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NPI 1063416998 · Wilmington, NC · Ambulatory Surgical Clinic/Center
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Wilmington Surgery Center, LP is a ambulatory surgical clinic/center provider located in Wilmington, North Carolina. This profile covers 31 Medicare and 5 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 | Wilmington Surgery Center, LP |
| Address | 1801 S 17th St |
| City | Wilmington |
| State | NC |
| ZIP | 28401 |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| NPI Enumerated | June 9, 2005 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $3.7M |
| Medicaid | $1.1M |
WILMINGTON SURGERY CENTER, LP operates as an ambulatory surgical clinic/center delivering a mix of ophthalmology, orthopedic, spine/neurostimulation and pediatric ENT procedures. Medicare top-procedure presence is led by cataract surgery (66984), spine neurostimulator implantation (63685), and total knee arthroplasty (27447), while Medicaid revenue is dominated by pediatric ear/airway procedures (69436, 42820) alongside cataract surgery (66984), indicating a multi-specialty ASC model rather than a single-focus practice.
Medicare revenue is concentrated in a few high-value procedures: the precomputed top 3 Medicare codes account for 58.2% of the provider's Medicare revenue, led by 66984 at $1.1M (30.9% of Medicare revenue), 63685 at $532.7K (14.7%), and 27447 at $458.5K (12.6%). This concentration shows that a small set of surgical services drive the majority of Medicare receipts for the site.
Medicaid revenue is highly concentrated in pediatric ENT and cataract services: the precomputed top 3 Medicaid codes account for 98.1% of Medicaid revenue, with 69436 generating $535.6K (47.1%), 66984 $303.2K (26.6%), and 42820 $278.3K (24.4%). The dominance of 69436 and 42820 indicates that the center is a major site of pediatric otolaryngology outpatient surgery for Medicaid patients.
On payer scale, Medicare revenue ($3.7M) substantially exceeds Medicaid revenue ($1.1M), so the facility’s overall revenue footprint is driven more by Medicare-level cases while Medicaid represents a meaningful but smaller portion concentrated in pediatric procedures. Both payers are represented, but Medicare is the larger revenue source given the provided totals.
National and procedure-level competitive standing is mixed: for Medicare, 66984 ranks #1576 of 15965 nationally (90th percentile) and is described as typical, unremarkable volume for that code, while 63685 ranks #204 of 1281 (83th percentile) and 27447 ranks #2110 of 12089 (82th percentile), placing the center as a respectable but not dominant national performer in these specialty surgeries. Several Medicare procedures do appear as clear above-average outliers — for example, 29827 (96th percentile, notably above typical), 29880 (95th percentile, notably above typical), and 49650 (94th percentile, notably above typical) — suggesting pockets of elevated arthroscopy and minimally invasive general-surgery throughput relative to national peers.
Within the state Medicaid market the center is among higher-volume providers for key pediatric and ophthalmic procedures: 69436 ranks #10 of 88 in-state (90th percentile; typical, unremarkable volume), 66984 ranks #11 of 74 (86th percentile; typical, unremarkable volume), and 42820 ranks #10 of 55 (83th percentile; typical, unremarkable volume). These in-state percentiles indicate the facility is a notable regional provider for ear tube and tonsil/adenoid surgeries in Medicaid populations.
The facility has an established operational history with NPI enumeration dated 2005-06-09 (~21 years ago), consistent with a longstanding ambulatory surgical center that has built procedure lines across ophthalmology, orthopedics, spine, and pediatric ENT over time. Tenure at this level of specialization supports the observed blend of routine cataract work and higher-acuity procedures such as neurostimulator implantation and joint replacement.
Revenue concentration creates operational sensitivity to reimbursement or referral changes for a small set of procedures: because the top 3 Medicare codes account for 58.2% of Medicare revenue and the top 3 Medicaid codes account for 98.1% of Medicaid revenue, shifts in utilization, payer policy, or access for 66984, 63685, 27447, or the pediatric ENT codes could materially affect payer-specific revenue streams. The prominence of 66984 across both payers additionally highlights a single-procedure influence on the center’s cross-payer revenue profile.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
31 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 | $810 | $1.1M |
| 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 | $17,180 | $532.7K |
| 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… | 70 | $6,840 | $458.5K |
| J1097 | phenylephrine 10.16 mg/ml and ketorolac 2.88 mg/ml ophthalmic irrigation solution, 1 ml | 2,860 | $80 | $217.1K |
| 63655 | In this procedure, the provider removes a portion of the vertebra called the lamina and places a permanent plate/paddle electrode in the epidural space, or area between the dura membrane and the wall… | 20 | $13,340 | $213.4K |
| 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… | 30 | $7,070 | $197.8K |
| 29827 | The provider examines the tissue inside the shoulder joint with an arthroscope. She inserts additional instruments to repair a torn rotator cuff, the grouping of muscles and tendons that surround and… | 60 | $2,030 | $115.9K |
| J1096 | Dexamethasone, lacrimal ophthalmic insert, 0.1 mg | 960 | $100 | $95K |
| 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 | $1,430 | $90.1K |
| 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 | $2,270 | $86.1K |
Showing 1–10 of 31
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 31 CPT/HCPCS codes.
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Full comparison — all codes billed, vs. state median
31 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| J1097 | 4 | 10 | 1,240 | $80 | $151.9K |
| 63685 | 14 | 40 | 20 | $5,660 | $147.2K |
| J1096 | 3 | 10 | 1,330 | $100 | $129.1K |
| V2785 | 5 | 10 | 30 | $3,760 | $101.5K |
| 63655 | 15 | 20 | 20 | $3,670 | $77.1K |
| 66984 | 164 | 580 | 230 | $70 | $73.7K |
| 66991 | 13 | 30 | 30 | $1,280 | $51.4K |
| 27447 | 69 | 460 | 30 | $1,000 | $41.8K |
| 27130 | 131 | 320 | 30 | $990 | $30.8K |
| 29827 | 10 | 120 | 20 | $1,000 | $25K |
Showing 1–10 of 31
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
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Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
5 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 69436 | This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia. | 1,680 | $320 | $535.6K |
| 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… | 1,900 | $160 | $303.2K |
| 42820 | The provider removes the tonsils and adenoids in a patient younger than 12 years old. | 620 | $450 | $278.3K |
| 42830 | The provider performs an initial adenoidectomy in a patient who is less than 12 years old. | 40 | $500 | $21.3K |
| 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… | 450 | $0 | $0 |
How this provider's Medicaid billing volume and revenue compare to other North Carolina providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. North Carolina median
5 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 69436 | This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia. | 10 | 90 | 120 | $350 | $184.9K |
| 42820 | The provider removes the tonsils and adenoids in a patient younger than 12 years old. | 10 | 60 | 100 | $390 | $123.1K |
| 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… | 11 | 70 | 130 | $160 | $107.5K |
| 42830 | The provider performs an initial adenoidectomy in a patient who is less than 12 years old. | 13 | 20 | 90 | $410 | $79.3K |
| 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 | 60 | 170 | $0 | $0 |
Other providers in the same ZIP code as Wilmington Surgery Center, LP, ranked by combined Medicare and Medicaid revenue.
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