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

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

Mid-america Surgery Institute LLC (NPI 1659473924)

Key Findings

Field	Value
Entity Type	Organization
Organization	Mid-america Surgery Institute LLC
Address	5525 West 119th Street
City	Overland Park
State	KS
ZIP	66209
Taxonomy	Ambulatory Surgical Clinic/Center
NPI Enumerated	September 5, 2006

Payer Source	Total Paid
Medicare	$1.4M
Medicaid	$0

This provider has reported Total Medicare revenue of $1.4M and no Medicaid billing on file, so its commercial public-payer footprint is effectively single-payer Medicare in the available data. The NPI was enumerated 2006-09-05 (~20 years ago), indicating the practice has been active for roughly two decades in Overland Park, KS, which may reflect an established outpatient surgical operation.

Revenue is highly concentrated in a small set of procedures: the precomputed top 3 Medicare codes by revenue account for 46.3% of this provider's total Medicare revenue, led by 64590 (27.8%), 64561 (10.3%), and C9740 (8.1%). This concentration means almost half of Medicare dollars come from a narrow set of implant/neurostimulation and transprostatic implant services, making those lines critical to financial performance and operational capacity.

The code mix and taxonomy (Ambulatory Surgical Clinic/Center) point to a specialty outpatient surgical center with a clinical emphasis on neuromodulation and urologic endoscopic therapies. High-revenue codes such as 64590 (implant/replace neurostimulator pulse generator), 64561 (sacral electrode implantation), C9740 (transprostatic implant), and multiple cystourethroscopy and ureteroscopy codes (e.g., 52356, 52332, 52352) support a service-line profile centered on neuromodulation, sacral nerve procedures, and endoscopic urology.

Competitive standing across the top neuromodulation/implant codes is modest to typical nationally: 64590 ranks #109 of 561 providers nationally (79th percentile; typical, unremarkable volume for this code), 64561 ranks #180 of 564 providers nationally (67th percentile; typical, unremarkable volume for this code), and C9740 ranks #99 of 162 providers nationally (35th percentile; typical, unremarkable volume for this code). These ranks suggest the provider is not a national outlier or dominant center for these implant procedures but does operate at a defensible, routine volume.

There are notable above-typical volumes in some endoscopy/urology procedures despite their smaller revenue shares: 52356 generates $86.5K (6.6% of Medicare revenue) and ranks #90 of 3090 providers nationally (97th percentile; notably above typical national volume), and 45385 generates $91.7K (7.0% of Medicare revenue) and ranks #1292 of 16310 providers nationally (92th percentile; typical, unremarkable volume for this code). These high percentiles for common endoscopic procedures indicate pockets of specialty strength—especially in ureteroscopy with lithotripsy and colon polypectomy—relative to national peers.

Procedure mix shows multi-specialty outpatient capability beyond neuromodulation and urology: high-volume GI codes (45385, 45380, G0105, G0121), pain-management injections (64483, 64493, 64635), ENT sinus surgery (31267), and orthopedic arthroscopy/rotator cuff repair (29827, 23430) each contribute measurable Medicare revenue. This breadth suggests the ASC model supports diverse surgical specialties rather than a single narrowly focused service line, which has implications for scheduling complexity and capital equipment needs.

Payment and utilization patterns highlight contrasting unit economics across codes: 64590 posts $14535 avg paid/claim with 25 claims for $363.4K in revenue, concentrating high per-claim reimbursement into a small number of cases, whereas J0585 shows 3.4K claims at $5 avg paid/claim for $17.1K in revenue, indicating very high claim counts but minimal revenue contribution per claim. These differences imply the practice relies on a handful of high-reimbursement implant procedures for the bulk of Medicare receipts while managing a large volume of low-dollar unitized services.

From a payer-strategy perspective, the absence of any Medicaid billing on file combined with a $1.4M Medicare-only revenue picture means this provider is effectively single-payer in the public program data, which may reflect patient mix, contractual arrangements, or non-participation in state Medicaid networks. For payers and competitors evaluating market access or referral opportunities, the provider’s long tenure (~20 years) and concentrated Medicare economics around neuromodulation and urologic endoscopy are key considerations for partnership or network inclusion decisions.

Medicare: Complete Services Breakdown

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

43 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	30	$14,540	$363.4K
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	$3,740	$134.7K
C9740	Cystourethroscopy, with insertion of transprostatic implant; 4 or more implants	20	$5,290	$105.8K
45385	The provider examines the colon and rectum using a colonoscope, a long, thin flexible tubular instrument with a light source and camera. He removes one or more tumors, polyps, or other lesions with a…	210	$440	$91.7K
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…	50	$1,630	$86.5K
45380	The provider examines the rectum and colon using a flexible colonoscope, a tubular instrument with a light source and camera, to look for the cause of a patient's symptoms, which may include…	160	$380	$59.4K
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.…	20	$2,940	$55.8K
G0105	Colorectal cancer screening; colonoscopy on individual at high risk	100	$410	$40.3K
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).	120	$270	$31.5K
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…	20	$1,460	$30.7K

Showing 1–10 of 43

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Lamar Court Assisted Living	KS	Assisted Living Facility	$0	$3.4M
Sarah Vodopest	KS	Rheumatology Physician	$1.5M	$0
Carrie Mihordin	KS	Rheumatology Physician	$1.5M	$0
Thomas Hocker	KS	MOHS-Micrographic Surgery Physician	$1.1M	$0
Midwest Heart & Vascular Specialists, LLC	KS	Cardiovascular Disease Physician	$0	$1M
Jonathan Amos	KS	Rheumatology Physician	$951.5K	$0
Playabilities For Sensational Kids, LLC	KS	Pediatric Occupational Therapist	$0	$790.8K
Ads Healthcare LLC	KS	Ambulatory Surgical Clinic/Center	$734K	$0
Michael Sokol	KS	Endocrinology, Diabetes & Metabolism Physician	$368.5K	$0
Cameron Ledford	KS	Orthopaedic Surgery Physician	$304.4K	$0

Mid-america Surgery Institute LLC — Billing Profile & Reimbursement Data

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Mid-america Surgery Institute 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

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
C9740	2	10	20	$5,220	$130.5K
64561	4	10	30	$2,260	$77K
64590	1	10	20	$4,980	$74.7K
J0585	34	40	7,650	$1	$60.1K
64483	41	80	110	$170	$27K
45385	14	160	60	$260	$23.7K
31267	10	30	20	$630	$18.2K
29827	24	60	20	$750	$17.3K
29848	5	20	30	$390	$17.1K
G0260	13	10	50	$200	$16.8K