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NPI 1881789964 · Lexington, KY · Ambulatory Surgical Clinic/Center
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New Lexington Clinic, Psc is a ambulatory surgical clinic/center provider located in Lexington, Kentucky. This profile covers 45 Medicare and 3 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 | New Lexington Clinic, Psc |
| Address | 1225 S Broadway |
| City | Lexington |
| State | KY |
| ZIP | 40504 |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| NPI Enumerated | October 4, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $2.3M |
| Medicaid | $12.2K |
Payer mix is heavily Medicare-weighted: the provider reports $2.3M in total Medicare revenue versus $12.2K in total Medicaid revenue, indicating Medicare is effectively the dominant payer for this ambulatory surgical clinic while Medicaid represents only a very small share of billed activity. This skew suggests financial and clinical operations are primarily aligned with Medicare patient populations.
Revenue concentration on Medicare is high: the precomputed top 3 Medicare codes (64590, C9740, 64561) account for 44.6% of this provider's total Medicare revenue, with 64590 alone contributing $543.7K (25.7%). This indicates a meaningful portion of Medicare income is driven by a small set of higher‑value surgical implants and neuromodulation procedures.
Service-line mix is consistent with a multispecialty ambulatory surgery center: the presence of high-revenue neuromodulation codes (64590, 64561), multiple cystourethroscopy and ureteroscopy codes (52000, 52332, 52356), arthroplasty codes (27447, 27130), and cataract surgery (66984) suggests the clinic performs device-implant procedures, endoscopic urology, orthopedics/hand surgery, and ophthalmology on an outpatient basis. This code mix aligns with the listed taxonomy (Ambulatory Surgical Clinic/Center) and points to capability for both endoscopic throughput and implantable-device procedures.
Competitive standing is mixed by code: the provider ranks near the top nationally for several procedural codes (for example 64590 ranks #38 of 561, 93rd percentile) and shows extreme national outlier volume on Medicare for cystoscopy 52000 (537 claims, $104.7K; ranks #66 of 8548 providers, 99th percentile, labeled “extreme outlier”). At the same time, other surgical codes (for example 27130 hip replacement at the 18th percentile) reflect more modest participation, indicating the organization is a major national-level performer on a subset of procedures but not uniformly across all service lines.
Medicaid activity is very small and highly concentrated: the top 3 Medicaid codes account for 100.0% of Medicaid revenue, with 52000 representing $9.9K (85.1%) and A4649 representing $1.7K (14.9%). In-state competitive positioning is modest for clinical procedural volume (52000 ranks #15 of 34, 58th percentile) while supply billing (A4649) ranks #1 of 5 in-state and is noted as “notably above typical state volume,” although the dollar amounts remain small.
Several codes are statistical outliers on Medicare and warrant operational attention: 52000 and 55700 are both described as 99th percentile “extreme outlier, far above typical national volume,” and 52332 is 95th percentile “notably above typical national volume.” These high-percentile rankings reflect unusually large procedure counts relative to national peers for specific endoscopic/urologic services and a deleted-code note (55700 was deleted December 31, 2025) may affect future billing patterns.
Billing pattern nuances: J0585 shows very high claim count (8.7K claims) but relatively low total revenue ($43.3K), indicating many small unit-based charges for onabotulinumtoxina rather than high-dollar single injections. Similarly, Medicare cystoscopy coding includes both high-volume low-unit codes (52000) and higher-value codes (52356, 52332) which together suggest significant endoscopy throughput with a mix of diagnostic and therapeutic cases.
The provider has longstanding enrollment and operating history: NPI enumerated 2006-10-04 (~20 years ago), indicating an established ambulatory surgical operation that has maintained varied procedural volume over time. Tenure combined with concentrated high-percentile volumes for specific codes suggests operational specialization and experience in selected outpatient surgical 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.
45 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 64590 | The provider inserts or replaces a peripheral, sacral, or gastric neurostimulator pulse generator or receiver. The system is one that requires surgical creation of a pocket for placement and that… | 40 | $13,590 | $543.7K |
| C9740 | Cystourethroscopy, with insertion of transprostatic implant; 4 or more implants | 40 | $5,060 | $202.4K |
| 64561 | The provider, under imaging guidance, implants electrodes around nerves in the sacral region to reduce the pain along the path of the nerve. | 60 | $3,560 | $195.9K |
| 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… | 30 | $6,640 | $179.3K |
| 66984 | The provider inserts an artificial lens after removing an extracapsular cataract by aspiration or use of ultrasonic waves. This procedure is done without the use of an endoscopic laser probe to… | 180 | $810 | $147.3K |
| 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… | 20 | $7,030 | $105.5K |
| 52000 | In this procedure, the provider performs an examination of the interior of the bladder, the urethra, and the ureteric openings by means of a cystourethroscope, a thin flexible or rigid tube with a… | 540 | $200 | $104.7K |
| 55700 | Code deleted December 31, 2025. | 160 | $610 | $100.1K |
| 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… | 80 | $550 | $44.3K |
| 52356 | The provider performs a cystourethroscopy, the inspection of the interior of the bladder, the urethra, prostatic urethra, and ureteric openings using a cystoscope passed through the urethra and into… | 30 | $1,630 | $44.1K |
Showing 1–10 of 45
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 45 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
45 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| 64561 | 2 | 10 | 40 | $3,320 | $302.3K |
| 64590 | 2 | 10 | 30 | $8,230 | $296.2K |
| C9740 | 2 | 10 | 40 | $5,180 | $155.3K |
| 66984 | 248 | 310 | 1,560 | $40 | $67.1K |
| 27447 | 90 | 160 | 30 | $1,090 | $45.7K |
| J0585 | 6 | 30 | 5,290 | $1 | $36.6K |
| 27130 | 71 | 90 | 20 | $1,090 | $32.6K |
| 31276 | 1 | 10 | 30 | $1,150 | $32.2K |
| 66982 | 58 | 70 | 30 | $270 | $20.8K |
| 52000 | 2 | 90 | 70 | $140 | $17.4K |
Showing 1–10 of 45
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.
3 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 52000 | In this procedure, the provider performs an examination of the interior of the bladder, the urethra, and the ureteric openings by means of a cystourethroscope, a thin flexible or rigid tube with a… | 110 | $90 | $9.9K |
| A4649 | Surgical supply; miscellaneous | 1,730 | $1 | $1.7K |
| 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… | 220 | $0 | $0 |
How this provider's Medicaid billing volume and revenue compare to other Kentucky providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Kentucky median
3 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 52000 | In this procedure, the provider performs an examination of the interior of the bladder, the urethra, and the ureteric openings by means of a cystourethroscope, a thin flexible or rigid tube with a… | 15 | 30 | 80 | $130 | $61.8K |
| A4649 | Surgical supply; miscellaneous | 1 | 10 | 370 | $1 | $670 |
| 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… | 13 | 20 | 260 | $1 | $1 |
Other providers in the same ZIP code as New Lexington Clinic, Psc, ranked by combined Medicare and Medicaid revenue.
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