Clinic
UPMC Hamot Surgery Center, LLC
UPMC Hamot Surgery Center, LLC was paid $720K by Medicaid between Jan 2018 and Oct 2024, across 13 billing codes. Its largest line is 43239, Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple — 24% of everything it billed.
33Billing provider infoUPMC HAMOT SURGERY CENTER, LLC
ERIE, PA 16507
ERIE, PA 16507
33aNPI1194790592assigned 02/20/2006
33bProvider typeAmbulatory Surgical Clinic/Center
28Total paid$720K
24GClaims2,733
24DCodes billed13
24AFirst – last monthJan 2018 – Oct 2024
Compared with peers
Next to other Ambulatory Surgical Clinic/Center providers in Pennsylvania
Rank by total paid#19 of 119
Median peer was paid$57K
This provider vs. median13×
Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.
Box 24A · Dates of service
Paid by month
Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2018 | 158 | $0.00 | |
| 2020 | 224 | $57K | |
| 2021 | 1,330 | $375K | |
| 2022 | 203 | $43K | |
| 2023 | 534 | $135K | |
| 2024incomplete | 284 | $110K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 43239 | Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple | 24% | 1,119 | 1,104 | $172K |
| 45380 | Colonoscopy, flexible; with biopsy, single or multiple | 17% | 502 | 494 | $123K |
| 43248 | 16% | 195 | 191 | $115K | |
| 45378 | Colonoscopy, flexible; diagnostic, including collection of specimen(s) | 14% | 246 | 240 | $102K |
| 62323 | 11% | 122 | 122 | $79K | |
| 64493 | 9.1% | 159 | 108 | $65K | |
| 45385 | Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) | 4.9% | 101 | 100 | $36K |
| 64483 | 2.4% | 31 | 29 | $17K | |
| 62321 | <1% | 12 | 12 | $6K | |
| 69436 | Tympanostomy (requiring insertion of ventilating tube), general anesthesia | <1% | 21 | 13 | $5K |
| 64494 | 0% | 55 | 37 | $0.00 | |
| L8699 | Prosthetic implant, not otherwise specified | 0% | 12 | 12 | $0.00 |
1 more codes
| 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 or hospital admission upon discharge from the facility | 0% | 158 | $0.00 |
Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.
From NPPES
Who's on the registration
Authorized officialBOLAND, PATRICIA (ADMINISTRATIVE DIRECTOR)