Loading...
NPI 1811125149 · Knoxville, TN · Ambulatory Surgical Clinic/Center
Customize your policy alerts
Get alerted when relevant policies change without checking for updates manually.
Monitor payer policy activity
Knoxville Orthopaedic Surgery Center LLC is a ambulatory surgical clinic/center provider located in Knoxville, Tennessee. This profile covers 32 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 | Knoxville Orthopaedic Surgery Center LLC |
| Address | 256 Ft. Sanders West Blvd. |
| City | Knoxville |
| State | TN |
| ZIP | 37922 |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| NPI Enumerated | June 25, 2009 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $3.1M |
| Medicaid | $19.1K |
KNOXVILLE ORTHOPAEDIC SURGERY CENTER LLC is an ambulatory surgical clinic/center whose Medicare billing is dominated by large joint arthroplasty codes, with 27447 (knee replacement) generating $1.1M (36.2% of the provider’s Medicare revenue) and 27130 (hip replacement) generating $679.8K (22.0%). The provider’s top three Medicare codes together account for 65.2% of its total Medicare revenue, indicating a service-line focus on major joint replacement procedures delivered in an outpatient surgical center setting.
The practice’s overall payer mix is heavily Medicare-weighted: lifetime Medicare revenue is $3.1M compared with just $19.1K in Medicaid revenue, so Medicaid is effectively de minimis for this entity. Precomputed Medicaid concentration shows the top Medicaid codes account for 100.0% of that small Medicaid revenue, underscoring that the facility operates with Medicare as its principal commercial driver.
On competitive standing for key procedures, the provider is a high-volume national outlier for knee arthroplasty: 27447 ranks #128 of 12089 providers nationally (99th percentile; extreme outlier). Hip arthroplasty (27130) is also well above typical national volume, ranking #164 of 8062 (98th percentile; notably above typical national volume), which together position the center as a major national performer for lower‑extremity joint replacement.
Beyond joint replacement, the center reports unusually high volumes for several soft-tissue and hand procedures, indicating broad orthopaedic scope beyond arthroplasty. For example, 29827 (rotator cuff repair) produced $211.8K (6.8% of Medicare revenue) and ranks #14 of 3445 (100th percentile; extreme outlier), while 64721 (carpal tunnel neuroplasty) produced $116.2K (3.8%) and ranks #7 of 3206 (100th percentile; extreme outlier), showing dominant activity in shoulder and hand surgery as well as joint replacement.
The provider also bills a range of foot, ankle and extremity procedures at above-typical volumes, consistent with a full-service orthopaedic ASC. Codes such as 28750 ($87.8K, 2.8% of Medicare revenue; rank #16 of 311, 94th percentile, notably above typical volume) and 28285 ($41.5K, 1.3%; rank #33 of 955, 97th percentile, notably above typical volume) indicate repeated forefoot and toe procedures in addition to the center’s higher-revenue joint work.
Interventional pain and injection services are a visible but smaller component of the revenue mix across payers. On Medicare, 62321 generated $30.1K (1.0% of Medicare revenue) and ranks #113 of 4493 (98th percentile; notably above typical volume), while 64483 generated $30K (1.0%) but ranks #2145 of 8202 (74th percentile; typical, unremarkable volume). The presence of these codes suggests the center provides some spine/pain interventions alongside its surgical caseload, though competitive standing varies by code.
Medicaid billing is concentrated entirely in a single injection code: 64483 accounts for all Medicaid revenue reported ($19K, 100.0% of Medicaid revenue) and ranks #27 of 39 in-state (32nd percentile; typical, unremarkable volume). This pattern indicates the center is only a modest Medicaid participant in interventional spine services at the state level and relies on Medicare as its principal commercial base.
The provider’s NPI was enumerated on 2009-06-25 (~17 years ago), indicating an established practice history. Combined with $3.1M in lifetime Medicare revenue and the concentrated, high-ranked arthroplasty and orthopaedic procedure mix, the data are consistent with a long-standing ambulatory surgical center specializing in high-volume joint replacement and a broad set of outpatient orthopaedic procedures.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
32 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… | 180 | $6,160 | $1.1M |
| 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… | 110 | $6,350 | $679.8K |
| 27446 | In this procedure, the provider reconstructs the diseased or damaged medial or lateral compartment of the knee along with the femoral condyles and tibial plateaus to relieve pain and improve the… | 40 | $6,110 | $219.8K |
| 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… | 120 | $1,710 | $211.8K |
| 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… | 210 | $540 | $116.2K |
| 28750 | In this procedure, the provider surgically immobilizes the metatarsophalangeal joint of the great toe. A metatarsophalangeal joint is a joint between the first metatarsal of the foot and the first… | 30 | $3,030 | $87.8K |
| 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… | 40 | $2,090 | $87.6K |
| 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… | 30 | $2,900 | $72.4K |
| 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… | 190 | $370 | $68.8K |
| 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… | 60 | $930 | $50.9K |
Showing 1–10 of 32
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 32 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
32 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| 27447 | 5 | 280 | 30 | $1,440 | $67.8K |
| 27446 | 2 | 10 | 30 | $1,990 | $55.8K |
| 27130 | 5 | 170 | 30 | $1,480 | $53.1K |
| 25609 | 1 | 10 | 10 | $2,220 | $33.3K |
| 29827 | 1 | 90 | 20 | $1,110 | $26.7K |
| 64483 | 45 | 150 | 70 | $190 | $25.8K |
| 64635 | 36 | 150 | 40 | $360 | $25.6K |
| 29828 | 2 | 30 | 20 | $1,130 | $24.9K |
| 28750 | 1 | 10 | 10 | $1,540 | $24.6K |
| 29881 | 2 | 40 | 20 | $770 | $17K |
Showing 1–10 of 32
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 |
|---|---|---|---|---|
| 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). | 110 | $170 | $19K |
| 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… | 20 | $0 | $0 |
How this provider's Medicaid billing volume and revenue compare to other Tennessee providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Tennessee median
2 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 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). | 27 | 40 | 210 | $90 | $49.7K |
| 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… | 60 | 70 | 160 | $1 | $10 |
Other providers in the same ZIP code as Knoxville Orthopaedic Surgery Center LLC, ranked by combined Medicare and Medicaid revenue.
Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.