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NPI 1093726796 · Missoula, MT · Ambulatory Surgical Clinic/Center
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Rocky Mountain Eye Surgery Center Inc is a ambulatory surgical clinic/center provider located in Missoula, Montana. This profile covers 23 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 | Rocky Mountain Eye Surgery Center Inc |
| Address | 700 West Kent |
| City | Missoula |
| State | MT |
| ZIP | 59801 |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| NPI Enumerated | August 10, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $2.1M |
| Medicaid | $381.3K |
ROCKY MOUNTAIN EYE SURGERY CENTER INC operates as an ambulatory surgical clinic/center with its billing dominated by ophthalmic surgical codes; Medicare revenue totals $2.1M and the top Medicare CPT codes are 66984 ($1.1M revenue, 1.4K claims, $809 avg paid/claim, 54.4% of Medicare revenue), 66991 ($274.5K, 112 claims, $2451 avg paid/claim, 13.0% of Medicare revenue) and 66821 ($111K, 603 claims, $184 avg paid/claim, 5.3% of Medicare revenue). These top codes reflect a primary service line of cataract extraction and intraocular lens procedures, with significant glaucoma-related device work bundled in 66991 and laser capsulotomy activity in 66821.
Revenue concentration is high: the precomputed top-3 Medicare codes account for 72.7% of the provider's total Medicare revenue, and the precomputed top-3 Medicaid codes account for 100.0% of Medicaid revenue. On Medicaid the billing picture is effectively single-code driven — 66984 is listed at $381.5K and reported as 100.0% of Medicaid revenue, while the provider-level Medicaid total is reported as $381.3K, underscoring that cataract surgery is the sole Medicaid revenue driver on file.
Payer mix is skewed toward Medicare in scale: total Medicare revenue is $2.1M versus total Medicaid revenue of $381.3K, indicating Medicare is the dominant payer by reported dollars. Because Medicaid revenue appears to be almost entirely concentrated in a single cataract code (66984), the center’s Medicaid exposure is narrow compared with its broader Medicare procedure mix.
National competitive standing is mixed by code: 66984 ranks #1547 of 15965 nationally (90th percentile; typical, unremarkable volume) indicating cataract volume is in line with many peers, while 66991 ranks #53 of 1445 (96th percentile; notably above typical national volume) and 66821 ranks #170 of 10087 (98th percentile; notably above typical national volume), showing this center has above-typical national volume for certain advanced cataract/glaucoma procedures. These percentile flags suggest the facility is a modest-to-strong national participant for higher-complexity anterior segment work while routine cataract volume is not exceptional.
In-state Medicaid positioning is strong for cataract surgery: 66984 ranks #2 of 11 providers in-state (90th percentile; notably above typical state volume), signaling a significant Medicaid cataract presence relative to Montana peers. The Medicaid file also lists G8918 and G8907 with large claim counts but $0 paid/claim, which are process/quality reporting codes that do not drive revenue but indicate active reporting of perioperative quality measures.
Procedure mix shows complementary specialty lines beyond routine cataract work: Medicare includes V2785 (processing/preserving corneal tissue, $103.9K, 29 claims, 4.9% of Medicare revenue) and 65756 (full corneal transplant, $35.6K, 24 claims), plus multiple glaucoma device/shunt codes such as 66180 ($51.1K) and 66174 ($50.9K). Together these codes demonstrate the center performs corneal and glaucoma surgeries in addition to high-volume cataract cases, supporting a multi-faceted anterior-segment surgical profile.
The provider has long tenure in claims data, with NPI enumeration on 2006-08-10 (~20 years ago), which supports longitudinal operation in the market and the accumulation of the above utilization patterns. Longevity combined with concentrated revenue in a few high-value codes implies both operational experience in ophthalmic surgery and potential sensitivity to reimbursement or utilization policy changes affecting those specific codes.
Because a large share of revenue is concentrated in a small set of codes (72.7% of Medicare revenue from the top three Medicare codes and 100.0% of Medicaid revenue from the top Medicaid codes), the provider’s financial performance may be particularly sensitive to payer coverage, reimbursement adjustments, or shifts in referral patterns for cataract and related glaucoma procedures. Analysts should monitor utilization trends for 66991 and 66821 (both flagged as notably above typical national volume) as potential levers of revenue volatility or growth.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
23 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… | 1,420 | $810 | $1.1M |
| 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… | 110 | $2,450 | $274.5K |
| 66821 | The provider removes the haziness from the capsule of the eye using a laser for a patient with a secondary membranous cataract. | 600 | $180 | $111K |
| V2785 | Processing, preserving and transporting corneal tissue | 30 | $3,580 | $103.9K |
| 66180 | The provider implants a shunt in the anterior chamber of the eye to facilitate drainage of aqueous humor, or fluid, in order to reduce intraocular pressure. He uses a graft to reinforce the tissue… | 30 | $1,970 | $51.1K |
| 66174 | The provider expands the aqueous outflow (drainage) canal of the eye to help relieve pressure in the eye. The procedure does not include leaving a device or stent in place. | 50 | $1,130 | $50.9K |
| 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… | 60 | $810 | $50.3K |
| 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… | 30 | $1,480 | $48.9K |
| 66183 | The provider inserts a small device into the anterior chamber of the eye that helps to reduce the intraocular pressure of the eye in patients with glaucoma. | 20 | $2,190 | $45.9K |
| 65756 | During this procedure, the provider performs a complete corneal transplant to replace a damaged corneal endothelium. | 20 | $1,480 | $35.6K |
Showing 1–10 of 23
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 23 CPT/HCPCS codes.
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Full comparison — all codes billed, vs. state median
23 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| 66991 | 1 | 10 | 50 | $1,370 | $79.5K |
| 66984 | 2 | 120 | 50 | $490 | $78.1K |
| V2785 | 1 | 10 | 20 | $3,600 | $71.9K |
| 66180 | 3 | 10 | 30 | $1,190 | $33.4K |
| 66183 | 1 | 10 | 20 | $1,500 | $31.6K |
| 66982 | 7 | 30 | 30 | $600 | $29.6K |
| 15823 | 4 | 10 | 30 | $510 | $23.6K |
| 67042 | 1 | 10 | 20 | $1,140 | $22.8K |
| 65756 | 2 | 10 | 20 | $1,180 | $22.3K |
| 66174 | 1 | 10 | 30 | $700 | $21.5K |
Showing 1–10 of 23
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… | 1,030 | $370 | $381.5K |
| 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… | 1,110 | $0 | $0 |
| G8918 | Patient without preoperative order for iv antibiotic surgical site infection (ssi) prophylaxis | 1,110 | $0 | $0 |
How this provider's Medicaid billing volume and revenue compare to other Montana providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Montana 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… | 2 | 10 | 210 | $270 | $90.8K |
| 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… | 1 | 10 | 140 | $0 | $0 |
| G8918 | Patient without preoperative order for iv antibiotic surgical site infection (ssi) prophylaxis | 1 | 10 | 40 | $0 | $0 |
Other providers in the same ZIP code as Rocky Mountain Eye Surgery Center Inc, ranked by combined Medicare and Medicaid revenue.
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