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

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

Orthopaedic Specialists Surgi-center, LLC (NPI 1780691386)

Key Findings

Field	Value
Entity Type	Organization
Organization	Orthopaedic Specialists Surgi-center, LLC
Address	1096 Old Churchmans Rd
City	Newark
State	DE
ZIP	19713
Taxonomy	Ambulatory Surgical Clinic/Center
NPI Enumerated	August 3, 2006

Payer Source	Total Paid
Medicare	$649.9K
Medicaid	$0

This facility appears to operate as a focused ambulatory surgical clinic with a heavy procedural mix in upper-extremity and joint arthroscopy services: high-revenue codes include 64721 (carpal tunnel neuroplasty), 29827 (arthroscopic rotator cuff repair), and 26055 (trigger finger release), and the list also contains multiple shoulder, wrist/hand, and small-joint procedures as well as image-guided spinal denervation codes. The CPT mix (arthroscopy codes 29827/29823/29824, hand surgery codes 64721/26055/64718, and facet/nerve procedures 64635/64633) is consistent with an orthopedic ASC model that treats a large volume of outpatient musculoskeletal surgical cases and selected pain interventions rather than broad inpatient or medical management services.

Revenue concentration is substantial: the precomputed figure shows the top 3 Medicare codes account for 44.3% of this provider's total Medicare revenue, so nearly half of the $649.9K in lifetime Medicare receipts are driven by a small set of procedures. Specifically, 64721 accounts for $110K (16.9%), 29827 for $107.8K (16.6%), and 26055 for $69.9K (10.8%), indicating reliance on a narrow set of high-value procedural lines.

This provider is effectively single-payer in scale: lifetime Medicare revenue is $649.9K while there is no Medicaid billing on file, so the practice’s public-payer activity is concentrated in Medicare and it does not appear to participate in Medicaid billing within the available data. That payer mix implies contract and utilization risk is tied predominantly to Medicare reimbursement trends and beneficiary referrals rather than to Medicaid volume.

Competitive standing by procedure is uneven but pronounced for several hand/nerve procedures: 64721 ranks #33 of 3206 providers nationally (99th percentile; extreme outlier) and 26055 ranks #47 of 2946 providers nationally (98th percentile; extreme outlier), indicating this provider is a national outlier with much higher-than-typical volume for these specific hand surgeries. 29827 ranks #194 of 3445 (94th percentile; notably above typical), showing the practice is also well above typical national volume for arthroscopic rotator cuff repair, but other high-revenue codes like 25609 and 64635 sit at more typical percentiles (69th and 91th respectively) and reflect more ordinary national positioning.

Specific procedural outliers suggest a specialty focus: 64718 (ulnar nerve decompression) ranks #2 of 739 providers nationally (100th percentile; extreme outlier) despite contributing $29K (4.5%) to Medicare revenue, reinforcing that the clinic concentrates on compressive neuropathy and peripheral nerve procedures beyond carpal tunnel work. These ranked outliers are consistent with a hand/nerve surgery niche within the ambulatory surgery center taxonomy.

The practice also bills a meaningful volume of image-guided and injection procedures (e.g., 64635 with 120 claims and $64.4K revenue, 9.9% of Medicare revenue, and 64633 with $24.1K revenue), which indicates an ancillary pain-management or spine-denervation capability co-located with the orthopedic surgical services. Those codes are described as typical, unremarkable volume at the national level, suggesting these services complement but do not dominate the provider’s revenue profile.

Operational longevity is notable: the NPI was enumerated on 2006-08-03 (approximately 20 years ago), signaling sustained presence in the market and time to develop referral relationships that could explain concentrated procedural volumes in hand and shoulder surgery. That tenure supports the interpretation of deliberate service-line specialization rather than a new or transient practice pattern.

From a payor strategy and network perspective, the combination of high national ranks for specific hand and nerve procedures and an absence of Medicaid billing suggests this entity may be most relevant to Medicare-focused networks and value-based arrangements emphasizing outpatient orthopedic procedures. Analysts evaluating contract negotiation or regional capacity should treat this provider as a specialized ambulatory surgical resource for upper-extremity surgery and select arthroscopic shoulder procedures rather than a broad multispecialty surgical hub.

Medicare: Complete Services Breakdown

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

21 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
64721	Neuroplasty 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…	170	$640	$110K
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…	50	$2,200	$107.8K
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…	150	$480	$69.9K
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…	20	$3,540	$67.2K
64635	Under fluoroscopic or CT guidance, the provider applies an agent to a lower back joint to destroy nerve tissue.	120	$540	$64.4K
29828	The provider examines the tissue inside the shoulder joint with an arthroscope. She inserts additional instruments to repair an unstable biceps tendon, the fibrous band that connects the biceps…	10	$2,510	$35.2K
64718	In 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…	80	$390	$29K
29823	The 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…	40	$590	$24.2K
64633	In this procedure, the provider destroys the facet joint nerve of a cervical or thoracic spinal segment using neurolytic agents like heat, electric current, or a chemical compound. He makes use of…	40	$560	$24.1K
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…	20	$1,130	$23.8K

Showing 1–10 of 21

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Associated Retinal Consultants LLC	DE	Ophthalmology Physician	$0	$25.2M
Columbus Medical Services, LLC	DE	Case Management Agency	$0	$18.7M
Christiana Care Health Services Inc	DE	Hospitalist Physician	$0	$13.6M
Caritas Home Health Services, Inc	DE	Home Health Agency	$0	$11.2M
Delaware Center For Maternal Fetal Medicine Of Christiana Care	DE	Maternal & Fetal Medicine Physician	$0	$9.8M
Christiana Care Health Services Inc	DE	Neonatal-Perinatal Medicine Physician	$0	$8.9M
Medical Oncology Hematology Consultants PA	DE	Hematology & Oncology Physician	$0	$7.7M
Christiana Care Quality Partners	DE	Urgent Care Clinic/Center	$0	$7M
Jamal Misleh	DE	Hematology & Oncology Physician	$6.8M	$0
Mid-atlantic Behavioral Health, LLC	DE	Intellectual & Developmental Disabilities Psychologist	$0	$6.5M

Orthopaedic Specialists Surgi-center, LLC — Billing Profile & Reimbursement Data

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Orthopaedic Specialists Surgi-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

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
25609	2	10	20	$2,410	$41K
64721	2	20	40	$470	$29.4K
29827	1	20	20	$1,130	$28.2K
64635	5	30	50	$390	$24.8K
26055	3	20	60	$310	$23.9K
29828	2	10	10	$1,090	$16.3K
29881	3	10	20	$850	$16.1K
64718	1	10	20	$420	$13.4K
25447	8	10	20	$570	$12.6K
29880	2	10	10	$760	$12.2K