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

Why is the Medicaid comparison limited to West Virginia 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. West Virginia (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.

Mgh Surgery LLC (NPI 1831545904)

Key Findings

Field	Value
Entity Type	Organization
Organization	Mgh Surgery LLC
Address	2000 Mon Health Medical Park Drive
City	Morgantown
State	WV
ZIP	26505
Taxonomy	Ambulatory Surgical Clinic/Center
NPI Enumerated	May 9, 2016

Payer Source	Total Paid
Medicare	$870.8K
Medicaid	$0

MGH SURGERY LLC is functionally an ambulatory surgical center focused on major joint replacements and orthopedics: its top revenue codes are 27447 (knee replacement), 27130 (hip replacement), and 29827 (arthroscopic rotator cuff repair), and the code descriptions indicate primary activity in joint arthroplasty and shoulder arthroscopy rather than primary care or non-operative specialties. The presence of multiple injection and minor procedure codes (e.g., 64721, 64483, 29881) suggests the center also performs a mix of outpatient hand, spine, and knee procedures alongside its joint-replacement volume.

Revenue is highly concentrated in a small number of services: the precomputed top-3 Medicare codes account for 86.8% of the provider’s total Medicare revenue, and the single largest code, 27447, alone represents $493.5K or 56.8% of Medicare revenue. This concentration implies the practice’s financial performance is heavily dependent on knee and hip arthroplasty activity.

MGH SURGERY LLC’s Medicare revenue totals $870.8K while there is no Medicaid billing on file, making the provider effectively single-payer from the dataset’s perspective. Analysts should treat this entity as Medicare-dominant for payer mix and population-risk modeling, since Medicaid contributes no measurable revenue.

On competitive standing for key procedures, the provider’s volume for 27447 ranks #1645 of 12089 (86th percentile), indicating it is a solid, above-average national participant in knee replacement but not a dominant national center. For 27130 the rank is #3147 of 8062 (59th percentile), consistent with typical, unremarkable hip replacement volume, and for 29827 the rank is #617 of 3445 (81st percentile), showing stronger-than-average shoulder arthroscopy activity relative to peers.

Several ancillary procedure codes are present at modest volumes and generally fall in typical-to-low national percentiles: 64721 (carpal tunnel neuroplasty) is 82nd percentile, 29881 (knee meniscectomy) is 78th percentile, and 64483 (transforaminal epidural) is 51st percentile. These mid-range rankings support a model where the center supplements its arthroplasty work with hand and spine injections/operations, broadening service lines without leading the market in those niches.

Tenure is established but not longstanding in the dataset: the NPI was enumerated on 2016-05-09 (approximately 10 years ago), indicating the organization has had a sustained presence long enough to build procedural volume and referral relationships, particularly in elective orthopedics.

A few lower-revenue codes show very limited national standing, which flags niche or locally focused services rather than outlier billing behavior: for example, 64635 (facet joint neurotomy) ranks in the 7th percentile nationally and 64493 (facet injection) is in the 11th percentile. These low percentiles imply these services are offered only occasionally and are not a competitive strength for the practice.

Given the concentration in three high-dollar elective procedures and lack of Medicaid activity, risk assessments and contract negotiations should prioritize Medicare payment rates, episode-of-care arrangements for joint replacement, and referral patterns for orthopedics; diversification into Medicaid or broader outpatient services would be required to materially change payer mix exposure.

Medicare: Complete Services Breakdown

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

10 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…	80	$6,490	$493.5K
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…	30	$6,550	$202.9K
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…	30	$1,920	$57.7K
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…	60	$560	$32.1K
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	$990	$23.7K
C9290	Injection, bupivacaine liposome, 1 mg	17,560	$1	$17.6K
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).	60	$250	$15.7K
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…	20	$440	$10.5K
64635	Under fluoroscopic or CT guidance, the provider applies an agent to a lower back joint to destroy nerve tissue.	20	$590	$8.8K
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…	20	$310	$6.5K

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Interim Healthcare Of Pittsburgh, Inc.	WV	Nursing Care Agency	$0	$23.1M
Monongalia County General Hospital Company	WV	General Acute Care Hospital	$0	$16.3M
Monongalia Emergency Medical Services Inc	WV	Ambulance	$1.4M	$11.3M
Gr&w, Inc	WV	Clinical Neuropsychologist	$0	$12.2M
Cardinal Pediatrics PLLC	WV	Pediatrics Physician	$0	$11.1M
Pace Training And Evaluation Center, Inc	WV	Developmentally Disabled Services Day Training Agency	$0	$9.2M
Therapy Services, LLC	WV	Speech-Language Pathologist	$0	$8.5M
Monongalia County General Hospital Company	WV	Specialist	$0	$6.8M
Gary Miller	WV	Ophthalmology Physician	$6.3M	$0
West Virginia Emergency Physicians, LLP	WV	Emergency Medicine Physician	$0	$4.7M

Mgh Surgery LLC — Billing Profile & Reimbursement Data

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Mgh Surgery 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
27447	7	70	30	$1,070	$38.6K
27130	9	50	20	$940	$23.6K
29881	2	10	20	$750	$18.8K
C9290	1	10	12,640	$1	$13.8K
29827	1	10	10	$850	$13.5K
64635	24	30	50	$200	$12.8K
64721	1	10	30	$360	$11.2K
64493	28	30	70	$110	$8.7K
64483	9	30	50	$120	$6.2K
26055	3	10	20	$240	$5.9K