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NPI 1811973639 · Woodbury, MN · Ambulatory Surgical Clinic/Center
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Summit Orthopedics Ltd is a ambulatory surgical clinic/center provider located in Woodbury, Minnesota. This profile covers 20 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 | Summit Orthopedics Ltd |
| Address | 7115 Tamarack Rd Ste 200 |
| City | Woodbury |
| State | MN |
| ZIP | 55125 |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| NPI Enumerated | December 22, 2005 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $1.1M |
| Medicaid | $20.1K |
Payer mix is heavily Medicare‑weighted: the provider reports Total Medicare revenue of $1.1M compared with Total Medicaid revenue of $20.1K, making Medicare by far the dominant source of billed revenue and indicating this clinic operates largely in the Medicare outpatient market. Medicaid activity is present but de minimis in scale relative to Medicare.
Revenue concentration on Medicare is significant and focused: the precomputed top 3 Medicare codes account for 53.1% of this provider's total Medicare revenue, driven primarily by 63650, 64483, and 64635. That concentration suggests a business model where a small number of interventional procedures produce most of the Medicare topline.
The three highest Medicare revenue items show the operational focus in clinical terms: 63650 accounts for $280.9K (26.3% of Medicare revenue) and involves epidural electrode placement/neuromodulation; 64483 accounts for $208.7K (19.6%) and is transforaminal epidural injection; and 64635 accounts for $76.8K (7.2%) and is a neurolytic facet/joint procedure. Together these codes indicate the clinic performs high-volume interventional spine/pain procedures and neuromodulation in an outpatient surgical setting.
Competitive standing is mixed across codes: for 64483 the provider ranks #85 of 8202 providers nationally and is labeled an "extreme outlier" (99th percentile), indicating unusually high national volume for transforaminal epidural injections; by contrast 63650 ranks #301 of 1371 (78th percentile; typical, unremarkable volume) and 64635 ranks #490 of 5957 (92th percentile; typical, unremarkable volume), so the clinic is an exceptional national performer for one injection code but otherwise a more typical participant.
The provider also shows a notable hand/upper‑extremity surgery footprint alongside spine interventions: 64721 (carpal tunnel neuroplasty) generated $71.1K (6.7% of Medicare revenue) and is ranked in the 97th percentile (notably above typical national volume), while additional codes such as 25609, 25607, 26055 and 29848 contribute smaller but meaningful shares of Medicare revenue. This mix reinforces that Summit Orthopedics operates as an ambulatory surgical clinic offering both interventional pain/spine care and hand/wrist surgical services.
Medicaid activity is concentrated entirely in a single service line: all reported Medicaid revenue (100.0% of Medicaid revenue) is from 64483 (47 claims, $427 avg paid/claim, $20.1K revenue), but the provider ranks #17 of 22 in‑state for that code (24th percentile; typical, unremarkable volume). That contrast—extreme outlier nationally on Medicare for 64483 but modest in‑state Medicaid volume—may reflect payer mix differences, referral patterns, or contractual/payment rate drivers across payers.
The provider has an established tenure: the NPI was enumerated on 2005-12-22 (~21 years ago), consistent with a long‑standing ambulatory surgical clinic likely to have stable referral relationships and procedural workflows. Analysts should consider that institutional experience when evaluating utilization and contracting.
From a utilization management and contracting perspective, the combination of high concentration (Medicare top 3 = 53.1%; Medicaid top 3 = 100.0%) and the extreme outlier status on 64483 suggests areas for focused review: payer negotiators and provider analysts should examine referral sources, capacity for transforaminal epidural injections, clinical documentation, and whether volume concentration aligns with expected population needs given the ambulatory surgical clinic taxonomy. These patterns are not accusatory but do indicate where deeper operational and contractual diligence would be most informative.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
20 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 63650 | In this procedure, the provider places electrodes in the epidural space to relieve pain and reduce or eliminate spasms. | 70 | $3,900 | $280.9K |
| 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). | 690 | $300 | $208.7K |
| 64635 | Under fluoroscopic or CT guidance, the provider applies an agent to a lower back joint to destroy nerve tissue. | 120 | $620 | $76.8K |
| 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… | 110 | $650 | $71.1K |
| 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… | 250 | $280 | $70.5K |
| 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 | $3,590 | $50.3K |
| 25607 | 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 the… | 10 | $3,590 | $39.4K |
| 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… | 80 | $510 | $38.8K |
| 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… | 50 | $650 | $32.9K |
| 62321 | The provider injects a diagnostic or a therapeutic substance, such as pain medication or a steroid, into the space around the spinal nerves of the cervical (neck) or thoracic (upper and middle back)… | 90 | $270 | $25.2K |
Showing 1–10 of 20
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 20 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
20 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| 63650 | 12 | 30 | 70 | $2,030 | $170.4K |
| 25609 | 2 | 10 | 20 | $3,590 | $61K |
| 25607 | 1 | 10 | 10 | $3,580 | $39.4K |
| G0260 | 9 | 20 | 80 | $210 | $24.2K |
| 64635 | 5 | 100 | 30 | $370 | $16.2K |
| 26123 | 2 | 10 | 10 | $1,100 | $15.5K |
| 26480 | 5 | 10 | 20 | $670 | $15.4K |
| 20680 | 6 | 10 | 20 | $650 | $14.3K |
| 64483 | 1 | 170 | 40 | $200 | $14.1K |
| 29848 | 10 | 20 | 30 | $460 | $13.2K |
Showing 1–10 of 20
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). | 50 | $430 | $20.1K |
| 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… | 30 | $0 | $0 |
How this provider's Medicaid billing volume and revenue compare to other Minnesota providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Minnesota 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). | 17 | 20 | 140 | $170 | $79.1K |
| 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… | 14 | 20 | 130 | $0 | $0 |
Other providers in the same ZIP code as Summit Orthopedics Ltd, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Valhalla Place, LLC | MN | Community/Behavioral Health Agency | $581K | $22.1M |
| St. Croix Psychiatric, LLC | MN | Psychiatry Physician | $0 | $19.9M |
| Kubei Holding Group Inc | MN | Community/Behavioral Health Agency | $0 | $15.5M |
| Holistic Home Care LLC | MN | Home Health Agency | $0 | $14.7M |
| Redeemer Services, Inc. | MN | Case Management Agency | $0 | $14.3M |
| Greatercare Facilities, LLC | MN | Home Health Agency | $0 | $10.4M |
| B Tek, LLC | MN | Clinical Medical Laboratory | $0 | $10.2M |
| Healtheast Woodwinds Hospital | MN | General Acute Care Hospital | $0 | $6.2M |
| Allina Health System | MN | Family Medicine Physician | $0 | $5.5M |
| Kubei Holdings Group LLC | MN | Home Health Agency | $0 | $5.1M |
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