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NPI 1013973825 · Owensboro, KY · Ambulatory Surgical Clinic/Center
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Owensboro Ambulatory Surgical Facility Ltd is a ambulatory surgical clinic/center provider located in Owensboro, Kentucky. This profile covers 17 Medicare and 10 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 | Owensboro Ambulatory Surgical Facility Ltd |
| Address | 1000 Breckenridge St |
| City | Owensboro |
| State | KY |
| ZIP | 42303 |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| NPI Enumerated | April 21, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $4.8M |
| Medicare | $1.3M |
Facility profile and tenure: OWENSBORO AMBULATORY SURGICAL FACILITY LTD is categorized as an Ambulatory Surgical Clinic/Center with an NPI enumerated on 2006-04-21 (~20 years ago), indicating long-standing enrollment and likely established referral relationships in the Owensboro market. The multi-specialty CPT mix (ophthalmic, endoscopy, and dental procedure codes) is consistent with a small to mid-size freestanding ASC offering procedure suites for several specialties.
Payer mix and scale: The provider reports $1.3M in total Medicare revenue and $4.8M in total Medicaid revenue, so Medicaid represents the larger share of billed government payer revenue by scale; this profile is effectively Medicaid-dominant in absolute dollars. Analysts should treat the provider as materially more active on Medicaid when assessing payer negotiations or network value.
Medicare revenue concentration: The top 3 Medicare codes by revenue account for 73.9% of this provider's total Medicare revenue, indicating high concentration in a few procedures. In particular, 66984 ($755.8K, 58.9% of Medicare revenue) is the single largest Medicare revenue driver and suggests cataract surgery is a primary service line for Medicare beneficiaries at this facility.
Medicaid revenue concentration: The top 3 Medicaid codes by revenue account for 94.0% of this provider's total Medicaid revenue, signaling extreme concentration on a very narrow set of services for Medicaid patients. Code 41899 alone accounts for $3.6M and 75.0% of Medicaid revenue, which makes dental or oral-procedure billing (reported under an unlisted dental code) the dominant Medicaid business line at this facility.
Service-line implications — ophthalmology and endoscopy: The Medicare code mix with large shares from 66984, 45385, and 66982 (including related screening codes G0105 and G0121) indicates the facility performs a mix of ophthalmic (cataract and intraocular lens) and GI endoscopy services for Medicare patients. High-volume cataract work (66984 at $804 avg paid/claim and 940 claims) combined with substantial colonoscopy polypectomy volume (45385 at 308 claims) suggests dedicated operating room and endoscopy capacity consistent with an ASC serving both specialties.
Competitive standing — Medicare: For Medicare, 66984 ranks #2038 of 15965 providers nationally (87th percentile) and is described as typical, unremarkable volume for that code, while 45385 ranks #646 of 16310 (96th percentile) and is described as notably above typical national volume. This mix implies the facility is a modest-to-strong regional performer for colon polypectomy but a more typical-volume provider for cataract surgery at the national level.
Competitive standing — Medicaid and in-state concentration: On Medicaid, 41899 ranks #7 of 42 in-state (85th percentile) and 41874 ranks #1 of 3 in-state (100th percentile), both labeled typical, unremarkable volume; however, the sheer dollar concentration behind 41899 ($3.6M, 75.0% of Medicaid revenue) makes the facility a top in-state reporter for that unlisted dental code and a significant Medicaid dental/oral-procedure provider in Kentucky.
Quality-control/administrative note from coding mix: The Medicaid top codes include procedure codes with $0 paid entries (G8918 and G8907) and an unlisted dental procedure (41899) generating the majority of Medicaid revenue. Given the very high Medicaid concentration in a single unlisted dental code alongside sizeable ophthalmic and endoscopic Medicare activity, contract reviewers should validate service-site capacity, billed service types, and documentation patterns when reconciling encounter-level detail with facility scope and payer contracts.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
17 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 66984 | The provider inserts an artificial lens after removing an extracapsular cataract by aspiration or use of ultrasonic waves. This procedure is done without the use of an endoscopic laser probe to… | 940 | $800 | $755.8K |
| 45385 | The provider examines the colon and rectum using a colonoscope, a long, thin flexible tubular instrument with a light source and camera. He removes one or more tumors, polyps, or other lesions with a… | 310 | $420 | $127.8K |
| 66982 | The provider inserts an intraocular lens prosthesis after extracapsular cataract extraction using complex techniques and devices. He may perform this by means of an iris expansion device, providing… | 80 | $800 | $63.4K |
| G0105 | Colorectal cancer screening; colonoscopy on individual at high risk | 150 | $400 | $58.1K |
| J1097 | phenylephrine 10.16 mg/ml and ketorolac 2.88 mg/ml ophthalmic irrigation solution, 1 ml | 650 | $80 | $48.9K |
| 45380 | The provider examines the rectum and colon using a flexible colonoscope, a tubular instrument with a light source and camera, to look for the cause of a patient's symptoms, which may include… | 120 | $330 | $38.7K |
| 43249 | The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum and dilates (widens) the esophagus with a balloon less than 30 mm in diameter. | 60 | $530 | $33.1K |
| G0121 | Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk | 80 | $390 | $31.8K |
| 43239 | The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis. | 150 | $210 | $31.4K |
| 67040 | The provider removes vitreous humor from the eye to access the posterior segment of the eye and introduce surgical instruments through incisions in the pars plana. This procedure also includes the… | 20 | $1,450 | $24.6K |
Showing 1–10 of 17
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 17 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
17 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| 66984 | 189 | 310 | 1,560 | $40 | $67.1K |
| J1097 | 2 | 10 | 480 | $80 | $65K |
| 67040 | 5 | 10 | 20 | $1,030 | $24.7K |
| 67042 | 9 | 10 | 20 | $1,170 | $23.4K |
| 15823 | 10 | 20 | 30 | $550 | $21.6K |
| 66982 | 16 | 70 | 30 | $270 | $20.8K |
| 45385 | 6 | 250 | 50 | $250 | $20.2K |
| 55700 | 44 | 50 | 20 | $310 | $11.2K |
| 45380 | 37 | 240 | 40 | $140 | $9.4K |
| G0105 | 5 | 140 | 30 | $230 | $9.3K |
Showing 1–10 of 17
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
View: By Year1 / 3
Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
10 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. | 2,530 | $1,440 | $3.6M |
| 66984 | The provider inserts an artificial lens after removing an extracapsular cataract by aspiration or use of ultrasonic waves. This procedure is done without the use of an endoscopic laser probe to… | 1,520 | $470 | $708.7K |
| 41874 | Alveoloplasty is done prior to placement of a dental prosthesis. In order to facilitate smooth fitting of the denture, the dentist performs alveoloplasty to make the alveolar process smoother.… | 140 | $1,490 | $212.4K |
| 43239 | The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis. | 520 | $210 | $107.1K |
| 45378 | The provider examines the colon and rectum using a colonoscope, a flexible tube with a camera at its inserted end. If he sees any areas of abnormal mucosa or tissue, he takes samples using a brush… | 240 | $330 | $80.5K |
| 45385 | The provider examines the colon and rectum using a colonoscope, a long, thin flexible tubular instrument with a light source and camera. He removes one or more tumors, polyps, or other lesions with a… | 260 | $300 | $76.8K |
| 45380 | The provider examines the rectum and colon using a flexible colonoscope, a tubular instrument with a light source and camera, to look for the cause of a patient's symptoms, which may include… | 120 | $230 | $26.2K |
| V2632 | Posterior chamber intraocular lens | 50 | $1 | $180 |
| 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… | 250 | $0 | $0 |
| G8918 | Patient without preoperative order for iv antibiotic surgical site infection (ssi) prophylaxis | 210 | $0 | $0 |
How this provider's Medicaid billing volume and revenue compare to other Kentucky providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Kentucky median
10 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 41899 | Use this code to report a procedure on the teeth and adjoining alveolar structures for which there is no specific code available. | 7 | 40 | 740 | $1,170 | $1.7M |
| 43239 | The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis. | 124 | 170 | 1,300 | $230 | $441K |
| 66984 | The provider inserts an artificial lens after removing an extracapsular cataract by aspiration or use of ultrasonic waves. This procedure is done without the use of an endoscopic laser probe to… | 14 | 70 | 210 | $310 | $290K |
| 45380 | The provider examines the rectum and colon using a flexible colonoscope, a tubular instrument with a light source and camera, to look for the cause of a patient's symptoms, which may include… | 85 | 120 | 300 | $320 | $215.2K |
| 45385 | The provider examines the colon and rectum using a colonoscope, a long, thin flexible tubular instrument with a light source and camera. He removes one or more tumors, polyps, or other lesions with a… | 50 | 110 | 230 | $340 | $175.7K |
| 45378 | The provider examines the colon and rectum using a colonoscope, a flexible tube with a camera at its inserted end. If he sees any areas of abnormal mucosa or tissue, he takes samples using a brush… | 39 | 90 | 170 | $400 | $145.8K |
| 41874 | Alveoloplasty is done prior to placement of a dental prosthesis. In order to facilitate smooth fitting of the denture, the dentist performs alveoloplasty to make the alveolar process smoother.… | 1 | 10 | 60 | $1,150 | $88.5K |
| V2632 | Posterior chamber intraocular lens | 13 | 20 | 180 | $50 | $17.8K |
| 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… | 11 | 20 | 260 | $1 | $1 |
| G8918 | Patient without preoperative order for iv antibiotic surgical site infection (ssi) prophylaxis | 5 | 10 | 180 | $1 | $1 |
Other providers in the same ZIP code as Owensboro Ambulatory Surgical Facility Ltd, ranked by combined Medicare and Medicaid revenue.
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