Brightpath Logistics

Carve-out target: 150% of Medicare

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Total Over-Benchmark
$17,238,026
Modeled Carve-Out Savings
$12,147,492
Blended % of Medicare
228%
Total Allowed Analyzed
$30,760,526
Total Medicare Benchmark
$13,522,500

All 55,730 lines benchmarked against 2025 Medicare fee schedules, adjusted for your geography.

Same procedure, two prices

The identical CPT, billed at different facilities in your own claims — each measured against the same Medicare rate.

CPT 27447 310 lines 2.2× the price $4,036,088 modeled savings
Caldova Surgical Center 140%
Calderwood Regional 309%
CPT 27130 270 lines 2.2× the price $3,860,336 modeled savings
Caldova Surgical Center 141%
Calderwood Regional 311%
CPT 70553 1,000 lines 2.8× the price $2,297,138 modeled savings
Hollowell Imaging Center 150%
Hollowell Imaging — Hospital 422%

Percentages are the allowed amount as a share of the Medicare rate for that same procedure. Steering volume toward the lower-cost site of care is what the carve-out models.

Top site-of-care carve-out opportunities

Procedures running at hospital outpatient that an ASC benchmarks far lower. Modeled at a 150% of Medicare target.

How we benchmarked this

Every line is priced against the Medicare fee schedule that matches its claim type, then geo-adjusted. Blended % of Medicare is the allowed amount as a share of that benchmark.

Hospital outpatient (OPPS) $21,837,470 allowed · 1,930 lines · 336% of Medicare
Professional (PFS) $7,712,236 allowed · 53,650 lines · 125% of Medicare
Ambulatory surgery (ASC) $1,210,821 allowed · 150 lines · 141% of Medicare

Professional care is priced on the Physician Fee Schedule (PFS), hospital outpatient on OPPS, and ambulatory surgery on the ASC schedule — geography via GPCI locality and CBSA wage index. Public rates, so the benchmark is one you can defend.

% of Medicare by facility

Blended allowed-to-Medicare across benchmarked lines. Bars over 200% are flagged.

Top over-benchmark procedures

CPTs by total dollars paid above the Medicare benchmark.

Executive summary

Rule-based summary · Jul 10, 2026

Brightpath Logistics's plan paid $30,760,526 on the benchmarked claims, against a Medicare allowed amount of $13,522,500 — a blended 227.5% of Medicare. That is $17,238,026 above the Medicare benchmark across 55,730 lines. Repricing the highest-cost services to a 150%-of-Medicare target models $12,147,492 in annual savings.

Why these stand out
  • Calderwood Regional: 430 lines at a blended 310% of Medicare, $10,346,688 over benchmark. — Modeled savings $7,881,688 at the 150%-of-Medicare target.
  • 230 CPT 27447 cases ran at hospital outpatient; steering to an ASC at 150% of Medicare models ~$5,926,652. — Running at 309% of Medicare; $5,294,152 above benchmark.
  • 200 CPT 27130 cases ran at hospital outpatient; steering to an ASC at 150% of Medicare models ~$5,652,535. — Running at 311% of Medicare; $5,052,535 above benchmark.
  • Hollowell Imaging — Hospital: 1500 lines at a blended 421% of Medicare, $5,000,782 over benchmark. — Modeled savings $4,220,782 at the 150%-of-Medicare target.
  • CPT 27447: 310 lines at a blended 284% of Medicare, $5,471,509 over benchmark. — Modeled savings $4,036,088 at the 150%-of-Medicare target.
  • CPT 27447 ranges 140% (Caldova Surgical Center) to 309% (Calderwood Regional) of Medicare. — Modeled savings $4,036,088 at the 150%-of-Medicare target.
  • Carving CPT 27447 at Calderwood Regional to 150% of Medicare models ~$4,029,152 across 230 cases. — Running at 309% of Medicare; $5,294,152 above benchmark.
  • CPT 27130: 270 lines at a blended 285% of Medicare, $5,225,999 over benchmark. — Modeled savings $3,860,336 at the 150%-of-Medicare target.
  • CPT 27130 ranges 141% (Caldova Surgical Center) to 311% (Calderwood Regional) of Medicare. — Modeled savings $3,860,336 at the 150%-of-Medicare target.
  • Carving CPT 27130 at Calderwood Regional to 150% of Medicare models ~$3,852,535 across 200 cases. — Running at 311% of Medicare; $5,052,535 above benchmark.
Draft recommendation memo

Carve-out opportunities for Brightpath Logistics, ranked by modeled savings:

1. Calderwood Regional: 430 lines at a blended 310% of Medicare, $10,346,688 over benchmark. — $7,881,688 modeled savings (310% of Medicare).

2. 230 CPT 27447 cases ran at hospital outpatient; steering to an ASC at 150% of Medicare models ~$5,926,652. — $5,926,652 modeled savings (309% of Medicare).

3. 200 CPT 27130 cases ran at hospital outpatient; steering to an ASC at 150% of Medicare models ~$5,652,535. — $5,652,535 modeled savings (311% of Medicare).

4. Hollowell Imaging — Hospital: 1500 lines at a blended 421% of Medicare, $5,000,782 over benchmark. — $4,220,782 modeled savings (421% of Medicare).

5. CPT 27447: 310 lines at a blended 284% of Medicare, $5,471,509 over benchmark. — $4,036,088 modeled savings (284% of Medicare).

This is decision-support modeling from your de-identified claims and public Medicare rates — not a guarantee of savings or a substitute for legal or actuarial advice.

Rule-based summary of your own figures — decision support, not legal, actuarial, or medical advice.

Last analyzed Jul 10, 2026.