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

Why is the Medicaid comparison limited to Rhode Island 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. Rhode Island (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.

Orthopedics Rhode Island, Inc. (NPI 1609472042)

Field	Value
Entity Type	Organization
Organization	Orthopedics Rhode Island, Inc.
Address	300 Crossings Blvd.
City	Warwick
State	RI
ZIP	02886
Taxonomy	Ambulatory Surgical Clinic/Center
NPI Enumerated	December 10, 2020

Payer Source	Total Paid
Medicare	$565.9K
Medicaid	$0

Key Findings

ORT HOPEDICS RHODE ISLAND, INC. is an ambulatory surgical clinic focused on major joint replacement and arthroscopic procedures, as evidenced by its top Medicare codes: 27447 (knee replacement), 27130 (hip replacement), and 29827 (arthroscopic rotator cuff repair). The code mix—large-share joint replacements supplemented by shoulder and knee arthroscopy codes—indicates the practice operates as a specialty surgical center concentrating on orthopedic operative care rather than primary care or nonsurgical musculoskeletal management.

Medicare revenue is the sole payer stream on file: lifetime Medicare revenue is $565.9K while there is no Medicaid billing recorded. This makes the entity effectively single-payer in the available data, with Medicaid absent from its public billing footprint and payor diversification limited based on these records.

Revenue concentration is high: the precomputed top 3 Medicare codes account for 75.0% of the provider’s total Medicare revenue. Those three codes are dominated by 27447 at $275K (48.6% of Medicare revenue) and 27130 at $98.3K (17.4%), showing the business is financially driven primarily by major joint arthroplasty services.

27447 (knee replacement) alone produced $275K across 38 claims and is the largest single revenue driver, and the provider’s national rank for this code (60th percentile, rank #4736 of 12089) indicates a reasonably typical volume for this service rather than market dominance. The practice achieves substantive revenue from knee arthroplasty but is not an extreme national outlier on volume for that procedure.

27130 (hip replacement) generated $98.3K from 13 claims but ranks at the 9th percentile nationally (rank #6957 of 8062), which signals relatively low national procedure volume for hip arthroplasty compared with peers. In contrast, 29827 (arthroscopic rotator cuff repair) sits at the 72th percentile (rank #897 of 3445) with $51K revenue, indicating stronger relative activity for shoulder arthroscopy within its service mix.

Several image-guided injection codes (62323, 64483, G0260, 62321, 64454) appear among top billings, collectively reflecting a meaningful secondary service line of spine and joint injection/management. Notably, 62323 (lumbar epidural injection) shows high claim count (147 claims) and $37K revenue and ranks at the 85th percentile nationally, suggesting the clinic provides a consistent volume of nonoperative interventional pain procedures alongside its surgical caseload.

Procedure-level percentile ranks reveal a mixed competitive standing: the provider is a modest-to-typical participant for high-revenue arthroplasty codes (27447 at 60th percentile; 27130 at 9th percentile) while showing above-typical activity in several injection and shoulder arthroscopy codes (62323 at 85th, 29827 at 72th, 64454 at 90th). This pattern is consistent with a specialty center that pairs surgery with higher-volume outpatient injections and targeted arthroscopy.

The NPI enumeration date is 2020-12-10 (about ~6 years ago), indicating the provider has a relatively recent active tenure compared with long-established centers. Given this timeline and the concentration of revenue in a few high-cost procedures, the practice appears to be an early-stage specialty ambulatory surgical center that has established a focused orthopedic procedural mix dominated by joint replacement and interventional services.

Medicare: Complete Services Breakdown

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

14 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…	40	$7,240	$275K
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…	10	$7,560	$98.3K
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…	30	$2,040	$51K
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)…	150	$250	$37K
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).	70	$340	$24.9K
29848	The provider inserts an endoscope into the wrist joint to divide the transverse carpal ligament and reduce compression on the median nerve in the carpal tunnel that results in pain and numbness.	40	$500	$17.4K
29881	The 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…	10	$1,120	$15.7K
29880	In 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…	10	$1,100	$12.1K
G0260	Injection procedure for sacroiliac joint; provision of anesthetic, steroid and/or other therapeutic agent, with or without arthrography	50	$230	$12K
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…	20	$400	$7.3K

Showing 1–10 of 14

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 14 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Rhode Island Distribution

Orthopedics Rhode Island, Inc. — 0 of 14 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Rhode Island

Full comparison — all codes billed, vs. state median

14 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
27447	19	50	30	$1,230	$43K
27130	29	30	20	$1,250	$33.8K
29827	3	10	20	$1,120	$21.3K
29881	1	10	10	$1,080	$15.2K
62323	6	20	50	$140	$13.2K
29848	3	10	30	$420	$12.7K
64483	6	20	50	$190	$12.2K
G0260	1	10	50	$230	$11.4K
26055	11	10	30	$340	$11.2K
29880	2	10	10	$920	$11K

Showing 1–10 of 14

Related Providers

Other providers that share a Tax Identification Number (TIN) with Orthopedics Rhode Island, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Orthopedics Rhode Island, Inc	RI	Orthopaedic Surgery Physician	$0	$2.5M
Crossings Surgery Center, LLC	RI	Ambulatory Surgical Clinic/Center	$939.1K	$0
Orthopedics Rhode Island, Inc	RI	Orthopaedic Surgery Physician	$0	$812.4K
Thomas Rocco	RI	Surgery Physician	$92.7K	$558.4K
Eric Walsh	RI	Orthopaedic Hand Surgery Physician	$67.9K	$336.2K
William Brennan	RI	Orthopaedic Surgery Physician	$99.4K	$301.4K
Jason Tartaglione	RI	Orthopaedic Foot and Ankle Surgery Physician	$61K	$320.6K
Keith Monchik	RI	Sports Medicine (Orthopaedic Surgery) Physician	$70K	$249.1K
Robert Marchand	RI	Orthopaedic Surgery Physician	$314.2K	$0
Maher El Khatib	RI	Anesthesiology Physician	$113.2K	$163.7K

Nearby Providers

Other providers in the same ZIP code as Orthopedics Rhode Island, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
West Bay Residential Services Inc.	RI	Developmentally Disabled Services Day Training Agency	$0	$145.8M
Kent County Memorial Hospital	RI	General Acute Care Hospital	$0	$90.8M
Avatar Residential, Inc.	RI	Developmentally Disabled Services Day Training Agency	$0	$72.9M
Thrive Behavioral Health, Inc.	RI	Community/Behavioral Health Agency	$0	$71.9M
Bayada Home Health Care, Inc.	RI	Home Health Agency	$0	$69.5M
Community Living Of Rhode Island	RI	Developmentally Disabled Services Day Training Agency	$0	$65.7M
J.arthur Trudeau Memorial Center Conversion Waivers	RI	Developmentally Disabled Services Day Training Agency	$0	$57.1M
Gateways To Change, Inc.	RI	Developmentally Disabled Services Day Training Agency	$0	$54.5M
Affinity Physicians LLC.	RI	Internal Medicine Physician	$0	$41.8M
J, Arthur Trudeau Memorial Center	RI	Developmentally Disabled Services Day Training Agency	$0	$33.9M

Orthopedics Rhode Island, Inc. — Billing Profile & Reimbursement Data

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Orthopedics Rhode Island, Inc. — 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

Related Providers

Nearby Providers

Frequently Asked Questions

References