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NPI 1649707324 · Potomac, MD · Ambulatory Surgical Clinic/Center
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Summit Ambulatory Surgical Center, LLC is a ambulatory surgical clinic/center provider located in Potomac, Maryland. This profile covers 25 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 | Summit Ambulatory Surgical Center, LLC |
| Address | 12435 Park Potomac Ave Ste 410 |
| City | Potomac |
| State | MD |
| ZIP | 20854 |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| NPI Enumerated | May 12, 2017 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $2.6M |
| Medicaid | $80.2K |
SUMMIT AMBULATORY SURGICAL CENTER, LLC is primarily a urology-focused ambulatory surgical center based on its Medicare and Medicaid code mix; high-revenue Medicare codes such as C9740, 52000, 52356, and multiple cystoscopy/ureteroscopy codes dominate the billing profile and align with procedures for bladder, urethral, and prostate treatment and endoscopic stone management. This mix indicates the center performs endoscopic urologic surgery, lithotripsy with stent placement, and implantable neurostimulator procedures rather than broad multispecialty ambulatory surgery services.
Medicare revenue is the overwhelming majority of the reported lifetime revenue for this facility with Total Medicare revenue: $2.6M versus Total Medicaid revenue: $80.2K, indicating an effectively Medicare-dominant payer mix. Medicaid activity is concentrated entirely in a single procedure for the state dataset (52000 accounts for 100.0% of this provider's total Medicaid revenue), so the center functions as a high-volume Medicare surgical provider with only limited Medicaid revenue.
Revenue concentration on Medicare is pronounced: the precomputed top 3 Medicare codes by revenue account for 49.4% of total Medicare revenue, indicating nearly half of Medicare receipts are driven by a very small set of high-value procedures. Similarly, Medicaid revenue is fully concentrated in 52000 (100.0% of Medicaid revenue), which reflects reliance on a single outpatient diagnostic/therapeutic cystoscopy CPT for state-paid cases.
SUMMIT is a national outlier on several Medicare procedures. C9740 (Cystourethroscopy with transprostatic implant; 4+ implants) generated $629.5K (24.4% of Medicare revenue) and ranks #4 of 162 providers nationally (98th percentile; extreme outlier), while 52000 on Medicare produced $334K (12.9%) and ranks #8 of 8548 providers nationally (100th percentile; extreme outlier). These rankings indicate the center performs these specific urologic interventions at volumes far above typical national peers, establishing it as a major national-volume site for those codes.
Other Medicare codes show mixed competitive standing: 64590 and 64561 (neurostimulator implantation and electrode implantation) are present with meaningful average paid/claim but rank in typical national percentiles (65th and 70th respectively), suggesting reasonable but not exceptional presence in interventional pain/neurostimulation services. Several cystoscopy and TURP-related codes (e.g., 55700, 52356, 52601, 52310) also rank at or near the top percentiles nationally (many described as extreme outliers or notably above typical national volume), reinforcing a concentrated, high-volume urology surgical focus.
The provider’s tenure is established: the NPI was enumerated on 2017-05-12 (~9 years ago), which supports that these high-volume patterns developed over multiple years rather than representing a brand-new entrant. That tenure combined with repeated outlier ranks suggests an entrenched specialty surgical operation rather than temporary or sporadic activity.
Medicaid-level competitive standing is modest in-state: the Medicaid 52000 volume (956 claims, $84 avg paid/claim, $80.3K revenue) ranks #3 of 21 providers in-state (90th percentile; typical, unremarkable volume for this code). Despite being a strong Medicare performer on the same CPT, the facility appears as a solid but not dominant Medicaid provider within Maryland for cystoscopy services.
Clinical-service implications: the combination of high-volume diagnostic and therapeutic cystoscopy codes, ureteroscopy with lithotripsy and stent placement (52356), TURP-related resections (52601, 52648), and prostate-focused ablation therapies (53854) indicates the center is structured to deliver both endoscopic stone and prostate disease procedures, plus specialized implantable device work. This breadth suggests operating room capability, endoscopic equipment, and perioperative pathways tailored to urologic surgical workflows rather than simple office-based cystoscopy alone.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
25 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| C9740 | Cystourethroscopy, with insertion of transprostatic implant; 4 or more implants | 110 | $5,720 | $629.5K |
| 52000 | In this procedure, the provider performs an examination of the interior of the bladder, the urethra, and the ureteric openings by means of a cystourethroscope, a thin flexible or rigid tube with a… | 1,540 | $220 | $334K |
| 64590 | The provider inserts or replaces a peripheral, sacral, or gastric neurostimulator pulse generator or receiver. The system is one that requires surgical creation of a pocket for placement and that… | 20 | $15,460 | $309.3K |
| 55700 | Code deleted December 31, 2025. | 330 | $670 | $218.4K |
| 52356 | The provider performs a cystourethroscopy, the inspection of the interior of the bladder, the urethra, prostatic urethra, and ureteric openings using a cystoscope passed through the urethra and into… | 90 | $1,750 | $162.8K |
| 64561 | The provider, under imaging guidance, implants electrodes around nerves in the sacral region to reduce the pain along the path of the nerve. | 40 | $3,990 | $151.6K |
| 52601 | During transurethral resection of the prostate (TURP), the surgeon inserts a resectoscope via the urethra and removes a portion of the prostate. This procedure includes several other urological… | 70 | $1,810 | $133.9K |
| 52648 | Transurethral resection of the prostate is performed in cases of BPH (benign prostate hyperplasia) which commonly occurs in middle–aged and elderly men, often causing lower urinary symptoms, with… | 50 | $1,810 | $92.3K |
| 52310 | The provider performs a simple cystourethroscopy, the inspection of the interior of the bladder, the urethra, prostatic urethra, and ureteric openings using a cystoscope passed through the urethra… | 130 | $680 | $85K |
| 52287 | The provider performs an examination of the interior of the bladder, the urethra, and the ureteric openings by means of a cystoscope. He then inserts a needle and injects a neurolytic drug into the… | 90 | $670 | $62.6K |
Showing 1–10 of 25
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 25 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
25 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| C9740 | 1 | 20 | 30 | $5,500 | $225.7K |
| 64590 | 8 | 20 | 20 | $7,550 | $151.1K |
| 64561 | 12 | 30 | 40 | $2,550 | $104.4K |
| J0585 | 30 | 80 | 8,130 | $1 | $49K |
| 52648 | 4 | 40 | 20 | $1,160 | $31.4K |
| 52601 | 1 | 40 | 20 | $1,260 | $29.1K |
| 52000 | 2 | 200 | 120 | $140 | $25.8K |
| 52356 | 3 | 100 | 20 | $900 | $25.3K |
| 52224 | 7 | 20 | 20 | $820 | $23.8K |
| 52630 | 3 | 10 | 10 | $1,710 | $22.2K |
Showing 1–10 of 25
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 |
|---|---|---|---|---|
| 52000 | In this procedure, the provider performs an examination of the interior of the bladder, the urethra, and the ureteric openings by means of a cystourethroscope, a thin flexible or rigid tube with a… | 960 | $80 | $80.3K |
| 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… | 150 | $0 | $0 |
| G8918 | Patient without preoperative order for iv antibiotic surgical site infection (ssi) prophylaxis | 150 | $0 | $0 |
How this provider's Medicaid billing volume and revenue compare to other Maryland providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Maryland median
3 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| G8918 | Patient without preoperative order for iv antibiotic surgical site infection (ssi) prophylaxis | 18 | 50 | 90 | $70 | $28.2K |
| 52000 | In this procedure, the provider performs an examination of the interior of the bladder, the urethra, and the ureteric openings by means of a cystourethroscope, a thin flexible or rigid tube with a… | 3 | 20 | 60 | $50 | $23.4K |
| 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… | 36 | 90 | 110 | $30 | $11.9K |
Other providers in the same ZIP code as Summit Ambulatory Surgical Center, LLC, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Minuteclinic LLC | MD | Family Nurse Practitioner | $0 | $14.1M |
| Washington Nephrology Associates, L.L.P. | MD | Nephrology Physician | $0 | $4.7M |
| Asefa Mekonnen | MD | Sleep Medicine (Internal Medicine) Physician | $557.9K | $0 |
| Samuel Galitzer | MD | Podiatrist | $340K | $49.6K |
| Nadia Yusuf | MD | Neurology Physician | $389.2K | $0 |
| Ezra Cohen | MD | Neurology Physician | $377.4K | $0 |
| Jay Bronder | MD | Psychiatry Physician | $355.5K | $0 |
| Maryland Cvs Pharmacy LLC | MD | Pharmacy | $344.6K | $0 |
| Chang Ching Lin | MD | Neurology Physician | $286K | $0 |
| Giant Of Maryland LLC | MD | Community/Retail Pharmacy | $278.5K | $0 |
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