Loading...
NPI 1053835058 · Franklin, OH · Ambulatory Surgical Clinic/Center
Customize your policy alerts
Get alerted when relevant policies change without checking for updates manually.
Monitor payer policy activity
Cei Physicians Psc LLC is a ambulatory surgical clinic/center provider located in Franklin, Ohio. This profile covers 21 Medicare and 1 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 | Cei Physicians Psc LLC |
| Address | 5950 Innovation Dr |
| City | Franklin |
| State | OH |
| ZIP | 45005 |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| NPI Enumerated | August 1, 2017 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $1.9M |
| Medicaid | $680.3K |
The provider operates as an ambulatory surgical clinic/center with a concentrated ophthalmology surgical mix: the Medicare top codes are dominated by cataract extraction and intraocular lens insertion (66984, 66982) and vitreoretinal surgery (67042), which aligns with an outpatient surgical facility model focused on cataract and retina procedures. The precomputed top-3 Medicare codes account for 75.0% of Medicare revenue, reinforcing that a narrow set of surgical services drives most Medicare earnings.
Revenue concentration is very high by payer: the top 3 Medicare codes drive 75.0% of the provider’s Medicare revenue, while Medicaid billing is effectively mono-coded — top-3 Medicaid codes account for 100.0% of Medicaid revenue, with 66984 alone reported at $679.8K (100.0% of Medicaid revenue). This pattern indicates the clinic’s Medicaid business is almost entirely derived from a single cataract procedure.
Payer mix shows Medicare as the larger revenue source: lifetime Medicare revenue is $1.9M compared with lifetime Medicaid revenue of $680.3K, so the practice generates materially more revenue from Medicare while still reporting a meaningful Medicaid caseload tied to cataract surgery. Analysts should treat Medicare as the primary commercial channel and Medicaid as a secondary but concentrated payer relationship.
Reimbursement profile for the signature cataract service (66984) differs across payers: Medicare paid an average of $807 per claim for 66984 while Medicaid averaged $465 per claim for the same code, and Medicaid’s 66984 volume is reported as 1.5K claims generating $679.8K. The gap in per-claim payment levels between Medicare and Medicaid is notable and will influence profitability and payer-negotiation dynamics for high-volume cataract work.
Competitive standing on flagship codes shows an above-average presence but not an extreme outlier: for Medicare, 66984 ranks #1456 of 15965 (91st percentile) and 66982 and 67042 rank in the 94th percentile on their respective national peer lists, which indicates the provider posts strong national-volume positions for core cataract and select vitreoretinal procedures even though the dataset labels these volumes as "typical, unremarkable." This suggests the clinic is a meaningful regional player on these ophthalmic procedures within the national distribution.
Within the state Medicaid market, the provider’s cataract volume is substantial: 66984 ranks #14 of 89 in-state (85th percentile), meaning the clinic is a high-volume Medicaid cataract provider relative to peers in Ohio. Given that Medicaid revenue is concentrated in 66984, the clinic is a noticeable in-state resource for Medicaid-covered cataract care.
The practice has been enumerated since 2017-08-01 (~9 years ago), indicating multiple years of billing history to evaluate trends. That tenure supports stable operational persistence for longitudinal analyses of coding mix, payer shifts, and revenue-per-claim trends.
There are no clear extreme statistical outliers among the reported Medicare codes; most line items are described as "typical, unremarkable volume" across a range of percentiles, and several lower-percentile codes (for example 14060 at the 16th percentile and 67840 at the 14th percentile) show modest activity in less central reconstructive or lacrimal procedures. This pattern points to a focused surgical practice that performs occasional ancillary eyelid and lacrimal work but concentrates its throughput on cataract and select vitreoretinal interventions.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
21 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 | $810 | $1.2M |
| 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… | 120 | $820 | $96.4K |
| 67042 | In this procedure, the provider removes vitreous humor, the gelatinous material that gives shape to the eye, using a mechanical cutting tool. He removes the internal limiting membrane of the retina… | 60 | $1,490 | $92.2K |
| 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… | 40 | $2,470 | $86.5K |
| 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 | $1,490 | $69.9K |
| 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… | 140 | $470 | $65.4K |
| 66821 | The provider removes the haziness from the capsule of the eye using a laser for a patient with a secondary membranous cataract. | 220 | $210 | $45.7K |
| 67036 | The provider removes vitreous fluid from the eye to access the posterior segment of the eye and introduce surgical instruments through incisions in the pars plana. | 20 | $1,490 | $32.7K |
| 67900 | The provider repairs a drooping eyebrow due to muscle weakness or paralysis, to improve cosmetic appearance or remove the obstruction to a patient’s vision. He makes an incision immediately above the… | 60 | $500 | $31.7K |
| 67108 | The provider repairs a detached retina using heat produced by a laser beam or by freezing the tissues. He may attach a scleral buckle to simplify the passage of fluid through and behind the retina or… | 20 | $1,490 | $28.3K |
Showing 1–10 of 21
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 21 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
21 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| 66984 | 116 | 530 | 210 | $110 | $92.8K |
| 66991 | 16 | 40 | 30 | $1,060 | $52.8K |
| 15823 | 6 | 50 | 50 | $500 | $35.8K |
| 65820 | 13 | 40 | 40 | $850 | $33.3K |
| 67042 | 3 | 50 | 20 | $960 | $29.7K |
| 67108 | 12 | 30 | 20 | $1,020 | $26.5K |
| 66982 | 12 | 150 | 30 | $470 | $24.9K |
| 67900 | 7 | 30 | 40 | $440 | $21.5K |
| 67903 | 3 | 10 | 50 | $510 | $21.3K |
| 67400 | 1 | 10 | 20 | $960 | $21.1K |
Showing 1–10 of 21
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.
1 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… | 1,460 | $470 | $679.8K |
How this provider's Medicaid billing volume and revenue compare to other Ohio providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Ohio median
1 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… | 14 | 90 | 180 | $410 | $234.6K |
Other providers in the same ZIP code as Cei Physicians Psc LLC, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Access Counseling Services LLC | OH | Community/Behavioral Health Agency | $0 | $30.5M |
| Atrium Medical Center | OH | General Acute Care Hospital | $0 | $27.5M |
| Ryan Steinmetz | OH | Radiation Oncology Physician | $784.1K | $0 |
| Praveena Cheruvu | OH | Radiation Oncology Physician | $726.2K | $0 |
| Radhika Rajsheker | OH | Hematology & Oncology Physician | $632.1K | $0 |
| Nkeiruka Okoye | OH | Hematology & Oncology Physician | $619K | $0 |
| Motaz Hossein | OH | Internal Medicine Physician | $405.4K | $2.1K |
| Lotfi Mamlouk | OH | Internal Medicine Physician | $304.2K | $0 |
| Ranjit Katneni | OH | Internal Medicine Physician | $301.2K | $0 |
| Ashok Poluri | OH | Physical Medicine & Rehabilitation Physician | $243.5K | $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.