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

Why is the Medicaid comparison limited to South Dakota 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. South Dakota (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.

Plastic Surgical Center Of Rapid City, Prof. L.L.C. (NPI 1760465207)

Field	Value
Entity Type	Organization
Organization	Plastic Surgical Center Of Rapid City, Prof. L.L.C.
Address	3615 5th St
City	Rapid City
State	SD
ZIP	57701
Taxonomy	Ambulatory Surgical Clinic/Center
NPI Enumerated	November 29, 2005

Payer Source	Total Paid
Medicare	$492.3K
Medicaid	$0

Key Findings

This entity is registered as an Ambulatory Surgical Clinic/Center and the Medicare billing mix is dominated by neurostimulation and epidural electrode procedures, indicating a specialty ambulatory-surgery focus on neuromodulation and interventional pain management rather than broad ambulatory surgery services. The leading CPTs reported — 63685 (pulse generator insertion/replacement) and 63650 (epidural electrode placement) — both align with surgical neuromodulation workflows.

Lifetime Medicare revenue for this provider is $492.3K while Total Medicaid revenue is none (no Medicaid billing on file), meaning the provider’s public-payer footprint is effectively single-payer Medicare in the available data. This lack of Medicaid billing limits any conclusions about dual-payer strategy or Medicaid-market participation.

Revenue is highly concentrated: the precomputed top-3 Medicare codes account for 100.0% of Medicare revenue, with 63685 representing 66.9% of Medicare revenue, 63650 representing 24.4%, and 0275T representing 8.7%. Such concentration indicates the business is narrowly driven by a small set of high-revenue procedures rather than a diversified outpatient surgery mix.

Procedure-level intensity is high for the top code: 63685 has 18 claims with an average paid per claim of $18303, which is consistent with device implantation requiring surgical pocket creation and a pulse generator. By contrast, 63650 shows 33 claims with an average paid per claim of $3638, and 0275T shows 12 claims with an average paid per claim of $3568, reflecting a mix of fewer very high-dollar device placements and somewhat lower-paid lead placements.

Competitive standing against national Medicare peers is modest rather than dominant. 63685 ranks #534 of 1281 providers (54th percentile; labeled "typical, unremarkable volume for this code"), 63650 ranks #987 of 1371 (26th percentile; "typical, unremarkable volume"), and 0275T ranks #515 of 597 (7th percentile; "typical, unremarkable volume"), so the practice is not a high-volume national leader for these procedures and often sits below median volume for some codes.

The provider has long tenor on file — NPI enumerated 2005-11-29 (~21 years ago) — which suggests operational longevity; however, the relatively small Medicare revenue ($492.3K) and concentrated code set point to a stable but limited-scale specialty practice rather than a large ambulatory surgery network.

From a risk and commercial perspective, reliance on a narrow set of neuromodulation codes (100.0% of Medicare revenue from the top three) concentrates revenue exposure to demand and reimbursement changes for spinal neurostimulator and epidural lead procedures. The appearance of a technology-specific code mix (including 63685 and 63650) suggests that payers or contracting teams should evaluate device-related reimbursement implications and capacity constraints when benchmarking this provider.

Interpretation is constrained by data gaps: there is no Medicaid billing on file and 0275T lacks a description in the dataset, which limits inferences about ancillary or non-Medicare services. Analysts should treat the observed Medicare-only pattern and the small set of reported codes as an incomplete view of the provider’s full commercial or cash-pay activity until additional data sources are available.

Medicare: Complete Services Breakdown

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

3 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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	$18,300	$329.5K
63650	In this procedure, the provider places electrodes in the epidural space to relieve pain and reduce or eliminate spasms.	30	$3,640	$120.1K
0275T	N/A	10	$3,570	$42.8K

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 3 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. South Dakota Distribution

Plastic Surgical Center Of Rapid City, Prof. L.L.C. — 0 of 3 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — South Dakota

Full comparison — all codes billed, vs. state median

3 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
63685	3	10	30	$4,180	$113K
63650	3	10	30	$860	$56.6K
0275T	2	10	20	$1,690	$25.3K

Nearby Providers

Other providers in the same ZIP code as Plastic Surgical Center Of Rapid City, Prof. L.L.C., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Behavior Management Systems, Inc.	SD	Community/Behavioral Health Agency	$0	$19.8M
Monument Health Rapid City Hospital, Inc	SD	Multi-Specialty Clinic/Center	$0	$18.7M
Monument Health Rapid City Hospital, Inc.	SD	General Acute Care Hospital	$0	$11.5M
Community Health Center Of The Black Hills Inc	SD	Federally Qualified Health Center (FQHC)	$0	$10.2M
Jrk Services, Inc	SD	Home Health Agency	$0	$10.1M
Black Hills Pediatrics, LLP	SD	Pediatrics Physician	$0	$9.7M
Rapid City Emergency Services PA	SD	Emergency Medicine Physician	$0	$8.2M
Wellspring Inc.	SD	Psychiatry Physician	$0	$7.4M
Prema Abraham	SD	Retina Specialist (Ophthalmology) Physician	$7.1M	$0
Radiology Associates Prof, LLC	SD	Diagnostic Radiology Physician	$0	$5.3M

Plastic Surgical Center Of Rapid City, Prof. L.L.C. — Billing Profile & Reimbursement Data

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Plastic Surgical Center Of Rapid City, Prof. L.L.C. — 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