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    OpenPayerNPI Medicare & MedicaidPrisma Health Ambulatory Surgery Centers-midlands,…
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    Prisma Health Ambulatory Surgery Centers-midlands, LLC — Billing Profile & Reimbursement Data

    NPI 1689326670 · Lexington, SC · Ambulatory Surgical Clinic/Center

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    Prisma Health Ambulatory Surgery Centers-midlands, LLC is a ambulatory surgical clinic/center provider located in Lexington, South Carolina. This profile covers 10 Medicare and 0 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)

    FieldValue
    Entity TypeOrganization
    OrganizationPrisma Health Ambulatory Surgery Centers-midlands, LLC
    Address104 Saluda Pointe Dr Ste 200
    CityLexington
    StateSC
    ZIP29072
    TaxonomyAmbulatory Surgical Clinic/Center
    NPI EnumeratedJanuary 21, 2022

    Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)

    Payer SourceTotal Paid
    Medicare$326.9K
    Medicaid$0

    Medicare: Total Revenue Breakdown by CPT/HCPCS Code

    Medicare revenue breakdown by CPT/HCPCS procedure code.

    View: Bar Chart1 / 2

    Medicare: Complete Services Breakdown

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

    10 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    27447In 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…20$6,400$121.6K
    29827The 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…30$1,980$61.4K
    64721Neuroplasty 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…90$580$50.7K
    29824The provider examines the tissue inside the shoulder joint with an arthroscope and inserts additional instruments to remove a portion of the clavicle, or collarbone. An arthroscopic Mumford procedure…30$740$22.2K
    26480In this procedure, the provider transfers or transplants a tendon in the carpometacarpal area or the back of the hand. The carpometacarpal area is the articulation of the wrist’s carpal bones with…20$950$20K
    29881The 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…20$1,000$15K
    25447The provider performs arthroplasty (joint replacement) of the intercarpal joints (between the small bones in the wrist) or carpometacarpal joints (where the carpal bones of the wrist meet the…20$590$14.1K
    29823The provider examines the tissue inside the shoulder joint with an arthroscope. He inserts additional instruments and excises extensive damaged tissues in the shoulder joint caused by trauma to the…20$570$8.6K
    26055Trigger 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…30$290$7.2K
    64718In this procedure, the provider uses an open approach to incise scar tissue or other sources of pressure to relieve tension on the ulnar nerve at the elbow, which an injury or swelling within the…10$470$6.1K

    Medicare: Competitive Analysis & Benchmarks

    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

    10 rows

    CPT/HCPCS CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    2744718622040$1,090$61.9K
    6472176040$400$20.4K
    29827209020$880$20.1K
    29881193020$620$13.7K
    26055547040$260$12.4K
    2544763020$580$11.6K
    2648062020$510$10.2K
    64718122010$440$6.6K
    2982495020$270$5.9K
    29823285020$180$3.7K

    Related Providers

    Other providers that share a Tax Identification Number (TIN) with Prisma Health Ambulatory Surgery Centers-midlands, LLC, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Daniel Del GaizoSCAdult Reconstructive Orthopaedic Surgery Physician$374.6K$0
    Jeffrey HopkinsSCOrthopaedic Surgery Physician$291.4K$0
    Bradley PresnalSCOrthopaedic Surgery Physician$255.3K$0
    David FultonSCOrthopaedic Hand Surgery Physician$230.7K$0
    James McfaddenSCOrthopaedic Hand Surgery Physician$196K$0
    Michael PeelleSCOrthopaedic Surgery of the Spine Physician$193.6K$0
    Paul DehollSCOrthopaedic Surgery of the Spine Physician$144.3K$0
    Gokul GondiSCAnesthesiology Physician$141K$0
    Mickey PlymaleSCSports Medicine (Orthopaedic Surgery) Physician$123.4K$0
    Ryan BerlinrutSCPhysician Assistant$52.8K$0

    Nearby Providers

    Other providers in the same ZIP code as Prisma Health Ambulatory Surgery Centers-midlands, LLC, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Southern Medical Management, LLCSCPediatrics Physician$0$43.9M
    Allcaregivers, Inc.SCNursing Care Agency$0$33.3M
    South Carolina Dept Of Mental Health Accounting OfficeSCMental Health Clinic/Center (Including Community Mental Health Center)$0$32M
    Lexington County EmsSCAmbulance$2.9M$6.9M
    Lexington Health IncSCUrgent Care Clinic/Center$0$8.7M
    Key Care Health Services, LLCSCHome Health Agency$0$8.5M
    Capital City Therapy Group, LLCSCSpecialist$0$7.3M
    Health Promotion SpecialistsSCDental Hygienist$0$6.5M
    Lexington School District OneSCLocal Education Agency (LEA)$0$5.7M
    Lexington Health IncSCPediatric Adolescent Medicine Physician$0$5.7M

    Frequently Asked Questions

    References

    1. 1.Medicare Physician & Other Practitioner by Provider and Service. CMS.gov.Provider-level Medicare Part B utilization and payment data.
    2. 2.NPPES NPI Registry. CMS.gov.National Provider Identifier registry used for provider enumeration and taxonomy metadata.

    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.

    Medicare Revenue by CPT/HCPCS Code
    Claims Volume vs. South Carolina Distribution
    Prisma Health Ambulatory Surgery Centers-midlands, LLC — 0 of 10 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — South Carolina