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NPI 1891759569 · Saint Joseph, MO · Ambulatory Surgical Clinic/Center
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St Joseph Center For Outpatient Surgery, LLC is a ambulatory surgical clinic/center provider located in Saint Joseph, Missouri. This profile covers 20 Medicare and 7 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 | St Joseph Center For Outpatient Surgery, LLC |
| Address | 4510 Frederick Ave |
| City | Saint Joseph |
| State | MO |
| ZIP | 64506 |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| NPI Enumerated | April 12, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $2M |
| Medicaid | $92.9K |
ST JOSEPH CENTER FOR OUTPATIENT SURGERY, LLC operates as an ambulatory surgical clinic/center that bills heavily for major orthopedic joint procedures and endoscopic GI services; its Medicare top revenue drivers include 27447 ($952.6K), 27130 ($212K), and 27446 ($156.8K), and the facility also reports substantial Medicare volume in colonoscopy and upper endoscopy codes such as 45385 ($138.4K) and 43249 ($100.6K), indicating a mixed orthopedics-plus-endoscopy service line within an ASC setting.
Medicare revenue is highly concentrated: the provider’s top 3 Medicare codes by revenue account for 65.0% of its total Medicare revenue, and those three codes are dominated by large-joint arthroplasty entries (27447, 27130, 27446), signaling material dependence on a small set of high-revenue procedures for Medicare income.
Medicaid billing is even more concentrated: the top 3 Medicaid codes account for 90.8% of the provider’s total Medicaid revenue, led by 43239 (638 claims, $72.7K; 78.3% of Medicaid revenue) with 45388 ($7.2K; 7.8%) and 43249 ($4.4K; 4.7%) completing that trio, which suggests Medicaid activity is largely limited to specific endoscopy procedures.
Payer mix is Medicare-dominant in scale: reported lifetime Medicare revenue is $2M compared with total Medicaid revenue of $92.9K, so Medicaid represents a small fraction of this provider’s billed public-payer dollars and the operation functions effectively as a Medicare-focused ASC.
On competitive standing for key Medicare codes, the provider ranks well above typical national volume for several procedures: 27447 ranks #333 of 12089 (97th percentile; notably above typical national volume) and 45385 ranks #586 of 16310 (96th percentile; notably above typical national volume), while 43249 is an extreme outlier at rank #28 of 3500 (99th percentile), indicating exceptional volume for esophageal dilation relative to national peers.
Within the state Medicaid landscape, competitive positioning is mixed and in some cases constrained by small peer pools: 43239 ranks #22 of 89 in-state (76th percentile; typical, unremarkable volume), whereas 45388 ranks #2 of 3 in-state (50th percentile) — rank positions that reflect generally typical in-state endoscopy volumes but are sensitive to small denominators for some codes.
The provider has long tenure in the Medicare/Medicaid payment system, with NPI enumeration on 2006-04-12 (~20 years ago), consistent with an established outpatient surgical operation that has developed stable procedure lines over time.
Billing mix includes routine screening and quality-reporting codes alongside high-revenue procedures: Medicare colorectal screening codes G0105 and G0121 appear in the top revenue list (G0105: 120 claims, $46.3K; G0121: 107 claims, $40.2K), and Medicaid shows a large count of the zero-paid safety metric code G8907 (310 claims, $0), indicating active use of preventive screening workflows and documentation of facility-level safety reporting in addition to surgical throughput.
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 |
|---|---|---|---|---|
| 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… | 140 | $6,850 | $952.6K |
| 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 | $7,070 | $211.9K |
| 27446 | In this procedure, the provider reconstructs the diseased or damaged medial or lateral compartment of the knee along with the femoral condyles and tibial plateaus to relieve pain and improve the… | 20 | $6,820 | $156.8K |
| 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… | 330 | $420 | $138.4K |
| 43249 | The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum and dilates (widens) the esophagus with a balloon less than 30 mm in diameter. | 180 | $550 | $100.6K |
| 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… | 240 | $330 | $78.8K |
| 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 | $2,080 | $64.6K |
| 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. | 340 | $190 | $64.6K |
| G0105 | Colorectal cancer screening; colonoscopy on individual at high risk | 120 | $390 | $46.3K |
| G0121 | Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk | 110 | $380 | $40.2K |
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How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 20 CPT/HCPCS codes.
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Full comparison — all codes billed, vs. state median
20 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| 27446 | 7 | 10 | 40 | $2,250 | $101.1K |
| 27447 | 6 | 250 | 30 | $1,140 | $50.2K |
| 27130 | 57 | 160 | 20 | $1,050 | $31.6K |
| 29827 | 15 | 70 | 20 | $990 | $24.6K |
| 45385 | 7 | 340 | 60 | $250 | $21K |
| 29880 | 3 | 10 | 20 | $890 | $17.8K |
| 64721 | 71 | 70 | 30 | $400 | $15.6K |
| 29881 | 3 | 20 | 10 | $810 | $15.4K |
| 29848 | 2 | 20 | 20 | $400 | $12.1K |
| 26055 | 14 | 50 | 30 | $270 | $9.8K |
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.
7 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 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. | 640 | $110 | $72.7K |
| 45388 | In this procedure, the provider performs flexible colonoscopy to destroy one or more tumors, polyps, or other lesions. The procedure includes, but does not require, guide wire passage and dilating… | 30 | $280 | $7.2K |
| 43249 | The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum and dilates (widens) the esophagus with a balloon less than 30 mm in diameter. | 10 | $310 | $4.4K |
| 69436 | This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia. | 10 | $300 | $3.9K |
| 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… | 20 | $130 | $3.1K |
| 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… | 10 | $130 | $1.5K |
| 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… | 310 | $0 | $0 |
How this provider's Medicaid billing volume and revenue compare to other Missouri providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Missouri median
7 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 43249 | The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum and dilates (widens) the esophagus with a balloon less than 30 mm in diameter. | 6 | 10 | 260 | $390 | $241.6K |
| 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… | 16 | 20 | 30 | $450 | $147.8K |
| 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. | 22 | 90 | 120 | $250 | $141.3K |
| 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… | 31 | 30 | 90 | $340 | $140.3K |
| 69436 | This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia. | 61 | 70 | 70 | $520 | $121K |
| 45388 | In this procedure, the provider performs flexible colonoscopy to destroy one or more tumors, polyps, or other lesions. The procedure includes, but does not require, guide wire passage and dilating… | 2 | 10 | 30 | $120 | $3.4K |
| 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… | 4 | 30 | 100 | $0 | $0 |
Other providers in the same ZIP code as St Joseph Center For Outpatient Surgery, LLC, ranked by combined Medicare and Medicaid revenue.
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