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NPI 1063878734 · Ellsworth, ME · Ambulatory Surgical Clinic/Center
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Cesc, LLC is a ambulatory surgical clinic/center provider located in Ellsworth, Maine. This profile covers 7 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 | Cesc, LLC |
| Address | 128 Bucksport Rd |
| City | Ellsworth |
| State | ME |
| ZIP | 04605 |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| NPI Enumerated | January 11, 2016 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $617.6K |
| Medicaid | $534.5K |
Service-line profile: Billing is concentrated in ophthalmic ambulatory surgery, with the top Medicare and Medicaid codes dominated by cataract and anterior-segment procedures (notably 66984, 66991, 66821 and related glaucoma/laser codes such as 65855 and 66761). The mix — extracapsular cataract extraction with intraocular lens insertion, anterior segment device placement, and eyelid lesion excision (15823) — matches an ASC model focused on high-throughput cataract and minor oculoplastic procedures.
Medicare revenue concentration: The top three Medicare codes account for 92.2% of this provider's Medicare revenue, led by 66984 at 74.0%, followed by 66991 at 11.8% and 15823 at 6.3%. This degree of concentration indicates that Medicare inflows are heavily dependent on a narrow set of ophthalmic procedures.
Medicaid revenue concentration: Medicaid revenue is essentially mono-coded — the top three Medicaid codes account for 100.0% of Medicaid revenue, with 66984 alone representing 100.0% of Medicaid revenue ($534.5K across 1.8K claims at $303 avg paid/claim). That makes Medicaid exposure almost entirely tied to cataract surgery volume and reimbursement for 66984.
Payer mix and scale: This provider reports $617.6K in lifetime Medicare revenue and $534.5K in lifetime Medicaid revenue, showing that both payers contribute meaningfully and at a comparable scale to total billing. Medicaid shows higher claim volume on the principal cataract code (1.8K Medicaid claims for 66984 versus 583 Medicare claims for 66984) while Medicare yields slightly higher total dollars, so the practice operates as a dual-payer ASC with dependence on both payer streams.
National competitive standing for Medicare codes: For Medicare, 66984 ranks #2648 of 15965 nationally (83th percentile; typical, unremarkable volume), 66991 ranks #672 of 1445 (51th percentile; typical, unremarkable volume), and 15823 ranks #300 of 1718 (82th percentile; typical, unremarkable volume). These percentiles indicate the provider is a solid, but not dominant, national participant for cataract surgery and related eyelid procedures — volumes are within expected ranges rather than extreme outliers.
State-level competitive position for Medicaid: Within the state Medicaid market, 66984 ranks #3 of 26 in-state (92th percentile; typical, unremarkable volume), signaling a leading in-state position for Medicaid cataract surgery despite the label "typical, unremarkable volume" at the national level. This combination suggests local market strength for cataract services under Medicaid.
Administrative/quality reporting: Two non-revenue codes — G8918 and G8907 — appear with 865 claims each and $0 avg paid/claim, reflecting routine preoperative antibiotic and adverse-event documentation reporting rather than paid services. The presence of high-volume, $0-paid compliance codes indicates systematic use of administrative reporting tied to surgical workflows.
Tenure and strategic implication: The provider's NPI was enumerated on 2016-01-11 (~10 years ago), indicating an established presence in the market; when combined with the high revenue concentration in 66984 and related ophthalmic codes, this tenure supports characterization as a specialized ASC focused on cataract throughput. For payers and competitive analysts, the profile suggests negotiating and network strategies should account for single-procedure dependency and in-state cataract market prominence.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
7 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… | 580 | $780 | $457.1K |
| 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… | 30 | $2,360 | $73K |
| 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… | 80 | $470 | $39.1K |
| 66821 | The provider removes the haziness from the capsule of the eye using a laser for a patient with a secondary membranous cataract. | 210 | $180 | $38.8K |
| 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. | 50 | $90 | $4.1K |
| 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 | $110 | $4K |
| 11440 | The provider excises a benign (noncancerous) lesion including margins from the face, ears, eyelids, nose, lips, or mucous membrane that is 0.5 cm in diameter or less and also performs a simple… | 30 | $50 | $1.5K |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 7 CPT/HCPCS codes.
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… | 1,760 | $300 | $534.5K |
| 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… | 870 | $0 | $0 |
| G8918 | Patient without preoperative order for iv antibiotic surgical site infection (ssi) prophylaxis | 870 | $0 | $0 |
How this provider's Medicaid billing volume and revenue compare to other Maine providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Maine 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… | 3 | 30 | 220 | $280 | $186.7K |
| 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… | 3 | 10 | 270 | $1 | $1 |
| G8918 | Patient without preoperative order for iv antibiotic surgical site infection (ssi) prophylaxis | 2 | 10 | 260 | $0 | $0 |
Other providers in the same ZIP code as Cesc, LLC, ranked by combined Medicare and Medicaid revenue.
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