Clinic
Upper Valley Surgery Center
Upper Valley Surgery Center was paid $377K by Medicaid between Jan 2018 and Oct 2024, across 6 billing codes. Its largest line is 42820, Tonsillectomy and adenoidectomy; younger than age 12 — 61% of everything it billed.
33Billing provider infoUPPER VALLEY SURGERY CENTER
REXBURG, ID 83440
REXBURG, ID 83440
33aNPI1821420571assigned 08/05/2013
33bProvider typeAmbulatory Surgical Clinic/Center
28Total paid$377K
24GClaims3,168
24DCodes billed6
24AFirst – last monthJan 2018 – Oct 2024
Compared with peers
Next to other Ambulatory Surgical Clinic/Center providers in Idaho
Rank by total paid#14 of 34
Median peer was paid$126K
This provider vs. median3.0×
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 | 84 | $47K | |
| 2019 | 320 | $16K | |
| 2020 | 281 | $20K | |
| 2021 | 608 | $37K | |
| 2022 | 752 | $125K | |
| 2023 | 670 | $101K | |
| 2024incomplete | 453 | $31K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 42820 | Tonsillectomy and adenoidectomy; younger than age 12 | 61% | 166 | 165 | $230K |
| 69436 | Tympanostomy (requiring insertion of ventilating tube), general anesthesia | 28% | 178 | 173 | $104K |
| 30140 | 6.2% | 26 | 26 | $23K | |
| 30520 | 5.2% | 27 | 27 | $19K | |
| G8918 | Patient without preoperative order for iv antibiotic surgical site infection (ssi) prophylaxis | 0% | 1,386 | 1,369 | $0.00 |
| 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% | 1,385 | 1,368 | $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 officialMCMASTER, JAY (PHYSICIAN/OWNER)
| Provider | Location | Paid |
|---|---|---|
| Upper Valley Ent & Allergy PLLC | Rexburg, ID | $401K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.