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

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

Missoula Bone & Joint Surgery Center, LLC (NPI 1639126303)

Field	Value
Entity Type	Organization
Organization	Missoula Bone & Joint Surgery Center, LLC
Address	2360 Mullan Rd
City	Missoula
State	MT
ZIP	59808
Taxonomy	Ambulatory Surgical Clinic/Center
NPI Enumerated	May 28, 2006

Payer Source	Total Paid
Medicare	$2.2M
Medicaid	$0

Key Findings

MISSOULA BONE & JOINT SURGERY CENTER, LLC operates as an ambulatory surgical clinic/center whose Medicare billing is dominated by large-joint arthroplasty: 27447 (159 claims, $7020 avg paid/claim, $1.1M revenue) and 27130 (84 claims, $7160 avg paid/claim, $601.4K revenue) are the clear service-line drivers, with a smaller contribution from lumbar decompression 63047 (31 claims, $2363 avg paid/claim, $73.3K revenue). The mix of high-paid joint replacement codes alongside shoulder, hand, and arthroscopic procedures indicates an orthopedic-focused ASC that performs elective total knee and hip replacements as its primary business.

Revenue concentration is high: this provider reports $2.2M in total Medicare revenue and the precomputed top-three Medicare codes account for 80.7% of that Medicare revenue. In dollar terms the top three are 27447 ($1.1M), 27130 ($601.4K), and 63047 ($73.3K), showing a narrow revenue base weighted toward arthroplasty.

Payer mix is effectively single-payer Medicare: there is $2.2M of Medicare revenue on file and no Medicaid billing on file, so Medicaid does not meaningfully contribute to this provider’s revenue profile. Analysts should treat this entity as Medicare-dependent when modeling payer risk or forecasting volume shifts.

Competitive standing for major arthroplasty is strong: 27447 ranks #221 of 12089 providers nationally (98th percentile; notably above typical national volume for this code) and 27130 ranks #403 of 8062 providers nationally (95th percentile; notably above typical national volume for this code). These rank/percentile positions indicate the center is a high-volume national performer for primary knee and hip replacements relative to peers.

Secondary service lines are present but much smaller: hand and upper-extremity procedures such as 64721 (79 claims, $627 avg paid/claim, $49.5K revenue), 26055 (97 claims, $456 avg paid/claim, $44.2K revenue), 23430 (14 claims, $3102 avg paid/claim, $43.4K revenue), and 23412 (22 claims, $1933 avg paid/claim, $42.5K revenue) collectively represent modest shares of Medicare revenue. These codes suggest the practice maintains capabilities for common elective hand and shoulder surgeries that diversify case mix but do not offset the dominant arthroplasty revenue.

Other procedure volumes such as spine decompression and arthroscopy are typical for specialty peers: 63047 (31 claims, $2363 avg paid/claim, $73.3K revenue) ranks #832 of 4170 providers (78th percentile; typical, unremarkable volume for this code) and knee arthroscopy 29881 ranks #169 of 1125 providers (84th percentile; typical, unremarkable volume for this code). This pattern shows respectable but not exceptional participation across non-arthroplasty orthopedic procedures.

The provider has long-tenure NPI enumeration (2006-05-28, ~20 years ago), which supports the interpretation that its current arthroplasty volume is built from an established local/regional practice rather than a recent entrant. Sustained enumeration combined with high arthroplasty ranks suggests stable referral relationships that favor elective joint-replacement throughput.

The combination of very high concentration in two codes (27447 and 27130) and the precomputed top-3 share of 80.7% highlights a strategic dependence on elective knee and hip replacements; this specialization boosts competitive standing for those services but also concentrates revenue exposure around policy, reimbursement, or demand changes affecting arthroplasty. Analysts evaluating network value, contracting leverage, or vulnerability to reimbursement shifts should weight findings toward arthroplasty performance given the provider’s concentrated Medicare book of business.

Medicare: Complete Services Breakdown

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

22 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…	160	$7,020	$1.1M
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…	80	$7,160	$601.4K
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…	30	$2,360	$73.3K
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…	80	$630	$49.5K
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…	100	$460	$44.2K
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.…	10	$3,100	$43.4K
23412	In this procedure, the provider performs an open surgical repair of a chronic, or persistent, tear of the rotator cuff in the shoulder. A rotator cuff is a group of four muscles that stabilizes the…	20	$1,930	$42.5K
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…	30	$1,070	$29.8K
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…	10	$2,110	$29.5K
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…	30	$1,050	$29.3K

Showing 1–10 of 22

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 22 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Montana Distribution

Missoula Bone & Joint Surgery Center, LLC — 6 of 22 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Montana

Full comparison — all codes billed, vs. state median

22 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
27447	5	80	40	$1,080	$60.6K
27130	7	50	40	$1,150	$54.1K
29827	24	30	20	$860	$26.7K
64721	4	20	60	$400	$20.5K
23430	6	20	10	$1,230	$18.5K
C9290	2	10	13,300	$1	$16.4K
29848	3	10	40	$420	$15.8K
64635	15	30	30	$320	$15.4K
63047	7	20	20	$640	$14K
26480	2	10	20	$610	$14K

Showing 1–10 of 22

Nearby Providers

Other providers in the same ZIP code as Missoula Bone & Joint Surgery Center, LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Consumer Direct Care Network Virginia	MT	Home Health Agency	$0	$2.1B
Consumer Direct Personal Care, LLC	MT	In Home Supportive Care Agency	$0	$49.1M
Hkj Inc	MT	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$15.2M
We Care Behavioral Health LLC	MT	Clinic/Center	$0	$14.8M
Partners In Home Care, Inc	MT	Nursing Care Agency	$0	$13M
Hkj Inc	MT	Case Management Agency	$0	$11.6M
Sunburst Health LLC	MT	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$6.1M
Providence Health & Services Mt	MT	Family Medicine Physician	$0	$4.9M
Welltower Tenant Group LLC	MT	Assisted Living Facility	$0	$3.8M
Norco, Inc	MT	Durable Medical Equipment & Medical Supplies	$0	$3.8M

Missoula Bone & Joint Surgery Center, LLC — Billing Profile & Reimbursement Data

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Missoula Bone & Joint 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