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NPI 1619370434 · Sandpoint, ID · Ambulatory Surgical Clinic/Center
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Sandpoint Surgery Center LLC is a ambulatory surgical clinic/center provider located in Sandpoint, Idaho. This profile covers 9 Medicare and 1 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 | Sandpoint Surgery Center LLC |
| Address | 1327 Superior St |
| City | Sandpoint |
| State | ID |
| ZIP | 83864 |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| NPI Enumerated | October 7, 2014 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $421.9K |
| Medicaid | $5.8K |
Service-line profile: The provider’s CPT mix is concentrated in interventional pain and spine procedures — high-volume spinal cord stimulation lead placement and a range of fluoroscopy-guided injections and neurolytic procedures. Codes such as 63650, 64635, 64483, 64493 and 62323 point to an ambulatory surgical center model focused on epidural/transforaminal injections, facet joint injections, radiofrequency/neurolytic procedures, and spinal cord stimulation rather than broad multispecialty surgery.
Medicare vs Medicaid scale: This facility is effectively Medicare-dominant in scale, reporting Total Medicare revenue of $421.9K versus Total Medicaid revenue of $5.8K. Medicaid billing is negligible compared with Medicare, indicating the center’s commercial and Medicare-facing payer mix is the primary revenue driver.
Medicare revenue concentration: The top three Medicare codes (63650, 64635, 64483) drive the majority of Medicare receipts — together they account for 62.1% of this provider's total Medicare revenue. Individually those codes are reported as 63650 $164K (38.9%), 64635 $53.1K (12.6%) and 64483 $45.1K (10.7%), showing a narrow set of services account for most Medicare income.
Medicaid concentration and state standing: Medicaid activity is entirely concentrated in a single service code, 62323, which accounts for 100.0% of the provider’s Medicaid revenue (25 claims, $232 avg paid/claim, $5.8K revenue). In-state ranking for 62323 is #10 of 12 (18th percentile), indicating this provider has below-average Medicaid volume for that lumbar/sacral epidural injection relative to state peers.
Competitive standing by code: Nationally the provider shows mixed presence across its top Medicare procedures — 63650 (spinal cord stimulator lead placement) ranks #611 of 1371 (54th percentile), a typical, unremarkable volume for that code, while several injection and facet codes rank well above peers (for example 64493 ranks #612 of 7519, 92nd percentile, and 64490 ranks #421 of 3759, 88th percentile), indicating stronger-than-typical volumes in image-guided injections and facet procedures.
High-reimbursement procedure influence: The single largest Medicare revenue driver is 63650, which carries a high average payment ($3416 avg paid/claim) and contributes $164K (38.9%) to Medicare revenue. This concentration means a small number of high-dollar SCS procedures materially affect total Medicare receipts for the center.
Operational concentration risk: The combination of a Medicare revenue base of $421.9K heavily weighted to a few interventional pain codes and virtually no Medicaid breadth (only $5.8K) suggests business risk if reimbursement policies or utilization for these specific codes change. The practice’s financial profile is sensitive to volume shifts in SCS placements and image-guided spinal injections.
Tenure and continuity: The provider’s NPI was enumerated on 2014-10-07 (~12 years ago), indicating it has been operating for about a dozen years under this NPI, which supports interpretation of current billing patterns as established rather than transient.
Medicare revenue breakdown by CPT/HCPCS procedure code.
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The CPT/HCPCS codes generating the most Medicare revenue for this provider.
9 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 63650 | In this procedure, the provider places electrodes in the epidural space to relieve pain and reduce or eliminate spasms. | 50 | $3,420 | $164K |
| 64635 | Under fluoroscopic or CT guidance, the provider applies an agent to a lower back joint to destroy nerve tissue. | 90 | $590 | $53.1K |
| 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). | 170 | $260 | $45.1K |
| 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… | 180 | $240 | $43.4K |
| 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)… | 140 | $230 | $31.6K |
| G0260 | Injection procedure for sacroiliac joint; provision of anesthetic, steroid and/or other therapeutic agent, with or without arthrography | 120 | $200 | $24K |
| 64633 | In this procedure, the provider destroys the facet joint nerve of a cervical or thoracic spinal segment using neurolytic agents like heat, electric current, or a chemical compound. He makes use of… | 40 | $590 | $23.7K |
| 64490 | The provider injects a diagnostic or therapeutic substance into a single cervical or thoracic paravertebral facet (zygapophyseal) joint, or into the nerves that supply that joint, using imaging… | 80 | $240 | $19.3K |
| 62321 | 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 cervical (neck) or thoracic (upper and middle back)… | 80 | $230 | $17.8K |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 9 CPT/HCPCS codes.
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Full comparison — all codes billed, vs. state median
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
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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 |
|---|---|---|---|---|
| 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)… | 30 | $230 | $5.8K |
How this provider's Medicaid billing volume and revenue compare to other Idaho providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Idaho median
1 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)… | 10 | 10 | 60 | $170 | $25.2K |
Other providers in the same ZIP code as Sandpoint Surgery Center LLC, ranked by combined Medicare and Medicaid revenue.
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