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    Careplex Orthopaedic Ambulatory Surgery Center, LLC — Billing Profile & Reimbursement Data

    NPI 1548582463 · Norfolk, VA · Ambulatory Surgical Clinic/Center

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    Careplex Orthopaedic Ambulatory Surgery Center, LLC is a ambulatory surgical clinic/center provider located in Norfolk, Virginia. This profile covers 24 Medicare and 2 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)

    FieldValue
    Entity TypeOrganization
    OrganizationCareplex Orthopaedic Ambulatory Surgery Center, LLC
    Address6015 Poplar Hall Dr
    CityNorfolk
    StateVA
    ZIP23502
    TaxonomyAmbulatory Surgical Clinic/Center
    NPI EnumeratedFebruary 19, 2010

    Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)

    Payer SourceTotal Paid
    Medicare$2.2M
    Medicaid$1.1K

    Medicare: Total Revenue Breakdown by CPT/HCPCS Code

    Medicare revenue breakdown by CPT/HCPCS procedure code.

    View: Bar Chart1 / 2

    Medicare: Complete Services Breakdown

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

    24 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    27447In 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…150$6,750$1M
    27130In 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$6,940$339.9K
    29827The 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…110$1,740$187.9K
    29828The provider examines the tissue inside the shoulder joint with an arthroscope. She inserts additional instruments to repair an unstable biceps tendon, the fibrous band that connects the biceps…60$2,340$135.5K
    64721Neuroplasty 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…130$600$76.1K
    26055Trigger 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…170$430$72.9K
    26480In this procedure, the provider transfers or transplants a tendon in the carpometacarpal area or the back of the hand. The carpometacarpal area is the articulation of the wrist’s carpal bones with…60$990$62.1K
    29880In 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…50$1,030$50.6K
    25447The provider performs arthroplasty (joint replacement) of the intercarpal joints (between the small bones in the wrist) or carpometacarpal joints (where the carpal bones of the wrist meet the…60$520$30.9K
    29881The provider examines the inside of the knee joint with an arthroscope. She repairs the joint by removing the meniscus, a crescent shaped cartilage cushion, from either the medial or lateral…30$960$29.6K

    Showing 1–10 of 24

    Medicare: Competitive Analysis & Benchmarks

    How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 24 CPT/HCPCS codes.

    View: State1 / 2

    Full comparison — all codes billed, vs. state median

    24 rows

    CPT/HCPCS CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    274471631040$1,150$64.4K
    271307021040$1,040$45.9K
    6448316917080$210$31.4K
    29827412020$1,010$29.2K
    2982854020$970$26.2K
    2612392020$830$16.5K
    2988012020$790$15.8K
    2544724020$580$15.6K
    6472119030$420$15.4K
    2988143020$780$14.9K

    Showing 1–10 of 24

    Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

    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

    Medicaid: Complete Services Breakdown

    Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.

    2 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    76942Ultrasonography uses sound waves of higher frequencies (above the normal hearing capacity of a healthy human, i.e., 20 kHz) to visualize inner organs. When the sound waves pass through the human…10$90$1.1K
    C1713Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable)60$0$0

    Medicaid: Competitive Analysis & Benchmarks

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

    Full comparison — all codes billed, vs. Virginia median

    2 rows

    CPT/HCPCS CodeDescriptionRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    C1713Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable)4050280$60$50.8K
    76942Ultrasonography uses sound waves of higher frequencies (above the normal hearing capacity of a healthy human, i.e., 20 kHz) to visualize inner organs. When the sound waves pass through the human…4140130$40$23.2K

    Nearby Providers

    Other providers in the same ZIP code as Careplex Orthopaedic Ambulatory Surgery Center, LLC, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Sentara HospitalsVAGeneral Acute Care Hospital$0$79.7M
    Tremont Road Dental Super, P.C.VAGeneral Practice Dentistry$0$63.5M
    Sentara Medical GroupVAFamily Medicine Physician$0$48.7M
    Emergency Physicians Of TidewaterVAEmergency Medicine Physician$0$47.9M
    Community Alternative IncVACommunity/Behavioral Health Agency$0$44.3M
    Life's JourneyVAAdult Mental Health Clinic/Center$0$24.4M
    Keys To Success Family & Developmental ServicesVACommunity/Behavioral Health Agency$0$16.1M
    Advantage Home Care, LLCVAHome Health Agency$0$15.7M
    National Counseling Group, IncVAMental Health Counselor$0$14.5M
    Childrens Medical Group IncVAPediatrics Physician$0$9.1M

    Frequently Asked Questions

    References

    1. 1.Medicare Physician & Other Practitioner by Provider and Service. CMS.gov.Provider-level Medicare Part B utilization and payment data.
    2. 2.NPPES NPI Registry. CMS.gov.National Provider Identifier registry used for provider enumeration and taxonomy metadata.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

    Medicare Revenue by CPT/HCPCS Code
    Claims Volume vs. Virginia Distribution
    Careplex Orthopaedic Ambulatory Surgery Center, LLC — 10 of 24 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Virginia
    Medicaid Revenue by Year vs. Virginia Providers
    0 of 2 years billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Claims Volume vs. Virginia Distribution
    Careplex Orthopaedic Ambulatory Surgery Center, LLC — 0 of 1 code billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Virginia