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

Why is the Medicaid comparison limited to Utah 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. Utah (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.

Surgery Center At Grove Creek, LLC (NPI 1962007757)

Field	Value
Entity Type	Organization
Organization	Surgery Center At Grove Creek, LLC
Address	2168 W Grove Pkwy Ste 101
City	Pleasant Grove
State	UT
ZIP	84062
Taxonomy	Ambulatory Surgical Clinic/Center
NPI Enumerated	December 1, 2020

Payer Source	Total Paid
Medicare	$768.7K
Medicaid	$0

Key Findings

Service-line profile: Billing is concentrated in spinal and neurostimulation procedures, consistent with an ambulatory surgical clinic that specializes in image-guided spine and pain interventions. The top Medicare codes are 63685 (spinal neurostimulator pulse generator insertion), 64628 (image-guided basivertebral nerve ablation), and 63650 (epidural electrode placement), which together reflect device implantation and targeted ablation therapies rather than broad general surgery services.

Revenue concentration: The provider’s Medicare revenue is highly concentrated — the precomputed top-3 Medicare codes account for 95.7% of total Medicare revenue. Individually, 63685 generates $375.9K (48.9% of this provider's total Medicare revenue), 64628 generates $187.7K (24.4%), and 63650 generates $171.7K (22.3%), indicating a narrow set of high-revenue procedures dominates billing.

Payer mix and scale: This entity reports Total Medicare revenue of $768.7K and no Medicaid billing on file (none), making it effectively a single-payer operation from the claims data available. The absence of Medicaid activity means revenue exposure, patient mix, and contractual negotiations will be driven almost entirely by Medicare and any commercial payers not shown here.

Competitive standing on primary codes: Although 63685 accounts for nearly half of Medicare revenue ($375.9K), the provider ranks #422 of 1281 nationally (64th percentile; typical, unremarkable volume for this code), indicating solid but not dominant national presence for neurostimulator generator work. 64628 ranks #65 of 247 (71th percentile; typical, unremarkable volume for this code) and 63650 ranks #643 of 1371 (51th percentile; typical, unremarkable volume for this code), so the provider’s volumes are generally in the middle-to-upper range nationally but not outlier-high.

Procedure-level economics: The top procedures are relatively high-reimbursement per encounter, with 63685 at $17902 avg paid/claim (21 claims), 64628 at $7506 avg paid/claim (25 claims), and 63650 at $3733 avg paid/claim (46 claims). This combination of modest claim counts and high average payments explains how a small number of procedures can constitute the majority of Medicare revenue.

Operational implications: The code mix (device implantation, epidural electrodes, and image-guided ablation) implies the center requires specialized implantation capabilities, imaging support, and perioperative workflows suited to same-day or short-stay spine/pain procedures. That specialization suggests referral relationships with pain management and spine surgeons and capital investment in device-related inventory and imaging/sterile procedure rooms.

Small ancillary spine work: A residual code, 63047, contributes $33.4K (4.3% of this provider's total Medicare revenue) from 14 claims and ranks #3064 of 4170 providers nationally (21th percentile; typical, unremarkable volume for this code), indicating occasional decompression-type spine surgery but not a major revenue driver compared with the top three codes.

Tenure and market entry: The provider’s NPI was enumerated 2020-12-01 (~6 years ago), so it is a relatively recent entrant in the Medicare billing landscape; its concentrated, specialized case mix suggests it has established a focused service niche within a short operating window.

Medicare: Complete Services Breakdown

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

4 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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	$17,900	$375.9K
64628	The provider uses a thermal (heat) method under imaging guidance to destroy an intraosseous basivertebral nerve. Use this code for the first two lumbar or sacral vertebral bodies treated at a session.	30	$7,510	$187.7K
63650	In this procedure, the provider places electrodes in the epidural space to relieve pain and reduce or eliminate spasms.	50	$3,730	$171.7K
63047	The provider performs a laminectomy (excision of the thin bony plate at the back of a vertebra), facetectomy (excision of an area of a vertebra characterized by its smooth surface), and foraminotomy…	10	$2,380	$33.4K

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 4 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Utah Distribution

Surgery Center At Grove Creek, LLC — 0 of 4 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Utah

Full comparison — all codes billed, vs. state median

4 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
63685	9	20	20	$6,650	$192.7K
63650	10	20	50	$1,750	$124.6K
64628	4	20	20	$3,880	$93.1K
63047	36	50	20	$530	$12.8K

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
The Green House Center For Growth And Learning	UT	Clinical Social Worker	$0	$3.2M
Alpine Pediatrics, PC	UT	Pediatrics Physician	$0	$2.4M
Premier Family Medical	UT	Family Medicine Physician	$0	$1.8M
Welcome Home Assisted Living Of American Fork	UT	Assisted Living Facility	$0	$1.7M
Spectrum Academy	UT	Local Education Agency (LEA)	$0	$1.4M
Trumobility Inc.	UT	Durable Medical Equipment & Medical Supplies	$0	$981.6K
Intermountain Orthopedic Care, LLC	UT	Customized Equipment (DME)	$0	$841.6K
4 The Youth	UT	Social Worker	$0	$691.7K
R. Bruce Howell D.d.s., M.s.	UT	Pediatric Dentistry	$0	$575.3K
Cataract & Lasik Center Of Utah PC	UT	Ambulatory Surgical Clinic/Center	$440.9K	$0

Surgery Center At Grove Creek, LLC — Billing Profile & Reimbursement Data

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Surgery Center At Grove Creek, 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