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NPI 1689860124 · Russell, PA · Ambulatory Surgical Clinic/Center
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Pine Grove Ambulatory Surgical is a ambulatory surgical clinic/center provider located in Russell, Pennsylvania. This profile covers 13 Medicare and 2 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 | Pine Grove Ambulatory Surgical |
| Address | 10 Timberview Lane |
| City | Russell |
| State | PA |
| ZIP | 16345 |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| NPI Enumerated | September 19, 2007 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $302.3K |
| Medicaid | $0 |
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
13 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 66984 | The provider inserts an artificial lens after removing an extracapsular cataract by aspiration or use of ultrasonic waves. This procedure is done without the use of an endoscopic laser probe to… | 150 | $770 | $116.6K |
| 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… | 130 | $240 | $31.5K |
| 64635 | Under fluoroscopic or CT guidance, the provider applies an agent to a lower back joint to destroy nerve tissue. | 60 | $460 | $28.2K |
| G0260 | Injection procedure for sacroiliac joint; provision of anesthetic, steroid and/or other therapeutic agent, with or without arthrography | 130 | $190 | $23.9K |
| 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). | 80 | $270 | $20.8K |
| 28285 | The provider repairs a hammertoe deformity, a painful condition in which the toe remains permanently bent in a downward position. | 30 | $610 | $19.6K |
| 62323 | 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 lumbar (lower back) or sacral (caudal, or tailbone)… | 80 | $220 | $17.4K |
| 64624 | The provider uses a chemical, heat, or radiofrequency as a neurolytic agent to destroy branches of the genicular nerves that supply the knee joint; imaging guidance is included, if performed, so it… | 30 | $540 | $14.7K |
| 66982 | The provider inserts an intraocular lens prosthesis after extracapsular cataract extraction using complex techniques and devices. He may perform this by means of an iris expansion device, providing… | 10 | $780 | $10.9K |
| 30930 | In this procedure, the provider fractures one or more inferior turbinates to correct the overgrowth of the inferior turbinates and release the nasal airway obstruction. | 10 | $650 | $7.8K |
Showing 1–10 of 13
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 13 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
13 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| 66984 | 237 | 670 | 80 | $530 | $97.8K |
| 66982 | 184 | 200 | 30 | $640 | $23.2K |
| 64483 | 137 | 340 | 60 | $190 | $18.6K |
| G0260 | 5 | 40 | 60 | $210 | $18.4K |
| 64635 | 46 | 230 | 30 | $360 | $16.1K |
| 62323 | 149 | 360 | 60 | $140 | $14.2K |
| 28285 | 9 | 30 | 20 | $400 | $11.5K |
| 64493 | 24 | 330 | 40 | $170 | $11K |
| 30520 | 15 | 20 | 10 | $510 | $7.7K |
| 64624 | 3 | 10 | 20 | $220 | $6.9K |
Showing 1–10 of 13
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.
2 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 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… | 50 | $0 | $0 |
| G8918 | Patient without preoperative order for iv antibiotic surgical site infection (ssi) prophylaxis | 30 | $0 | $0 |
How this provider's Medicaid billing volume and revenue compare to other Pennsylvania providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Pennsylvania median
2 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 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… | 26 | 40 | 100 | $0 | $0 |
| G8918 | Patient without preoperative order for iv antibiotic surgical site infection (ssi) prophylaxis | 21 | 30 | 100 | $0 | $0 |
Other providers in the same ZIP code as Pine Grove Ambulatory Surgical, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| John Susz | PA | Podiatrist | $182.6K | $15.5K |
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