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

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

Capital Orthopaedic Surgery Center, LLC (NPI 1548896095)

Key Findings

Field	Value
Entity Type	Organization
Organization	Capital Orthopaedic Surgery Center, LLC
Address	20680 Seneca Meadows Pkwy Ste 200
City	Germantown
State	MD
ZIP	20876
Taxonomy	Ambulatory Surgical Clinic/Center
NPI Enumerated	March 17, 2020

Payer Source	Total Paid
Medicare	$2.5M
Medicaid	$0

CAPITAL ORTHOPAEDIC SURGERY CENTER, LLC is effectively a Medicare-focused ambulatory surgical clinic: its lifetime Medicare revenue is $2.5M while there is no Medicaid billing on file. The provider’s NPI was enumerated on 2020-03-17 (~6 years ago), indicating a relatively recent tenure in the Medicare program compared with long-established centers. This single-payer profile means Medicare reimbursement dynamics will be the primary driver of its financial performance.

Revenue concentration is extreme: the precomputed top three Medicare codes (27447, 27130, 27446) together account for 95.3% of this provider’s total Medicare revenue. Individually those codes represent $1M (42.1%), $921.1K (37.2%), and $397.1K (16.0%) of Medicare revenue respectively, showing the business is highly dependent on a narrow set of joint-replacement and reconstruction procedures.

The service-line mix is strongly orthopaedic and lower-extremity focused. The top-revenue codes are 27447 (total knee replacement; 140 claims, $7454 avg paid/claim, $1M revenue), 27130 (total hip replacement; 122 claims, $7550 avg paid/claim, $921.1K revenue) and 27446 (knee compartment reconstruction; 54 claims, $7354 avg paid/claim, $397.1K revenue), which together indicate the center’s operations center on joint arthroplasty and major knee procedures rather than a broad mix of minor ambulatory procedures.

Competitive standing for its leading services is well above typical national volume. For hip replacement (27130) the provider ranks #105 of 8062 providers nationally (99th percentile) and is labeled an "extreme outlier, far above typical national volume for this code," while knee replacement (27447) ranks #326 of 12089 (97th percentile) and 27446 ranks #28 of 450 (94th percentile); these placements identify the center as a major national-volume participant for these specific procedures.

Other procedure lines billed to Medicare are modest or typical for a specialized orthopaedic center. Examples include 29827 (arthroscopic rotator cuff repair; 14 claims, $1882 avg paid/claim, $26.3K revenue) which ranks #2254 of 3445 (27th percentile) and is characterized as typical/unremarkable, and C9290 (bupivacaine liposome injection; 31.9K claims, $1 avg paid/claim, $31.9K revenue) which is described as typical/unremarkable despite a 92th percentile rank among a different provider set. These items suggest a narrow high-revenue core supplemented by lower-revenue ancillary procedures.

The provider’s dependence on a very small set of high-value CPTs creates concentration risk: with 95.3% of Medicare revenue tied to 27447, 27130, and 27446, any changes in reimbursement, coverage policy, or referral patterns for joint arthroplasty could materially affect revenue. Because there is no Medicaid billing on file, the center lacks diversification across public payers, amplifying sensitivity to Medicare-specific payment or utilization shifts.

Operational implications for network and competitive strategy are clear: CAPITAL ORTHOPAEDIC appears positioned as a specialized arthroplasty/reconstruction center rather than a general ambulatory surgical center. Its outsized national rankings on 27130 and 27447 suggest the center competes at scale for hip and knee replacements and may attract referrals specifically for those procedures; conversely, lower percentile placements on other codes indicate it is not a high-volume provider for broader orthopaedic or diagnostic services.

From a contracting and utilization review perspective, the profile flags a small number of revenue-driving CPTs to monitor closely: 27447, 27130, and 27446 should be the focus of payer-provider dialogs, audit sampling, and episode-cost analysis because they collectively generate $1M, $921.1K, and $397.1K respectively and constitute the overwhelming majority of the center’s Medicare revenue. Given the center’s ~6-year Medicare tenure and concentrated payer mix, payers and analysts should prioritize these codes when evaluating performance, network value, or risk-sharing arrangements.

Medicare: Complete Services Breakdown

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

10 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…	140	$7,450	$1M
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…	120	$7,550	$921.1K
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…	50	$7,350	$397.1K
C9290	Injection, bupivacaine liposome, 1 mg	31,920	$1	$31.9K
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…	10	$1,880	$26.3K
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	$1,260	$20.1K
20680	Skeletal deformities or injuries such as fractures often require the use of skeletal fixation devices, like pins, rods, wires, bands, or plates, to join skeletal parts and maintain their normal…	20	$860	$14.6K
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…	20	$650	$13.7K
28285	The provider repairs a hammertoe deformity, a painful condition in which the toe remains permanently bent in a downward position.	10	$650	$9.1K
76000	In this procedure, the provider uses fluoroscopy for up to one hour as an imaging technique to obtain real time images of internal structures.	20	$20	$440

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Roberts Home Medical LLC	MD	Durable Medical Equipment & Medical Supplies	$0	$17.4M
Aa Plus Adult Medical Day Care Center Corporation	MD	Adult Day Care Clinic/Center	$0	$8.9M
Vesta, Inc.	MD	Community/Behavioral Health Agency	$0	$7.5M
Jeffrey Wang	MD	Vascular Surgery Physician	$1.9M	$0
Shan E Ali Haider	MD	Vascular Surgery Physician	$1.4M	$0
Dustin Yoon	MD	Single Specialty Group	$1.1M	$0
Renu Berry	MD	Diagnostic Radiology Physician	$769.3K	$0
Richard Silva	MD	Vascular Surgery Physician	$684.1K	$0
Alka Singh	MD	Diagnostic Radiology Physician	$664K	$0
Robert Isaacs	MD	Diagnostic Radiology Physician	$474.8K	$0

Capital Orthopaedic Surgery Center, LLC — Billing Profile & Reimbursement Data

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Capital Orthopaedic Surgery Center, LLC — 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

Nearby Providers

Frequently Asked Questions

References

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
27446	2	20	30	$3,330	$103.2K
27447	11	270	30	$1,500	$72K
27130	3	180	30	$1,430	$56K
29827	58	80	20	$1,210	$30.3K
64721	42	60	30	$490	$22.1K
28285	28	30	20	$560	$15K
20902	2	10	30	$420	$12.7K
20680	5	10	20	$680	$12.3K
C9290	1	20	4,920	$1	$7.5K
76000	19	40	20	$20	$720