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NPI 1568421840 · Concord, NH · Ambulatory Surgical Clinic/Center
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Capital Orthopedic Surgery Center is a ambulatory surgical clinic/center provider located in Concord, New Hampshire. This profile covers 27 Medicare and 3 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 | Capital Orthopedic Surgery Center |
| Address | 116 Langley Parkway |
| City | Concord |
| State | NH |
| ZIP | 03301 |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| NPI Enumerated | March 23, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $1.5M |
| Medicaid | $11.2K |
CAPITAL ORTHOPEDIC SURGERY CENTER operates as an ambulatory surgical clinic/center with a clear orthopedic focus: the provider’s top Medicare revenue drivers are 27130 ($362.9K), 27447 ($330.1K), and 64721 ($104.8K), and the total Medicare revenue on file is $1.5M. The presence of high-dollar arthroplasty codes (27130, 27447) alongside high-volume hand and peripheral nerve procedures (64721) indicates a mixed service line performing both major joint replacement work and a substantial volume of smaller, procedure-based ambulatory cases.
Revenue concentration is pronounced: the top three Medicare codes by revenue account for 52.6% of this provider’s total Medicare revenue, and the top three Medicaid codes by revenue account for 100.0% of this provider’s total Medicaid revenue. That concentration signals that a relatively small set of procedures drives the majority of billed revenue to each payer.
Payer mix is heavily weighted toward Medicare in scale: Medicare revenue is $1.5M versus total Medicaid revenue of $11.2K, so the provider is effectively Medicare-driven in financial scale and Medicaid plays a negligible role in overall revenue. Medicaid billing is nearly exclusively for a single service (62323 on Medicaid accounts for $11.1K and 100.0% of Medicaid revenue), which reinforces a narrow Medicaid footprint.
Competitive standing is mixed by service line: for carpal tunnel release 64721 the practice is a national outlier (ranks #35 of 3206; 99th percentile; extreme outlier, far above typical national volume for this code), and for trigger finger 26055 it is also extreme (ranks #38 of 2946; 99th percentile). By contrast, its hip replacement 27130 and knee replacement 27447 volumes sit in typical ranges for national peers (27130 ranks at the 79th percentile, 27447 at the 68th percentile), suggesting dominance in hand procedures but typical market participation for major arthroplasty.
The practice also maintains a sizable image-guided spine/pain injection footprint on Medicare: 62323 shows 300 claims and $75.6K revenue (5.0% of Medicare revenue), 64493 shows 218 claims and $61.3K (4.0%), and 64483 shows 177 claims and $58.1K (3.8%). These counts and revenues indicate a substantive outpatient pain-management service line embedded alongside orthopedic surgical volume.
Procedure mix implies an ambulatory model that balances high-revenue joint arthroplasties with high-throughput minor procedures and injection-based pain services. The coexistence of major codes (27130, 27447) and high-claim, lower-paid procedures (64721 at 161 claims, 26055 at 153 claims) is consistent with a center that schedules both episodic high-reimbursement surgeries and frequent, procedure-oriented visits.
Medicaid activity is narrowly concentrated and modest: Medicaid billing is dominated by 62323 (89 claims, $11.1K, 100.0% of Medicaid revenue) and that code ranks #3 of 9 in-state (75th percentile; typical, unremarkable volume for this code). This pattern suggests the provider takes a limited Medicaid caseload concentrated in lumbar injection services rather than a broad Medicaid surgical mix.
The provider’s NPI was enumerated on 2006-03-23 (~20 years ago), indicating long-standing enrollment and suggesting operational stability in the market. Coupled with the concentrated revenue drivers and the mixed dominance across procedure types, this tenure supports the interpretation of an established ambulatory orthopedic practice with niche strengths in hand surgery and spine injections.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
27 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 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… | 50 | $7,560 | $362.9K |
| 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 | $7,180 | $330.1K |
| 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… | 160 | $650 | $104.8K |
| 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… | 40 | $1,900 | $83.4K |
| 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)… | 300 | $250 | $75.6K |
| 26055 | Trigger 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… | 150 | $450 | $68.7K |
| 23430 | In this procedure, the provider surgically cleans the long tendon of the biceps from its damaged fragment and fixes the tendon to the upper end of the humerus to improve the stability of the joint.… | 20 | $3,200 | $63.9K |
| 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… | 220 | $280 | $61.3K |
| 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). | 180 | $330 | $58.1K |
| 63047 | The provider performs a laminectomy (excision of the thin bony plate at the back of a vertebra), facetectomy (excision of an area of a vertebra characterized by its smooth surface), and foraminotomy… | 20 | $2,490 | $49.7K |
Showing 1–10 of 27
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 27 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
27 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| 27447 | 37 | 90 | 40 | $1,310 | $57.7K |
| 27130 | 15 | 70 | 30 | $1,580 | $55.3K |
| 29827 | 2 | 20 | 20 | $1,160 | $24.4K |
| 63030 | 3 | 10 | 20 | $950 | $20.9K |
| 64721 | 1 | 30 | 40 | $450 | $19.3K |
| 23430 | 2 | 10 | 20 | $940 | $16.9K |
| 64635 | 9 | 40 | 40 | $370 | $16.1K |
| 64483 | 3 | 40 | 60 | $180 | $15.4K |
| 62323 | 2 | 50 | 80 | $150 | $13.8K |
| 63047 | 8 | 20 | 10 | $730 | $13.8K |
Showing 1–10 of 27
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.
3 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)… | 90 | $130 | $11.1K |
| 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… | 450 | $0 | $0 |
| G8918 | Patient without preoperative order for iv antibiotic surgical site infection (ssi) prophylaxis | 110 | $0 | $0 |
How this provider's Medicaid billing volume and revenue compare to other New Hampshire providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. New Hampshire median
3 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average 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)… | 3 | 10 | 20 | $140 | $14.4K |
| 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 | 10 | 120 | $0 | $0 |
| G8918 | Patient without preoperative order for iv antibiotic surgical site infection (ssi) prophylaxis | 2 | 10 | 40 | $0 | $0 |
Other providers in the same ZIP code as Capital Orthopedic Surgery Center, ranked by combined Medicare and Medicaid revenue.
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