Loading...
NPI 1053378265 · Weymouth, MA · Ophthalmologic Surgery Clinic/Center
Customize your policy alerts
Get alerted when relevant policies change without checking for updates manually.
Monitor payer policy activity
New England Eye Surgical Center Inc is a ophthalmologic surgery clinic/center provider located in Weymouth, Massachusetts. This profile covers 10 Medicare and 2 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 | New England Eye Surgical Center Inc |
| Address | 696 Main St |
| City | Weymouth |
| State | MA |
| ZIP | 02190 |
| Taxonomy | Ophthalmologic Surgery Clinic/Center |
| NPI Enumerated | May 1, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $1.8M |
| Medicaid | $271.1K |
Business profile: NEW ENGLAND EYE SURGICAL CENTER INC operates as an ophthalmologic surgery clinic/center with billing dominated by cataract and anterior-segment procedures, as evidenced by high-volume codes for lens insertion and capsular management (66984, 66982, 66821) as well as glaucoma procedures (65820, 66180, 65855). The presence of both routine cataract extraction with IOL placement and more complex glaucoma/shunt codes suggests the site performs a mix of standard cataract surgery and select specialty glaucoma interventions rather than being a purely diagnostic or solo comprehensive ophthalmology practice.
Medicare revenue concentration: the provider’s Medicare billing is highly concentrated — the precomputed top 3 Medicare codes account for 87.3% of Medicare revenue, driven primarily by 66984 (1.5K claims, $908 avg paid/claim, $1.4M revenue; 76.3% of this provider's total Medicare revenue), with 66982 ($116K, 6.4%) and 65820 ($81.4K, 4.5%) completing the top three. This concentration indicates reliance on a small number of high-revenue procedural codes for the bulk of Medicare income.
Medicaid concentration: Medicaid revenue is effectively mono-coded — the precomputed top-3 Medicaid codes account for 100.0% of Medicaid revenue, and in practice 66984 alone accounts for $270.9K (874 claims, $310 avg paid/claim) or 100.0% of this provider's Medicaid revenue. The only other Medicaid-listed code, G8907, reports 149 claims but $0 revenue, underscoring that Medicaid reimbursement at this site is concentrated in cataract surgical services.
Payer mix: the provider is Medicare-dominant by scale, with Total Medicare revenue of $1.8M versus Total Medicaid revenue of $271.1K. This gap positions Medicare as the primary revenue driver for the practice and Medicaid as a materially smaller component of overall payer mix.
National competitive standing (Medicare): for the core cataract code 66984 the provider ranks #1461 of 15965 nationally (91th percentile; labeled as “typical, unremarkable volume for this code”), and for complex lens exchange 66982 it ranks #217 of 4580 (95th percentile; also labeled “typical, unremarkable volume for this code”), indicating above-average national placement on these cataract procedures even as the dataset characterizes the volumes as within typical ranges. These rank/percentile signals suggest the practice is a solid, above-average contributor to cataract surgical volumes nationally, but not a dominant national outlier.
Notable statistical signals: certain procedures show elevated relative use — 65855 ranks #86 of 2796 (97th percentile; explicitly noted as "notably above typical national volume") and 66821 ranks #358 of 10087 (96th percentile; typical). The elevated percentile on 65855 (trabecular laser) points to unusually frequent use of that glaucoma laser intervention compared with peers, which may reflect a local clinical focus or referral pattern.
State-level competitive standing (Medicaid): for Medicaid cataract surgery (66984) the provider ranks #20 of 63 in-state (69th percentile; typical, unremarkable volume for this code), placing it as a moderate-to-strong Medicaid cataract provider within Massachusetts but not among the very highest-volume state centers. Given the Medicaid concentration in a single code, the provider’s in-state competitive position for Medicaid is heavily tied to cataract surgical throughput.
Tenure and operational implication: the NPI was enumerated 2006-05-01 (~20 years ago), indicating a long-established presence in the market. Combined with high concentration on a few procedural lines (top 3 Medicare codes = 87.3% of Medicare revenue and Medicaid top codes = 100.0% of Medicaid revenue), this tenure plus procedural concentration suggests operational sensitivity to changes in cataract reimbursement or local referral patterns and a likely focus on maintaining surgical throughput and payer contracting for cataract services.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
10 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… | 1,520 | $910 | $1.4M |
| 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… | 130 | $890 | $116K |
| 65820 | The provider incises the limbus to improve drainage of aqueous humor in the eye. This procedure is typically performed on children, usually to treat congenital glaucoma. | 50 | $1,660 | $81.4K |
| 66821 | The provider removes the haziness from the capsule of the eye using a laser for a patient with a secondary membranous cataract. | 350 | $220 | $78.4K |
| 66991 | The provider inserts an intraocular lens prosthesis during the same session as extracapsular cataract extraction. The provider also inserts one or more anterior segment aqueous drainage devices in… | 30 | $2,790 | $69.8K |
| 66180 | The provider implants a shunt in the anterior chamber of the eye to facilitate drainage of aqueous humor, or fluid, in order to reduce intraocular pressure. He uses a graft to reinforce the tissue… | 20 | $2,210 | $33.2K |
| 65855 | In this procedure, the provider uses a laser to burn the trabecular meshwork, the tissue of mesh where the iris meets the sclera, to drain aqueous humor from the anterior chamber and treat glaucoma. | 160 | $110 | $16.8K |
| 15823 | In this procedure, the provider surgically trims excessive skin that weighs down the upper eyelid, typically to improve the cosmetic appearance of the face and due to the interference of the tissue… | 30 | $500 | $14.9K |
| 66710 | The provider destroys a portion of ciliary body using a laser beam. This procedure decreases the fluid production in the eye, thereby decreasing intraocular pressure. | 10 | $740 | $10.4K |
| 66761 | The provider uses a laser beam to create a small hole in the iris that equalizes the intraocular pressure between anterior and posterior chamber of the eyes. Report this code for single session of… | 40 | $140 | $5.7K |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 10 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
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.
2 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… | 870 | $310 | $270.9K |
| 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… | 150 | $0 | $0 |
How this provider's Medicaid billing volume and revenue compare to other Massachusetts providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Massachusetts median
2 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average 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… | 20 | 60 | 330 | $380 | $352.9K |
| 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… | 24 | 40 | 350 | $1 | $560 |
Other providers in the same ZIP code as New England Eye Surgical Center Inc, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| South Shore Hospital Inc. | MA | General Acute Care Hospital | $0 | $95.1M |
| Coastal Medical Associates | MA | Anesthesiology Physician | $0 | $10M |
| Jennifer Byer | MA | Medical Oncology Physician | $3.5M | $0 |
| Shields Imaging Of Eastern Massachusetts LLC | MA | Mobile Radiology Clinic/Center | $2.7M | $774.1K |
| Harbor Medical Associates, Inc. | MA | Clinical Medical Laboratory | $1.8M | $420.7K |
| Harbor Medical Associates, Inc. | MA | Diagnostic Radiology Physician | $753K | $191K |
| Weymouth Endoscopy, LLC | MA | Endoscopy Clinic/Center | $844.3K | $4.7K |
| Patricia Hopkins | MA | Internal Medicine Physician | $733.6K | $0 |
| George Kroumpouzos | MA | Dermatology Physician | $721.7K | $0 |
| Harbor Medical Associates, Inc. | MA | Diagnostic Radiology Physician | $620.5K | $0 |
Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.