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NPI 1861492530 · Grants Pass, OR · Ambulatory Surgical Clinic/Center
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Grants Pass Surgery Center, LLC is a ambulatory surgical clinic/center provider located in Grants Pass, Oregon. This profile covers 16 Medicare and 6 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 | Grants Pass Surgery Center, LLC |
| Address | 1601 Nw Hawthorne Ave |
| City | Grants Pass |
| State | OR |
| ZIP | 97526 |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| NPI Enumerated | July 26, 2005 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $1.1M |
| Medicaid | $113.1K |
GRANTS PASS SURGERY CENTER, LLC presents a service mix dominated by orthopedic procedures on Medicare and gastrointestinal endoscopy for Medicaid. The top Medicare revenue drivers are 27447 (knee arthroplasty), 27130 (hip arthroplasty) and 29828 (biceps tenodesis/shoulder arthroscopy), while Medicaid revenue is concentrated exclusively in endoscopy codes 45385, 45380 and 43239, indicating the center performs both high-value joint procedures and routine GI work.
Medicare revenue is highly concentrated: the provider reports Total Medicare revenue of $1.1M with its top 3 Medicare codes accounting for 74.9% of that Medicare revenue. Within that mix 27447 contributes $464.1K (43.5%) and 27130 contributes $262.7K (24.6%), so a small number of arthroplasty codes generate the bulk of Medicare receipts.
On the Medicaid side the provider reports Total Medicaid revenue of $113.1K and the top 3 Medicaid codes account for 100.0% of Medicaid revenue. Those Medicaid drivers are 45385 ($68K, 60.2%), 45380 ($42K, 37.2%) and 43239 ($3K, 2.7%), showing Medicaid activity is effectively limited to colonoscopy and upper endoscopy services.
Payer mix is heavily skewed toward Medicare in scale: Medicare revenue ($1.1M) dwarfs Medicaid revenue ($113.1K), making Medicare the dominant payer for this facility’s billed services. This imbalance implies that financial performance and risk exposure are more sensitive to Medicare volume and reimbursement trends than to Medicaid.
Competitive standing is mixed by service line. For Medicare arthroplasty the facility ranks #2333 of 12089 for 27447 (80th percentile; typical, unremarkable volume) and #2291 of 8062 for 27130 (70th percentile; typical, unremarkable volume), indicating modest but not dominant national presence in joint replacement; by contrast shoulder arthroscopy (29828) ranks #91 of 1007 (90th percentile; typical, unremarkable volume), suggesting relatively higher activity in that niche. For Medicaid endoscopy the provider’s in-state ranks are more modest or low (45385: #22 of 38, 43th percentile; 45380: #29 of 51, 44th percentile; 43239: #59 of 60, 2th percentile), so it is not a leading GI provider statewide.
There are notable Medicaid billing patterns that merit attention: codes E0675 and E0666 show high claim counts (169 and 159 respectively) with $0 revenue recorded, and C1713 has 224 claims with $0 revenue but ranks #1 of 9 providers in-state (100th percentile; notably above typical state volume). These $0-paid-code clusters could reflect contract/coverage quirks, pass-through supply billing, or reporting artifacts and should be validated against claim-level detail.
Operational implications for an Ambulatory Surgical Clinic/Center taxonomy: the prominence of 27447 and 27130 on Medicare indicates the center is performing a significant share of major joint procedures that typically produce high per-claim payments, while the Medicaid mix concentrated in 45385/45380/43239 indicates substantial endoscopy throughput under state programs. Together these patterns suggest a dual focus on orthopedic surgery and GI endoscopy rather than a single-service specialty.
The provider has a long NPI tenure: NPI enumerated 2005-07-26 (~21 years ago), which supports interpretation of these patterns as established service lines rather than start-up volume spikes and provides a longer history for benchmarking peer comparisons and trend analysis.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
16 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… | 60 | $7,370 | $464.1K |
| 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… | 40 | $6,740 | $262.7K |
| 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… | 30 | $2,440 | $73.2K |
| 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… | 40 | $1,700 | $73.1K |
| 45385 | The provider examines the colon and rectum using a colonoscope, a long, thin flexible tubular instrument with a light source and camera. He removes one or more tumors, polyps, or other lesions with a… | 100 | $460 | $47.2K |
| 45380 | The provider examines the rectum and colon using a flexible colonoscope, a tubular instrument with a light source and camera, to look for the cause of a patient's symptoms, which may include… | 70 | $400 | $27.3K |
| 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… | 30 | $640 | $18.6K |
| 28285 | The provider repairs a hammertoe deformity, a painful condition in which the toe remains permanently bent in a downward position. | 20 | $720 | $17.3K |
| G0105 | Colorectal cancer screening; colonoscopy on individual at high risk | 40 | $430 | $16.7K |
| 58558 | The provider either biopsies the lining of the uterus (endometrium) or removes polyps, or both, through a hysteroscope ; he may or may not perform a dilation and curettage (D&C). He sends all samples… | 10 | $1,080 | $14K |
Showing 1–10 of 16
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 16 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
16 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| 27447 | 22 | 170 | 30 | $1,590 | $60.3K |
| 27130 | 34 | 110 | 30 | $1,610 | $53.1K |
| 29848 | 17 | 20 | 40 | $470 | $26.8K |
| 45385 | 40 | 230 | 50 | $310 | $25.2K |
| 29827 | 2 | 40 | 20 | $1,060 | $22.3K |
| 29828 | 2 | 20 | 20 | $1,100 | $20.9K |
| 64721 | 15 | 40 | 30 | $470 | $16.5K |
| 28285 | 7 | 10 | 30 | $460 | $14.8K |
| 58558 | 2 | 10 | 10 | $950 | $13.3K |
| 28308 | 4 | 10 | 20 | $770 | $13.1K |
Showing 1–10 of 16
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.
6 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 45385 | The provider examines the colon and rectum using a colonoscope, a long, thin flexible tubular instrument with a light source and camera. He removes one or more tumors, polyps, or other lesions with a… | 200 | $350 | $68K |
| 45380 | The provider examines the rectum and colon using a flexible colonoscope, a tubular instrument with a light source and camera, to look for the cause of a patient's symptoms, which may include… | 130 | $320 | $42K |
| 43239 | The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis. | 10 | $230 | $3K |
| C1713 | Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) | 220 | $0 | $0 |
| E0666 | Non-segmental pneumatic appliance for use with pneumatic compressor, half leg | 160 | $0 | $0 |
| E0675 | Pneumatic compression device, high pressure, rapid inflation/deflation cycle, for arterial insufficiency (unilateral or bilateral system) | 170 | $0 | $0 |
How this provider's Medicaid billing volume and revenue compare to other Oregon providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Oregon median
6 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 45385 | The provider examines the colon and rectum using a colonoscope, a long, thin flexible tubular instrument with a light source and camera. He removes one or more tumors, polyps, or other lesions with a… | 22 | 40 | 310 | $420 | $325.7K |
| 43239 | The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis. | 59 | 60 | 350 | $260 | $251.9K |
| 45380 | The provider examines the rectum and colon using a flexible colonoscope, a tubular instrument with a light source and camera, to look for the cause of a patient's symptoms, which may include… | 29 | 50 | 200 | $370 | $238.2K |
| C1713 | Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) | 1 | 10 | 30 | $20 | $990 |
| E0666 | Non-segmental pneumatic appliance for use with pneumatic compressor, half leg | 1 | 10 | 160 | $0 | $0 |
| E0675 | Pneumatic compression device, high pressure, rapid inflation/deflation cycle, for arterial insufficiency (unilateral or bilateral system) | 1 | 10 | 170 | $0 | $0 |
Other providers in the same ZIP code as Grants Pass Surgery Center, LLC, ranked by combined Medicare and Medicaid revenue.
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