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NPI 1992706840 · Burley, ID · Ambulatory Surgical Clinic/Center
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Ambulatory Surgery Center Of Burley, LLC is a ambulatory surgical clinic/center provider located in Burley, Idaho. This profile covers 8 Medicare and 11 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 | Ambulatory Surgery Center Of Burley, LLC |
| Address | 1344 Hiland Ave |
| City | Burley |
| State | ID |
| ZIP | 83318 |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| NPI Enumerated | August 2, 2005 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $560.6K |
| Medicare | $504.8K |
This facility appears to operate principally as an interventional pain/ambulatory surgery site for Medicare patients: Medicare top revenue drivers are 63685, 63650, and 64483 and the three codes together account for 76.9% of the provider's total Medicare revenue. 63685 (spinal neurostimulator pulse generator insertion) alone generates $206.2K (40.9% of Medicare revenue) from 12 claims, while 63650 (epidural electrode placement) contributes $136.6K (27.1%); these procedure-level codes indicate a focus on neuromodulation and image-guided spine interventions. The remaining high Medicare codes (for example, 64635 and 64493) further point to a spine/pain management service mix delivered in an ASC setting.
This provider’s Medicaid business shows a very different service mix dominated by a single non-specific dental code and general clinic encounters: 41899 and T1015 together account for 95.6% of Medicaid revenue and the top three Medicaid codes (41899, T1015, D2930) account for 97.2% of total Medicaid revenue. 41899 alone is $335.2K (59.8% of Medicaid revenue, 586 claims) while T1015 is $200.4K (35.8% of Medicaid revenue, 328 claims), suggesting the site bills substantial clinic and unspecified dental work to Medicaid beneficiaries rather than replicating the Medicare interventional pain mix.
Payer mix is balanced but not identical in scale: lifetime Medicaid revenue is $560.6K versus lifetime Medicare revenue of $504.8K, so Medicaid represents a slightly larger revenue stream overall. This indicates the facility maintains meaningful lines of business in both payer populations rather than being effectively single-payer.
Revenue concentration is high in both payers but more extreme in Medicaid: the three Medicare codes concentratedly drive 76.9% of Medicare revenue, whereas the top three Medicaid codes drive 97.2% of Medicaid revenue. That pattern signals dependence on a very small set of services for both payers, with Medicaid particularly concentrated in 41899 and T1015.
Competitive standing on Medicare is mixed by code: high-revenue Medicare code 63685 ranks #1012 of 1281 nationally (11th percentile) and is described as 'typical, unremarkable volume,' suggesting the provider captures substantial dollars from that code locally but is a modest participant at the national level. By contrast, several imaging-guided injection codes (for example 64483 and 64493) rank in the 84th percentile nationally, indicating relatively higher-than-average volume for those specific injection services compared with national peers.
State-level competitive posture for Medicaid is uneven: the largest Medicaid code 41899 ranks #8 of 18 in-state (59th percentile) and is labeled 'typical, unremarkable volume,' meaning the facility is a mid-level performer in-state for that code. T1015 ranks #114 of 143 (20th percentile), indicating below-median state volume for all-inclusive clinic encounters despite its high revenue share, and G0260, while reported, is one of only three in-state providers but ranks #3 of 3 (0th percentile), so the provider is not a dominant state player for that service.
Statistical descriptors in the source data underline that many high-revenue codes are nonetheless characterized as 'typical, unremarkable volume' relative to peers; for example, 63685 and 63650 (the two largest Medicare revenue drivers) are both flagged as typical, which suggests the facility’s high revenue for these codes comes from price/setting mix or selective case mix rather than unusually high procedural volume by national standards. Similarly, several Medicaid codes including 41899 and T1015 are described as 'typical, unremarkable volume' within the in-state peer group despite their outsized contribution to this provider’s Medicaid revenue.
The provider has a long tenure in the NPI registry, enumerated on 2005-08-02 (~21 years ago), indicating an established operation; given the concentrated revenue mix across a small set of codes and the mixed competitive rankings, this tenure likely reflects an established specialty footprint (interventional spine/pain for Medicare and clinic/dental-coded services for Medicaid) rather than rapid recent expansion into new service lines. Analysts should consider the concentrated-code risk if contracting or forecasting, because changes in reimbursement or utilization for just a few codes would materially affect total revenue.
Medicare revenue breakdown by CPT/HCPCS procedure code.
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The CPT/HCPCS codes generating the most Medicare revenue for this provider.
8 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… | 10 | $17,190 | $206.2K |
| 63650 | In this procedure, the provider places electrodes in the epidural space to relieve pain and reduce or eliminate spasms. | 40 | $3,420 | $136.6K |
| 64483 | This procedure is the injection of an anesthetic agent and/or steroid in the form of a transforaminal epidural injection into a single level (either lumbar or sacral). | 180 | $260 | $45.3K |
| 64635 | Under fluoroscopic or CT guidance, the provider applies an agent to a lower back joint to destroy nerve tissue. | 90 | $450 | $38.1K |
| 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… | 120 | $240 | $28.3K |
| G0260 | Injection procedure for sacroiliac joint; provision of anesthetic, steroid and/or other therapeutic agent, with or without arthrography | 110 | $190 | $21.3K |
| 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)… | 80 | $230 | $17.4K |
| 62321 | 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 cervical (neck) or thoracic (upper and middle back)… | 50 | $230 | $11.5K |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 8 CPT/HCPCS codes.
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Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
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Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
11 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 41899 | Use this code to report a procedure on the teeth and adjoining alveolar structures for which there is no specific code available. | 590 | $570 | $335.2K |
| T1015 | Clinic visit/encounter, all-inclusive | 330 | $610 | $200.4K |
| D2930 | N/A | 270 | $30 | $9.3K |
| 64483 | This procedure is the injection of an anesthetic agent and/or steroid in the form of a transforaminal epidural injection into a single level (either lumbar or sacral). | 30 | $200 | $5.4K |
| G0260 | Injection procedure for sacroiliac joint; provision of anesthetic, steroid and/or other therapeutic agent, with or without arthrography | 20 | $190 | $4.5K |
| 62321 | 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 cervical (neck) or thoracic (upper and middle back)… | 10 | $220 | $2.8K |
| 99152 | The provider performing a diagnostic or therapeutic procedure administers medication to reduce consciousness, but not render the patient unconscious or asleep, in a patient five years of age or… | 10 | $130 | $1.5K |
| D9420 | N/A | 20 | $90 | $1.3K |
| D0272 | N/A | 10 | $10 | $170 |
| D3220 | N/A | 30 | $0 | $0 |
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How this provider's Medicaid billing volume and revenue compare to other Idaho providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Idaho median
11 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| T1015 | Clinic visit/encounter, all-inclusive | 114 | 140 | 5,470 | $180 | $2.6M |
| 41899 | Use this code to report a procedure on the teeth and adjoining alveolar structures for which there is no specific code available. | 8 | 20 | 500 | $820 | $662.5K |
| D2930 | N/A | 39 | 50 | 750 | $70 | $171.2K |
| D9420 | N/A | 39 | 40 | 180 | $150 | $80.8K |
| D7140 | Extraction, erupted tooth or exposed root (elevation and/or forceps removal) | 106 | 110 | 300 | $30 | $32.4K |
| 64483 | This procedure is the injection of an anesthetic agent and/or steroid in the form of a transforaminal epidural injection into a single level (either lumbar or sacral). | 8 | 10 | 30 | $240 | $26.4K |
| G0260 | Injection procedure for sacroiliac joint; provision of anesthetic, steroid and/or other therapeutic agent, with or without arthrography | 3 | 10 | 70 | $100 | $9.3K |
| 99152 | The provider performing a diagnostic or therapeutic procedure administers medication to reduce consciousness, but not render the patient unconscious or asleep, in a patient five years of age or… | 19 | 20 | 120 | $20 | $8.2K |
| 62321 | 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 cervical (neck) or thoracic (upper and middle back)… | 5 | 10 | 30 | $200 | $8K |
| D3220 | N/A | 22 | 30 | 250 | $10 | $4.7K |
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Other providers in the same ZIP code as Ambulatory Surgery Center Of Burley, LLC, ranked by combined Medicare and Medicaid revenue.
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