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NPI 1083188478 · Rocky Hill, CT · Ambulatory Surgical Clinic/Center
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Rocky Hill Surgery Center, LLC is a ambulatory surgical clinic/center provider located in Rocky Hill, Connecticut. This profile covers 9 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 | Rocky Hill Surgery Center, LLC |
| Address | 1111 Cromwell Ave Ste 100 |
| City | Rocky Hill |
| State | CT |
| ZIP | 06067 |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| NPI Enumerated | January 18, 2019 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $1.3M |
| Medicaid | $254.9K |
Rocky Hill Surgery Center, LLC’s billing profile is concentrated in ophthalmic surgery: the top Medicare revenue driver is code 66984 (cataract extraction with lens insertion), which generated $960.3K and accounts for 71.7% of the provider’s total Medicare revenue, and the facility’s Medicaid revenue is entirely from the same code (66984: $255.6K, 100.0% of Medicaid revenue). This concentration indicates the center primarily performs cataract procedures and positions cataract surgery as its core service line across both payers.
Revenue concentration on Medicare is heavily skewed toward a very small set of procedures: the precomputed top 3 Medicare codes together account for 87.3% of Medicare revenue. That level of concentration implies most payer reimbursement is driven by a narrow set of ophthalmic surgeries (primarily cataract-related codes 66984, 66991, 66982), making the business sensitive to volume or reimbursement shifts for those procedures.
Payer mix is Medicare-dominant in scale: lifetime Medicare revenue is $1.3M versus total Medicaid revenue of $254.9K. While the center does receive Medicaid payments, Medicare is the substantially larger revenue source and the practice appears effectively Medicare-focused in lifetime dollars.
Competitive standing for the center on its primary Medicare code is modest nationally: 66984 ranks #1915 of 15965 providers (88th percentile) for volume, described as typical, unremarkable volume for this code. For Medicaid, the center ranks #7 of 39 in-state for 66984 (84th percentile) which indicates relatively high state-level activity for cataract cases among Medicaid-reporting ambulatory surgery centers in Connecticut.
Secondary Medicare codes show a mix of typical specialty activity rather than dominance: 66991 ($129.8K, 9.7% of Medicare revenue) ranks #357 of 1445 (74th percentile) and 66982 ($78.8K, 5.9%) ranks #450 of 4580 (90th percentile), both characterized as typical, unremarkable volumes. These placements suggest the center offers complex or combined anterior segment procedures in addition to routine cataract surgery but does not dominate those segments nationally.
The facility reports a range of vitreoretinal and corneal procedures on Medicare (codes 67042, 67036, 67113, 65756, V2785), which together make up the remaining smaller shares of revenue; V2785 (corneal tissue processing) is notable in ranking #218 of 231 nationally but is still described as typical volume. This mix indicates the center provides ancillary ophthalmic specialty services (vitreoretinal and corneal work) beyond standard cataract care, likely supporting referral cases or combined procedures.
Operational tenure is established but relatively recent: the NPI was enumerated on 2019-01-18 (~7 years ago). This suggests the center has built its Medicare and Medicaid billing profile over several years but remains a relatively young entrant compared with long-standing surgical centers.
Given the extreme concentration of Medicaid revenue in a single code (66984 at 100.0% of Medicaid revenue) and the Medicare top-3 concentration (87.3%), the provider’s financial performance is highly dependent on cataract surgery volumes and reimbursement for those codes. Payers and network planners should consider this single-service sensitivity when evaluating contracting, capacity planning, or episode-of-care arrangements.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
9 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… | 1,070 | $900 | $960.3K |
| 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… | 50 | $2,700 | $129.8K |
| 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… | 90 | $900 | $78.8K |
| V2785 | Processing, preserving and transporting corneal tissue | 10 | $3,840 | $46K |
| 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 | $1,630 | $34.2K |
| 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… | 20 | $1,630 | $34.2K |
| 67113 | The provider repairs a complicated detached retina. He removes vitreous humor, the gelatinous material that gives shape to the eye, and peels the retinal membrane. He reattaches the retina with… | 20 | $1,620 | $27.6K |
| 65756 | During this procedure, the provider performs a complete corneal transplant to replace a damaged corneal endothelium. | 10 | $1,630 | $17.9K |
| 66986 | The provider removes a previously placed intraocular lens and places a new one. | 20 | $580 | $10.4K |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 9 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
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… | 1,970 | $130 | $255.6K |
How this provider's Medicaid billing volume and revenue compare to other Connecticut providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Connecticut 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… | 7 | 40 | 380 | $310 | $334K |
Other providers in the same ZIP code as Rocky Hill Surgery Center, LLC, ranked by combined Medicare and Medicaid revenue.
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