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NPI 1063999662 · Bowling Green, KY · Ambulatory Surgical Clinic/Center
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Southern Kentucky Surgicenter, LLC is a ambulatory surgical clinic/center provider located in Bowling Green, Kentucky. This profile covers 20 Medicare and 6 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 | Southern Kentucky Surgicenter, LLC |
| Address | 484 Golden Autumn Way |
| City | Bowling Green |
| State | KY |
| ZIP | 42103 |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| NPI Enumerated | July 26, 2018 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $1.2M |
| Medicaid | $579K |
This facility operates as an Ambulatory Surgical Clinic/Center with a mixed procedural mix that emphasizes ophthalmology, orthopedics, and GI endoscopy. Medicare top codes include 66984 (cataract extraction/IOL), 27447 (total knee replacement), and 27130 (total hip replacement), while high-volume endoscopy codes such as 45380 and 43239 also appear in both payers' top lists, indicating an ASC that bills for outpatient ophthalmic, orthopedic, and gastrointestinal procedures. The presence of both high-unit orthopedic arthroplasty codes and high-volume endoscopy/cataract codes suggests a diversified surgical service line rather than a single-specialty center.
Revenue concentration on Medicare is acute: the provider reports $1.2M in total Medicare revenue and the top 3 Medicare codes account for 62.1% of that Medicare revenue. Notably, 66984 generates $439.1K (36.1% of Medicare revenue), 27447 generates $204.5K (16.8%), and 27130 generates $110.6K (9.1%), signaling heavy reliance on a small set of high-revenue procedures to drive Medicare volumes. This concentration makes performance and utilization of those specific codes material to overall Medicare revenue stability.
Medicaid revenue is similarly concentrated but even more top-heavy: total Medicaid revenue is $579K and the top 3 Medicaid codes account for 90.0% of Medicaid revenue. The Medicaid top codes are 66984 ($189.7K, 32.8%), 45380 ($172.1K, 29.7%), and 43239 ($159.7K, 27.6%), showing the provider depends on cataract surgery and GI endoscopy for nearly all Medicaid receipts. This payer-level concentration implies that small changes in access, reimbursement, or referral patterns for those three services would disproportionately affect Medicaid revenue.
Payer mix skews toward Medicare by scale: Medicare revenue is $1.2M compared with $579K in Medicaid, so the practice generates substantially more revenue from Medicare patients. Operationally, the Medicare book shows a larger share coming from higher-paid orthopedic procedures (e.g., 27447 at $6596 avg paid/claim and 27130 at $6913 avg paid/claim), while Medicaid revenue is driven by high-volume, lower-paid cataract and endoscopy activity (e.g., Medicaid 66984 at $340 avg paid/claim and 43239 at $180 avg paid/claim). This split suggests different service and payer revenue drivers: higher-value joint replacements on Medicare versus high-volume outpatient procedures on Medicaid.
Competitive standing is mixed across codes and payers: for Medicare, 66984 ranks #2720 of 15965 nationally (83th percentile; described as typical, unremarkable volume), while 45380 ranks #768 of 16427 (95th percentile; notably above typical national volume), indicating the practice is nationally notable for colonoscopy/biopsy volume but otherwise typical for cataract work. For Medicaid in-state comparisons, 66984 ranks #23 of 71 (69th percentile) and 45380 ranks #40 of 122 (68th percentile), which positions the provider as a solid but not dominant in-state performer for cataract and colonoscopy services. Conversely, orthopedic codes like 27447 and 27130 sit nearer the middle or lower national percentiles for Medicare (49th and 22th percentiles respectively), implying more modest orthopedic market share relative to national peers.
Statistical outliers and notable volume signals: 45380 is labeled "notably above typical" for Medicare (95th percentile) and appears as a major Medicaid revenue driver as well, which highlights endoscopic biopsy services as a standout area of elevated utilization for this site. Several other codes are described as "typical, unremarkable volume," including 66984 on Medicare (83th percentile) and many specialty procedures such as 64721 and 43239, so apart from colonoscopy the provider's code-level utilization generally aligns with peer norms. The Medicaid list also includes V2632 with $0 revenue reported, which is an administrative anomaly to flag for coding/reimbursement review rather than a revenue source.
Tenure and operational maturity: the NPI was enumerated on 2018-07-26 (~8 years ago), indicating the clinic has established several years of billing history across both Medicare and Medicaid. That tenure is sufficient to observe stable patterns—high concentration in a few procedures and a consistent payer mix—so recent changes in top-code volumes would more likely reflect operational shifts rather than startup noise. Analysts should treat the current billing profile as reflective of an established ambulatory surgery operation in Bowling Green, KY.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
20 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… | 560 | $790 | $439.1K |
| 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… | 30 | $6,600 | $204.5K |
| 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 | $6,910 | $110.6K |
| 45385 | The provider examines the colon and rectum using a colonoscope, a long, thin flexible tubular instrument with a light source and camera. He removes one or more tumors, polyps, or other lesions with a… | 220 | $410 | $88.8K |
| 45380 | The provider examines the rectum and colon using a flexible colonoscope, a tubular instrument with a light source and camera, to look for the cause of a patient's symptoms, which may include… | 250 | $310 | $79.5K |
| 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… | 20 | $2,070 | $47.6K |
| 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… | 70 | $580 | $38.3K |
| 43239 | The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis. | 160 | $220 | $35K |
| 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… | 30 | $800 | $25.5K |
| G0121 | Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk | 60 | $390 | $23.2K |
Showing 1–10 of 20
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 20 CPT/HCPCS codes.
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Full comparison — all codes billed, vs. state median
20 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| 66984 | 206 | 310 | 1,560 | $40 | $67.1K |
| 27447 | 74 | 160 | 30 | $1,090 | $45.7K |
| 27130 | 66 | 90 | 20 | $1,090 | $32.6K |
| 66982 | 34 | 70 | 30 | $270 | $20.8K |
| 45385 | 15 | 250 | 50 | $250 | $20.2K |
| 29827 | 11 | 40 | 20 | $760 | $15.1K |
| 64721 | 5 | 40 | 20 | $360 | $11.8K |
| 45380 | 5 | 240 | 40 | $140 | $9.4K |
| 45390 | 10 | 10 | 20 | $400 | $9.3K |
| G0105 | 46 | 140 | 30 | $230 | $9.3K |
Showing 1–10 of 20
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.
6 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… | 560 | $340 | $189.7K |
| 45380 | The provider examines the rectum and colon using a flexible colonoscope, a tubular instrument with a light source and camera, to look for the cause of a patient's symptoms, which may include… | 710 | $240 | $172.1K |
| 43239 | The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis. | 890 | $180 | $159.7K |
| 45385 | The provider examines the colon and rectum using a colonoscope, a long, thin flexible tubular instrument with a light source and camera. He removes one or more tumors, polyps, or other lesions with a… | 180 | $270 | $49K |
| 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… | 20 | $540 | $8.6K |
| V2632 | Posterior chamber intraocular lens | 20 | $0 | $0 |
How this provider's Medicaid billing volume and revenue compare to other Kentucky providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Kentucky median
6 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 43239 | The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis. | 104 | 170 | 1,300 | $230 | $441K |
| 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… | 23 | 70 | 210 | $310 | $290K |
| 45380 | The provider examines the rectum and colon using a flexible colonoscope, a tubular instrument with a light source and camera, to look for the cause of a patient's symptoms, which may include… | 40 | 120 | 300 | $320 | $215.2K |
| 45385 | The provider examines the colon and rectum using a colonoscope, a long, thin flexible tubular instrument with a light source and camera. He removes one or more tumors, polyps, or other lesions with a… | 58 | 110 | 230 | $340 | $175.7K |
| 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… | 18 | 20 | 50 | $680 | $140.1K |
| V2632 | Posterior chamber intraocular lens | 16 | 20 | 180 | $50 | $17.8K |
Other providers in the same ZIP code as Southern Kentucky Surgicenter, LLC, ranked by combined Medicare and Medicaid revenue.
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