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

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

Western Connecticut Orthopedic Surgical Center LLC (NPI 1720227945)

Field	Value
Entity Type	Organization
Organization	Western Connecticut Orthopedic Surgical Center LLC
Address	226 White St
City	Danbury
State	CT
ZIP	06810
Taxonomy	Ambulatory Surgical Clinic/Center
NPI Enumerated	February 11, 2009

Payer Source	Total Paid
Medicare	$1.3M
Medicaid	$0

Key Findings

Practice profile and service mix: As an Ambulatory Surgical Clinic/Center, the provider’s Medicare claims are concentrated in major joint and arthroscopic procedures, including knee replacement (27447), hip replacement (27130), and biceps/tendon/rotator cuff work (23430, 29827, 29880). The top codes and their descriptions indicate the center performs both higher-acuity joint arthroplasties and high-volume outpatient arthroscopies and hand/wrist procedures, consistent with an orthopedic specialty ASC model.

Revenue concentration: Total Medicare revenue is $1.3M and the top three Medicare codes (27447, 27130, 23430) together account for 64.0% of that Medicare revenue. Individually those codes contribute $452.9K (35.3%), $235.1K (18.3%), and $131.7K (10.3%) respectively, showing strong revenue dependence on a small set of procedures.

Payer mix and exposure: The provider has no Medicaid billing on file, so its public-payer exposure is effectively single-payer Medicare at scale; Medicaid does not appear in the reported billing data. This makes the provider operationally reliant on Medicare reimbursement patterns and volumes for public-payer revenue.

Competitive standing for arthroplasty: For the leading arthroplasty code 27447 the practice ranks #2752 of 12089 (77th percentile; typical, unremarkable volume), and for hip arthroplasty 27130 it ranks #3396 of 8062 (56th percentile; typical, unremarkable volume). Those percentiles indicate a modest or typical national participation in joint replacement rather than market dominance among Medicare providers.

Strong outpatient arthroscopy throughput: Several arthroscopy and related codes show above-typical national volumes — 29880 ranks #21 of 878 (98th percentile; notably above typical national volume), 29848 ranks #44 of 1333 (97th percentile; notably above typical national volume), and 29827 ranks #282 of 3445 (92nd percentile; typical, unremarkable volume). This pattern suggests the center is comparatively busy on arthroscopic knee/shoulder and wrist procedures relative to peers.

Niche strength in specific soft-tissue procedures: The provider’s 23430 (biceps tendon fixation) ranks #78 of 811 (90th percentile; typical, unremarkable volume), indicating relatively strong volume for that specific shoulder/tendon procedure compared with national peers. Coupled with high percentiles on arthroscopy codes, the data imply a focused referral stream for shoulder and knee soft-tissue pathology.

Operational risk from concentration: With the top three codes making up 64.0% of Medicare revenue and a total Medicare revenue of $1.3M, the provider’s financial performance is concentrated in a few high-revenue procedures. That concentration creates sensitivity to changes in procedure mix, referral patterns, or reimbursement for those specific CPTs.

Tenure and scale: The NPI was enumerated on 2009-02-11 (~17 years ago), indicating an established operation. At $1.3M of reported Medicare revenue, the center operates at a modest Medicare scale relative to national ASC cohorts, but its high percentiles on key arthroscopy codes show pockets of above-average procedural throughput.

Medicare: Complete Services Breakdown

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

19 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…	60	$7,950	$452.9K
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	$8,110	$235.1K
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.…	40	$3,470	$131.7K
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…	40	$1,950	$81.8K
29848	The provider inserts an endoscope into the wrist joint to divide the transverse carpal ligament and reduce compression on the median nerve in the carpal tunnel that results in pain and numbness.	120	$620	$74.5K
29880	In this procedure, the provider performs arthroscopic examination of the knee joint. She removes the damaged and torn meniscus from the medial and lateral compartments of the knee joint along with…	50	$1,190	$60.9K
25609	The provider surgically repairs a fracture of the lower radius, the larger of the two lower arm bones, beyond the joint or a separation of the radius from the joint through an incision and fixes…	10	$3,770	$45.2K
26055	Trigger 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…	70	$530	$38.9K
29881	The 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…	30	$1,180	$35.5K
23412	In this procedure, the provider performs an open surgical repair of a chronic, or persistent, tear of the rotator cuff in the shoulder. A rotator cuff is a group of four muscles that stabilizes the…	10	$2,010	$24.1K

Showing 1–10 of 19

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 19 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Connecticut Distribution

Western Connecticut Orthopedic Surgical Center LLC — 4 of 19 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Connecticut

Full comparison — all codes billed, vs. state median

19 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
27447	19	160	20	$1,320	$39.6K
27130	34	100	20	$1,200	$34.9K
29827	4	30	20	$1,350	$29.7K
25609	2	10	10	$2,260	$27.1K
23412	1	10	10	$1,930	$23.2K
29881	2	10	20	$1,100	$22K
29880	1	10	20	$1,010	$21.2K
64721	34	40	30	$490	$16.2K
26123	2	10	20	$1,050	$14.6K
29848	1	30	20	$480	$14K

Showing 1–10 of 19

Nearby Providers

Other providers in the same ZIP code as Western Connecticut Orthopedic Surgical Center LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Danbury Hospital	CT	General Acute Care Hospital	$0	$123.8M
Family And Children's Aid, Inc.	CT	Adolescent and Children Mental Health Clinic/Center	$0	$64M
Midwestern Connecticut Council On Alcoholism, Inc	CT	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$39.9M
Connecticut Institute For Communities Inc	CT	Federally Qualified Health Center (FQHC)	$0	$32.8M
Nuvance Health Medical Practice Ct, Inc.	CT	Internal Medicine Physician	$0	$20.2M
Connecticut Institute For Communities Inc	CT	Federally Qualified Health Center (FQHC)	$0	$14.9M
Connecticut Counseling Centers, Inc.	CT	Methadone Clinic	$243.5K	$12.1M
Center For Pediatric Medicine	CT	Pediatrics Physician	$0	$9.4M
Optimum Medical LLC	CT	Pediatrics Physician	$0	$8.9M
Kids Dental Specialists LLC	CT	Pediatric Dentistry	$0	$7.8M

Western Connecticut Orthopedic Surgical Center LLC — Billing Profile & Reimbursement Data

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Western Connecticut Orthopedic Surgical Center 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