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NPI 1619998648 · Boise, ID · Ambulatory Surgical Clinic/Center
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Pain Care Center Boise, LLC is a ambulatory surgical clinic/center provider located in Boise, Idaho. This profile covers 10 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)
| Field | Value |
|---|---|
| Entity Type | Organization |
| Organization | Pain Care Center Boise, LLC |
| Address | 301 W Myrtle St |
| City | Boise |
| State | ID |
| ZIP | 83702 |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| NPI Enumerated | July 23, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $741.8K |
| Medicaid | $10.4K |
PAIN CARE CENTER BOISE, LLC operates as an Ambulatory Surgical Clinic/Center with billing dominated by interventional spine and pain procedures; its top Medicare CPTs include 63685 (spinal neurostimulator pulse generator insertion), 63650 (epidural electrode placement), and 64635 (neurolytic treatment of lower back joint), which together define a procedural mix centered on implantable neuromodulation and image-guided spine injections. This clinical profile aligns with an ASC-style workflow that combines device implantation and outpatient interventional pain management.
Medicare revenue is the primary commercial driver for this practice: total Medicare revenue is $741.8K and the precomputed top-3 Medicare codes account for 77.9% of that Medicare revenue. Within Medicare, 63685 alone represents 40.4% of Medicare revenue and 63650 represents 29.6%, indicating that a small set of high-value procedures dominates payer receipts.
The provider’s Medicaid footprint is minimal in scale compared with Medicare: total Medicaid revenue is $10.4K, and the precomputed top-3 Medicaid codes account for 100.0% of the provider’s Medicaid revenue. Medicaid billing is concentrated in two injection codes, with 62323 contributing 55.5% of Medicaid revenue and 64493 contributing 44.5%, underscoring that Medicaid activity is narrowly focused and materially small relative to Medicare.
Competitive standing across the provider’s top Medicare codes is mixed but generally in the “typical” range: 63685 ranks #662 of 1281 providers nationally (42th percentile, labeled "typical, unremarkable volume"), 63650 ranks #459 of 1371 (66th percentile, labeled "typical, unremarkable volume"), and 64635 ranks #473 of 5957 (92th percentile, labeled "typical, unremarkable volume"). The 92nd-percentile placement for 64635 signals relatively stronger national activity on that particular neurolytic facet procedure compared with the provider’s other high-revenue codes, even though all are described as typical in the supplied labels.
In Medicaid-level competitive terms the provider is not a major in-state participant for the listed codes: 62323 ranks #11 of 12 providers in-state (9th percentile, labeled "typical, unremarkable volume") and 64493 ranks #5 of 6 (20th percentile, labeled "typical, unremarkable volume"). These low in-state percentiles reinforce that the practice’s Medicaid presence is limited and not a primary source of market influence within Idaho.
The provider has a long tenure in the NPI registry, enumerated on 2006-07-23 (~20 years ago), which suggests an established operating history and likely stable referral relationships for spine and pain procedures. That longevity, combined with the concentrated procedure mix, indicates an established niche rather than a newly entering operation.
The revenue profile shows material concentration risk: because the top three Medicare codes account for 77.9% of Medicare revenue and two codes alone account for 100.0% of Medicaid revenue, the practice’s financial performance is highly sensitive to payment, coverage, or utilization shifts for a very small set of spinal and injection procedures (notably 63685 and 63650). Payer policy or reimbursement changes affecting these high-revenue codes would likely have an outsized impact on overall receipts.
Procedure-level descriptors in the dataset uniformly label most high-volume codes as "typical, unremarkable volume," which indicates that, apart from the relatively elevated national percentile for 64635, the provider’s coding and volume pattern falls within common practice behavior for interventional pain centers rather than showing unusual statistical outlier behavior. This characterization should be weighed alongside the financial concentration noted above when assessing business and reimbursement risk.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
10 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 63685 | The provider inserts or replaces a spinal neurostimulator pulse generator or receiver. The system is one that requires surgical creation of a pocket for placement and that requires a connection… | 20 | $18,730 | $299.6K |
| 63650 | In this procedure, the provider places electrodes in the epidural space to relieve pain and reduce or eliminate spasms. | 60 | $3,720 | $219.5K |
| 64635 | Under fluoroscopic or CT guidance, the provider applies an agent to a lower back joint to destroy nerve tissue. | 130 | $470 | $59.1K |
| 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 | $260 | $45.2K |
| 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). | 90 | $290 | $25.7K |
| 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)… | 100 | $250 | $24.3K |
| 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 | $500 | $21K |
| 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… | 70 | $260 | $18.6K |
| G0260 | Injection procedure for sacroiliac joint; provision of anesthetic, steroid and/or other therapeutic agent, with or without arthrography | 80 | $220 | $16.9K |
| 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)… | 50 | $250 | $11.8K |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 10 CPT/HCPCS codes.
View: State1 / 2
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.
View: By Year1 / 3
Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
2 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)… | 20 | $260 | $5.8K |
| 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… | 30 | $180 | $4.6K |
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
2 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 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… | 5 | 10 | 50 | $360 | $57.4K |
| 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)… | 11 | 10 | 60 | $170 | $25.2K |
Other providers in the same ZIP code as Pain Care Center Boise, LLC, ranked by combined Medicare and Medicaid revenue.
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