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NPI 1053385856 · Jackson, TN · Ambulatory Surgical Clinic/Center
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Jackson Ophthalmology Asc LLC is a ambulatory surgical clinic/center provider located in Jackson, Tennessee. This profile covers 28 Medicare and 3 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 | Jackson Ophthalmology Asc LLC |
| Address | 207 Stonebridge Blvd |
| City | Jackson |
| State | TN |
| ZIP | 38305 |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| NPI Enumerated | February 16, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $3.1M |
| Medicaid | $20.7K |
Business mix and service lines: The provider is registered as an Ambulatory Surgical Clinic/Center and the Medicare code mix shows a strong ophthalmology presence (notably 66984, 66821, 66174, 66982 and multiple eyelid codes such as 67904/67900/67917) alongside significant spine/pain and orthopedic procedures (63685, 63650, 27447, 27130). This combination indicates a multi‑specialty ASC operation that bills high‑volume cataract and other eye procedures while also performing device implantation and joint replacement work in the outpatient setting. The presence of both ophthalmic and higher‑complexity implant codes supports a facility configured for same‑day surgeries across multiple surgical specialties.
Revenue concentration (Medicare): The provider’s top three Medicare CPT/HCPCS codes (66984, 63685, 27447) are responsible for 58.0% of its total Medicare revenue, with those individual contributions listed as $989.7K (32.4%), $412.1K (13.5%), and $371.3K (12.2%) respectively. That concentration shows the business is highly dependent on a small set of high‑revenue procedures, with cataract surgery (66984) alone making up nearly a third of Medicare revenue.
Payer mix and scale: Medicare dominates this provider’s public payor income — total Medicare revenue is $3.1M versus total Medicaid revenue of $20.7K, so the entity is effectively Medicare‑driven at scale while Medicaid activity is minimal. Medicaid receipts are almost entirely from a single code (66984) and therefore do not represent a material diversified Medicaid revenue stream for the facility.
Medicaid concentration and reimbursement pattern: Medicaid revenue is concentrated 100.0% in one code (66984), where Medicaid records show 930 claims at $22 avg paid/claim producing $20.5K in Medicaid revenue. That single‑code dependence means in‑state Medicaid exposure is narrowly tied to cataract cases and subject to the low per‑claim Medicaid payment observed for that code in this dataset.
Competitive standing and high‑percentile specialties: For Medicare, several codes show national standing well above typical peer volume — 0275T ranks #12 of 597 (98th percentile; notably above typical national volume), 66821 ranks #174 of 10087 (98th percentile; notably above typical national volume), and 64721 ranks #31 of 3206 (99th percentile; extreme outlier). At the same time, 66984 ranks #1576 of 15965 (90th percentile; typical, unremarkable volume for this code), indicating the provider is a strong national outlier on certain procedure lines while holding typical volumes on other high‑revenue codes.
High‑value per‑claim procedures: Several Medicare line items show substantial avg paid/claim amounts that reflect device implantation and complex procedures—63685 at $16484 avg paid/claim and 27447 at $5894 avg paid/claim—supporting the interpretation that the ASC is performing higher‑intensity implant and joint replacement work in addition to routine ophthalmic surgery. These high avg paid/claim figures are business drivers that align with the ASC’s multi‑specialty surgical profile.
Operational tenure: The provider’s NPI was enumerated on 2006-02-16 (~20 years ago), indicating long operational tenure in the market; combined with $3.1M in lifetime Medicare revenue, this suggests an established outpatient surgical presence rather than a new entrant. Analysts should consider longevity when assessing referral networks and contracting leverage with Medicare plans.
Mixed patterns of typical vs. outlier volumes: While several codes are noted as 'typical, unremarkable volume' (for example 66984 on Medicare), a set of other codes are explicitly labeled as notably above typical or extreme outliers (0275T, 66821, 64721, 15823, 29881), which signals pockets of unusually high activity relative to national peers. This uneven profile suggests focused strengths in a handful of procedures that materially shape revenues, and these procedure‑level outliers are the logical targets for deeper clinical and utilization review if payers or network managers want to understand capacity or strategic alignment.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
28 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… | 1,390 | $710 | $989.7K |
| 63685 | The provider inserts or replaces a spinal neurostimulator pulse generator or receiver. The system is one that requires surgical creation of a pocket for placement and that requires a connection… | 30 | $16,480 | $412.1K |
| 27447 | In this procedure, the provider replaces the damaged weight bearing surfaces of both the medial and lateral compartments in the knee joint using implants of metal or other strong materials. The… | 60 | $5,890 | $371.3K |
| 0275T | N/A | 110 | $3,210 | $356.4K |
| 63650 | In this procedure, the provider places electrodes in the epidural space to relieve pain and reduce or eliminate spasms. | 40 | $3,280 | $127.8K |
| 66821 | The provider removes the haziness from the capsule of the eye using a laser for a patient with a secondary membranous cataract. | 590 | $170 | $99.5K |
| 27130 | In this procedure, the provider surgically replaces the hip joint by prosthesis, or artificial hip joint. He replaces both the femoral and acetabular components with or without using an autograft or… | 20 | $6,340 | $95.1K |
| 64721 | Neuroplasty or transposition of the median nerve at the carpal tunnel is done to treat a condition called carpal tunnel syndrome (CTS). The carpal tunnel is a narrow tunnel in the wrist through which… | 170 | $540 | $92K |
| 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… | 190 | $430 | $82.9K |
| 27446 | In this procedure, the provider reconstructs the diseased or damaged medial or lateral compartment of the knee along with the femoral condyles and tibial plateaus to relieve pain and improve the… | 10 | $6,120 | $73.4K |
Showing 1–10 of 28
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 28 CPT/HCPCS codes.
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Full comparison — all codes billed, vs. state median
28 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| 63685 | 15 | 40 | 20 | $6,810 | $170.2K |
| 63650 | 29 | 40 | 50 | $1,650 | $123.8K |
| 66984 | 90 | 450 | 170 | $120 | $89.5K |
| 0275T | 1 | 10 | 20 | $1,940 | $77.5K |
| 27447 | 61 | 280 | 30 | $1,440 | $67.8K |
| 27446 | 13 | 10 | 30 | $1,990 | $55.8K |
| 27130 | 136 | 170 | 30 | $1,480 | $53.1K |
| 15823 | 4 | 60 | 50 | $490 | $33K |
| 67904 | 8 | 40 | 40 | $510 | $30.2K |
| 66174 | 17 | 20 | 40 | $680 | $29.8K |
Showing 1–10 of 28
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.
3 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… | 930 | $20 | $20.5K |
| 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… | 190 | $0 | $0 |
| G8918 | Patient without preoperative order for iv antibiotic surgical site infection (ssi) prophylaxis | 180 | $0 | $0 |
How this provider's Medicaid billing volume and revenue compare to other Tennessee providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Tennessee median
3 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… | 18 | 70 | 250 | $110 | $96.9K |
| 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… | 32 | 70 | 160 | $1 | $10 |
| G8918 | Patient without preoperative order for iv antibiotic surgical site infection (ssi) prophylaxis | 19 | 50 | 100 | $0 | $0 |
Other providers in the same ZIP code as Jackson Ophthalmology Asc LLC, ranked by combined Medicare and Medicaid revenue.
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