Loading...
NPI 1689222317 · Flagstaff, AZ · Ambulatory Surgical Clinic/Center
Customize your policy alerts
Get alerted when relevant policies change without checking for updates manually.
Monitor payer policy activity
Flagstaff Bone & Joint Surgical Center, LLC is a ambulatory surgical clinic/center provider located in Flagstaff, Arizona. This profile covers 29 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 | Flagstaff Bone & Joint Surgical Center, LLC |
| Address | 501 N Switzer Canyon Dr |
| City | Flagstaff |
| State | AZ |
| ZIP | 86001 |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| NPI Enumerated | August 27, 2019 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $3.1M |
| Medicaid | $229K |
FLAGSTAFF BONE & JOINT SURGICAL CENTER, LLC is Medicare-dominant by scale: it reported $3.1M in lifetime Medicare revenue versus $229K in lifetime Medicaid revenue, indicating the practice’s business is driven primarily by Medicare patients rather than Medicaid. The provider is effectively a Medicare-first ambulatory surgical clinic with a modest Medicaid footprint.
Medicare revenue is concentrated: the precomputed top 3 Medicare codes account for 45.3% of the provider’s total Medicare revenue, driven by 27447 ($720.1K; 23.6% of Medicare revenue), 63685 ($360.4K; 11.8%), and 64483 ($301.1K; 9.9%). This concentration shows a handful of high-revenue procedures disproportionately shape Medicare collections.
The procedure mix indicates a combined orthopedic and interventional spine/pain focus consistent with an ambulatory surgical center: high-value joint replacement work such as 27447 (97 claims, $7424 avg paid/claim, $720.1K revenue) and 27130 (31 claims, $7562 avg paid/claim, $234.4K revenue) sits alongside high-volume, image-guided spine and pain procedures including 64483 (1K claims, $299 avg paid/claim, $301.1K revenue) and neurostimulator codes like 63685 (19 claims, $18967 avg paid/claim, $360.4K revenue). The mix suggests the facility performs implant-based orthopedics and maintains substantial capacity for fluoroscopy/CT-guided injections and spine implant procedures.
In national competitive standing the provider is an extreme outlier on certain injection codes: 64483 ranks #24 of 8202 providers nationally (100th percentile; extreme outlier) and 64493 ranks #134 of 7519 (98th percentile; extreme outlier), indicating injection volumes far above typical national peers. By contrast, its joint replacement activity is more typical — 27447 ranks #968 of 12089 (92th percentile; typical, unremarkable volume) — so the facility is a national leader in interventional spine/injection volume but a more modest participant for arthroplasty at the national level.
Medicaid activity is almost entirely injection-driven: the precomputed top 3 Medicaid codes account for 100.0% of Medicaid revenue, with 64483 alone representing $201.4K (88.1% of the provider’s Medicaid revenue) and 64493 contributing $22.8K (10.0%). This shows the provider’s Medicaid business is concentrated in transforaminal epidural and facet injection services rather than surgical implants.
State-level competitiveness for Medicaid differs from Medicare patterns: 64483 is only modestly elevated in-state (ranks #23 of 77, 71th percentile; typical, unremarkable volume) and 64493 is mid-to-lower statewide (ranks #35 of 55, 37th percentile), so while Medicare comparisons flag extreme national injection volumes, the provider’s Medicaid injection volumes are not exceptional within Arizona.
Operational throughput is apparent from claim counts: Medicare shows 1K claims for 64483 and 371 claims for 64493, and Medicaid shows 941 claims for 64483 and 100 claims for 64493, reflecting sustained high-frequency, low-unit-cost encounters typical of an interventional pain pipeline. Those volumes, together with numerous other image-guided and ablation codes (e.g., 64635: 221 claims; 64628: 19 claims), point to a business model built around repeated, scheduled injection and ablation procedures in addition to periodic surgical cases.
The practice has a relatively recent NPI enumeration date (2019-08-27, ~7 years ago), so its current scale — particularly the extreme national standing on certain injection codes — appears to have been built in a relatively short operating window. Given the revenue concentration (45.3% of Medicare from the top 3 codes and 100.0% of Medicaid from the top 3 codes), the provider’s financial performance is sensitive to utilization and reimbursement changes for a small set of high-volume injection and implant codes.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
29 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… | 100 | $7,420 | $720.1K |
| 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 | $18,970 | $360.4K |
| 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). | 1,010 | $300 | $301.1K |
| 63650 | In this procedure, the provider places electrodes in the epidural space to relieve pain and reduce or eliminate spasms. | 60 | $3,860 | $243.4K |
| 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… | 30 | $7,560 | $234.4K |
| 27446 | In this procedure, the provider reconstructs the diseased or damaged medial or lateral compartment of the knee along with the femoral condyles and tibial plateaus to relieve pain and improve the… | 30 | $7,060 | $190.5K |
| 64628 | The provider uses a thermal (heat) method under imaging guidance to destroy an intraosseous basivertebral nerve. Use this code for the first two lumbar or sacral vertebral bodies treated at a session. | 20 | $7,870 | $149.5K |
| 64635 | Under fluoroscopic or CT guidance, the provider applies an agent to a lower back joint to destroy nerve tissue. | 220 | $520 | $114.7K |
| 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… | 370 | $270 | $100.9K |
| 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… | 40 | $2,460 | $88.6K |
Showing 1–10 of 29
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 29 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
29 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| 63685 | 21 | 70 | 20 | $10,020 | $200.4K |
| 63650 | 24 | 70 | 40 | $2,040 | $116K |
| 64628 | 4 | 20 | 10 | $4,880 | $78K |
| 27446 | 9 | 20 | 20 | $2,210 | $59.6K |
| 27447 | 28 | 290 | 40 | $1,290 | $59.3K |
| 0275T | 5 | 20 | 20 | $2,460 | $51.6K |
| 27130 | 90 | 210 | 30 | $1,270 | $45.7K |
| 64483 | 3 | 250 | 90 | $210 | $31K |
| 64635 | 6 | 210 | 60 | $390 | $30.3K |
| 29827 | 11 | 100 | 20 | $1,020 | $25.4K |
Showing 1–10 of 29
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 |
|---|---|---|---|---|
| 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). | 940 | $210 | $201.4K |
| 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… | 100 | $230 | $22.8K |
| 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)… | 30 | $130 | $4.4K |
How this provider's Medicaid billing volume and revenue compare to other Arizona providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Arizona median
3 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 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). | 23 | 80 | 350 | $160 | $259.1K |
| 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… | 35 | 60 | 240 | $140 | $133.3K |
| 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)… | 31 | 40 | 140 | $150 | $80.9K |
Other providers in the same ZIP code as Flagstaff Bone & Joint Surgical Center, LLC, ranked by combined Medicare and Medicaid revenue.
Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.