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

Why is the Medicaid comparison limited to South Carolina 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. South Carolina (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.

Midlands Orthopaedics Surgery Center, LLC (NPI 1881620466)

Field	Value
Entity Type	Organization
Organization	Midlands Orthopaedics Surgery Center, LLC
Address	1930 Blanding St
City	Columbia
State	SC
ZIP	29201
Taxonomy	Ambulatory Surgical Clinic/Center
NPI Enumerated	June 24, 2006

Payer Source	Total Paid
Medicare	$3.5M
Medicaid	$0

Key Findings

MIDLANDS ORTHOPAEDICS SURGERY CENTER, LLC operates as an orthopedic and spine-focused ambulatory surgical clinic based on its Medicare code mix: large-volume joint replacement and device work (27447 knee replacement, 27130 hip replacement) combined with multiple neurostimulation and spine procedure codes (64555, 63685, 63650). The prominence of high-reimbursement implant and generator codes alongside injection and arthroscopic codes indicates a blended service line of joint arthroplasty, spine interventions, and peripheral nerve procedures performed in an outpatient surgical setting.

Revenue is highly concentrated in a few services: the precomputed top 3 codes account for 50.4% of this provider's total Medicare revenue, driven by 27447 ($980.1K, 28.6%), 64555 ($427K, 12.5%), and 27130 ($318.7K, 9.3%). This concentration means changes in volume, reimbursement, or coverage for those particular codes would disproportionately affect the provider’s Medicare revenue stream.

The provider’s payer mix is effectively single-payer Medicare: lifetime Medicare revenue is $3.5M while Medicaid is listed as none (no Medicaid billing on file). This skew implies revenue and utilization trends will be driven by Medicare policy and beneficiary demand rather than by Medicaid populations or state Medicaid payment dynamics.

For several high-revenue procedures the practice ranks well above national norms, signaling competitive prominence in specific niches: 27447 ranks #274 of 12089 providers nationally (98th percentile; notably above typical national volume) and 64555 ranks #9 of 211 providers nationally (96th percentile; notably above typical national volume). By contrast, 27130 is more typical in scale at rank #1695 of 8062 (78th percentile), indicating strength in knee arthroplasty and neurostimulation but only modest national standing in hip replacement relative to peers.

The practice shows extreme outlier activity in some spine and pain-service codes, which points to a heavy procedural throughput in those areas: 62323 reports 850 claims and $198.9K revenue (5.8%) and ranks #10 of 7397 providers nationally (100th percentile; extreme outlier). High procedural counts for image-guided spinal injections suggest an active interventional pain or spine injection program alongside surgical services.

Beyond spine injections, several other non-arthroplasty procedures are unusually high versus peers, reflecting broad procedural scope: 29827 (arthroscopic rotator cuff repair) is $162.8K (4.8%) and ranks #46 of 3445 (99th percentile; extreme outlier), while 64721 (carpal tunnel surgery) is $82.3K (2.4%) and ranks #46 of 3206 (99th percentile; extreme outlier). These signals indicate the center delivers substantial shoulder and hand surgery volume in addition to its implant and spine work.

Device- and implant-dependent codes contribute materially to revenue and carry higher per-claim payments: examples include 27447 at $6622 avg paid/claim, 27130 at $6780 avg paid/claim, and 63685 at $17630 avg paid/claim. The business therefore appears dependent on device supply, implant utilization, and high-cost generator procedures, which can drive revenue volatility and require supply-chain and credentialing capabilities aligned with implant-based care.

This entity has an established operational history, with its NPI enumerated 2006-06-24 (~20 years ago), and a measured Medicare footprint of $3.5M lifetime revenue. The combination of long tenure and concentrated Medicare-only billing suggests operational stability in an outpatient orthopedic/spine niche but also a concentrated exposure to Medicare policy and procedure-level reimbursement trends.

Medicare: Complete Services Breakdown

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

33 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…	150	$6,620	$980.1K
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…	110	$3,990	$427K
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…	50	$6,780	$318.7K
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…	20	$17,630	$317.3K
62323	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 lumbar (lower back) or sacral (caudal, or tailbone)…	850	$230	$198.9K
63650	In this procedure, the provider places electrodes in the epidural space to relieve pain and reduce or eliminate spasms.	60	$3,500	$196.2K
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…	80	$2,090	$162.8K
63655	In this procedure, the provider removes a portion of the vertebra called the lamina and places a permanent plate/paddle electrode in the epidural space, or area between the dura membrane and the wall…	10	$12,800	$140.8K
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…	140	$580	$82.3K
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…	300	$240	$70.2K

Showing 1–10 of 33

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 33 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. South Carolina Distribution

Midlands Orthopaedics Surgery Center, LLC — 7 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — South Carolina

Full comparison — all codes billed, vs. state median

33 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
63685	18	40	20	$5,770	$138.5K
64555	1	10	30	$1,860	$74.5K
63650	10	40	40	$1,580	$66.5K
27447	11	220	40	$1,090	$61.9K
63655	13	20	10	$2,800	$50.3K
27130	55	150	40	$1,060	$44.7K
64483	60	130	90	$190	$33K
62323	3	130	80	$160	$28.8K
64493	10	130	70	$170	$22.7K
64635	12	110	40	$350	$22.4K

Showing 1–10 of 33

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Doctors Care, PA	SC	Family Medicine Physician	$0	$50.7M
Robertson Optical Laboratories Inc	SC	Eyewear Supplier	$0	$13.5M
Dhec Hemophilia-cshcn Program	SC	Pharmacy	$0	$13.3M
Addus Healthcare (south Carolina), Inc.	SC	In Home Supportive Care Agency	$0	$12.1M
Pruitthealth Hospice, Inc.	SC	Inpatient Hospice	$0	$11.8M
Prisma Health-midlands	SC	General Acute Care Hospital	$0	$11.8M
State Of South Carolina	SC	Public Health or Welfare Agency	$0	$10.4M
South Carolina Dept Of Mental Health Accounting Office	SC	Community/Behavioral Health Agency	$0	$8.8M
Palladium Hospice And Palliative Care, LLC	SC	Community Based Hospice Care Agency	$0	$8.2M
Lutheran Family Services In The Carolinas	SC	Community/Behavioral Health Agency	$0	$7.8M

Midlands Orthopaedics Surgery Center, LLC — Billing Profile & Reimbursement Data

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Midlands Orthopaedics 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