringe operator.

Claims-level economics: The reported L8699 activity includes 3.1K claims with an average paid amount of $2263 per claim, signaling high unit revenue per event consistent with implantable device billing. This per-claim reimbursement profile reflects the capitalized nature of prosthetic implants and suggests margins and working-capital needs will be influenced by inventory and supply arrangements.

Concentration risk and operational implications: Reliance on a single HCPCS code for 100.0% of Medicaid revenue creates concentration risk—policy changes, code edits, or shifts in clinical practice affecting L8699 could materially impact revenue. From an operational standpoint, the provider may need to manage inventory, vendor relationships, and state-level contract terms tightly to mitigate that single-code exposure.

Tenure and market persistence: The NPI was enumerated on 2010-08-31 (~16 years ago), indicating the provider has been active for an extended period and has sustained its Medicaid-focused business model over multiple years. This longevity supports the interpretation that the current single-code concentration is an established business pattern rather than a short-term anomaly.

Regulatory and contracting considerations: Absence of Medicare claims may limit the provider’s leverage in multi-payer contracting and positions Medicaid as the primary payer relationship to manage. Analysts assessing network value or negotiating strategy should account for the provider’s Medicaid dependence and the concentrated L8699 revenue stream when evaluating partnership or credentialing decisions.

Medicaid: Complete Services Breakdown

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
L8699	Prosthetic implant, not otherwise specified	3,130	$2,260	$7.1M

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other Puerto Rico providers billing the same CPT/HCPCS codes.

Claims Volume vs. Puerto Rico Distribution

Surgical Solutions-j.a. Puerto Rico, Inc — 0 of 1 code billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Puerto Rico

Full comparison — all codes billed, vs. Puerto Rico median

1 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
L8699	Prosthetic implant, not otherwise specified	7	20	740	$2,660	$4.6M

Nearby Providers

Other providers in the same ZIP code as Surgical Solutions-j.a. Puerto Rico, Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Elderly Transportation Services, LLC	PR	Transportation Broker	$0	$25.7M
Rmc Orthopedic & Surgical, Inc.	PR	Prosthetic/Orthotic Supplier	$0	$7.5M
Bless Therapy Place Psc	PR	Hearing and Speech Clinic/Center	$0	$3.7M
Elderly Transportation Services Management LLC	PR	Transportation Broker	$0	$3.4M
Osvaldo Niebla Diaz	PR	General Practice Physician	$2.9K	$3.1M
Four Molar Psc	PR	Oral and Maxillofacial Surgery (Dentist)	$0	$3M
Ccs Psc	PR	Cardiovascular Disease Physician	$0	$2.3M
Johnson & Johnson Medical Caribbean	PR	Prosthetic/Orthotic Supplier	$0	$2.2M
J.e.r.i. Cardiomed, P.s.c.	PR	Cardiovascular Disease Physician	$0	$1.1M
Rs Gastroenterology, LLC	PR	Gastroenterology Physician	$0	$896.6K

Surgical Solutions-j.a. Puerto Rico, Inc — Billing Profile & Reimbursement Data

Sign up for Surgical Solutions-j.a. Puerto Rico, Inc — Billing Profile & Reimbursement Data policy alerts

Surgical Solutions-j.a. Puerto Rico, Inc — Billing Profile & Reimbursement Data

Sign up for Surgical Solutions-j.a. Puerto Rico, Inc — Billing Profile & Reimbursement Data policy alerts

Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References