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

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

Main Line Spine Surgery Center, LLC (NPI 1790876431)

Field	Value
Entity Type	Organization
Organization	Main Line Spine Surgery Center, LLC
Address	700 S Henderson Rd
City	King Of Prussia
State	PA
ZIP	19406
Taxonomy	Ambulatory Surgical Clinic/Center
NPI Enumerated	September 27, 2006

Payer Source	Total Paid
Medicare	$3.8M
Medicaid	$0

Key Findings

MAIN LINE SPINE SURGERY CENTER, LLC bills exclusively to Medicare among public payers, reporting Total Medicare revenue of $3.8M and no Medicaid billing on file; this makes the provider effectively single-payer (Medicare) in its public-program footprint and concentrates public-revenue exposure in the Medicare program. The facility’s taxonomy as an Ambulatory Surgical Clinic/Center aligns with the procedure mix reported.

The provider’s revenue is highly concentrated in a few interventional spine and neuromodulation procedures: the precomputed top 3 codes (63685, 64483, 63650) account for 53.0% of its total Medicare revenue. Individually those codes represent $796K (20.7%) for 63685, $656K (17.1%) for 64483, and $579.5K (15.1%) for 63650, indicating the business is economically driven by neurostimulator implantation and high-volume epidural/interventional pain services.

Service-line implications from the top codes point to a specialized interventional spine/pain surgery operation: 63685 and 63650 are device implantation/neurostimulation procedures, 64483 and 64493 are image-guided epidural/transforaminal injections, and 64628 and 64635 reflect thermal/radiofrequency ablation treatments. Combined with the ambulatory surgical center taxonomy, this mix suggests the center focuses on minimally invasive spine procedures, neuromodulation implants, and image-guided pain interventions rather than broad general surgery.

Competitive standing on national Medicare volume is mixed but strongly favorable for several spine-intervention codes. The center is a national volume leader for 64483 (rank #3 of 8202; 100th percentile; extreme outlier) and ranks highly for 64628 (rank #5 of 247; 98th percentile; extreme outlier) and 64635 (rank #65 of 5957; 99th percentile; extreme outlier), while 63650 (rank #62 of 1371; 95th percentile; notably above typical) also shows above-typical volume; by contrast 63685 (rank #95 of 1281; 92th percentile; typical, unremarkable volume) is strong but less exceptional.

Several individual CPT/HCPCS codes are flagged as statistical outliers nationally, reinforcing a specialized, high-throughput profile: 64483, 64628, 64635, and 62321 are labeled "extreme outlier" or equivalent in the data, while 63650 is "notably above typical". These outlier designations indicate the center performs these specific injection, ablation, and neuromodulation services at volumes well above most peers, which may reflect focused referral patterns or a regional niche in interventional spine care.

Although the top three codes dominate revenue, the practice shows additional substantial Medicare lines of business that diversify procedure types and revenue streams: 64628 contributes $512.7K (13.4%), 0275T contributes $422.6K (11.0%), and G0260 contributes $97K (2.5%), demonstrating meaningful activity in basivertebral nerve ablation, procedure codes without public descriptions, and sacroiliac joint injections respectively. This mix suggests the center’s financial performance is not solely reliant on implants but includes a broad portfolio of interventional pain procedures.

The provider has sustained an established presence in the Medicare program, with NPI enumerated on 2006-09-27 (~20 years ago). That tenure supports the interpretation that observed high volumes for specific spine and pain codes likely reflect mature referral relationships and an established ambulatory spine service line rather than a new or transient operation.

Medicare: Complete Services Breakdown

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

15 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…	40	$18,950	$796K
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).	2,320	$280	$656K
63650	In this procedure, the provider places electrodes in the epidural space to relieve pain and reduce or eliminate spasms.	150	$3,760	$579.5K
64628	The provider uses a thermal (heat) method under imaging guidance to destroy an intraosseous basivertebral nerve. Use this code for the first two lumbar or sacral vertebral bodies treated at a session.	70	$7,650	$512.7K
0275T	N/A	110	$3,770	$422.6K
0627T	The provider injects a cellular or tissue–based product under fluoroscopic guidance to treat a lumbar intervertebral disc. This code applies to the first level injected. The injection may occur on…	30	$7,310	$182.7K
64635	Under fluoroscopic or CT guidance, the provider applies an agent to a lower back joint to destroy nerve tissue.	310	$540	$165K
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…	560	$280	$156.2K
64555	A neurostimulator includes electrodes which are inserted under the skin and induced by a generator to stimulate the nerve tissue. Use of this stimulator involves implantation of electrodes around a…	30	$4,390	$140.5K
G0260	Injection procedure for sacroiliac joint; provision of anesthetic, steroid and/or other therapeutic agent, with or without arthrography	440	$220	$97K

Showing 1–10 of 15

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 15 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Pennsylvania Distribution

Main Line Spine Surgery Center, LLC — 8 of 15 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Pennsylvania

Full comparison — all codes billed, vs. state median

15 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
0627T	1	10	30	$7,300	$182.6K
63685	5	40	20	$6,350	$139.6K
64628	1	10	30	$4,420	$132.5K
0275T	7	50	30	$2,160	$112.6K
63650	3	40	40	$1,960	$107.6K
64555	1	10	20	$2,390	$59.8K
64483	1	340	60	$190	$18.6K
G0260	2	40	60	$210	$18.4K
64635	1	230	30	$360	$16.1K
62323	111	360	60	$140	$14.2K

Showing 1–10 of 15

Nearby Providers

Other providers in the same ZIP code as Main Line Spine Surgery Center, LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
The Promptcare Companies, Inc.	PA	Oxygen Equipment & Supplies (DME)	$0	$78.5M
Behavior Interventions, Inc	PA	Behavior Analyst	$0	$73.7M
Children's Hospital Of Philadelphia	PA	Durable Medical Equipment & Medical Supplies	$0	$27.6M
Cnnh Therapy LLC	PA	Behavior Analyst	$0	$26.2M
Children's Hospital Of Philadelphia	PA	Home Infusion Agency	$0	$23.1M
Helping Hands Family Pennsylvania LLC	PA	Community/Behavioral Health Agency	$0	$15.8M
Trustees Of The University Of Pennsylvania	PA	Home Infusion Agency	$159.1K	$7.2M
Ambulnz PA, LLC	PA	Ambulance	$3.3M	$3.8M
Quality Life Healthcare LLC	PA	Nursing Care Agency	$0	$6.3M
Wal-mart Stores, Inc.	PA	Optician	$0	$5.7M

Main Line Spine Surgery Center, LLC — Billing Profile & Reimbursement Data

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Main Line Spine Surgery 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