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NPI 1124022595 · Cedar Rapids, IA · Ambulatory Surgical Clinic/Center
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The Outpatient Surgery Center Of Cedar Rapids, LLC is a ambulatory surgical clinic/center provider located in Cedar Rapids, Iowa. This profile covers 31 Medicare and 10 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 | The Outpatient Surgery Center Of Cedar Rapids, LLC |
| Address | 1075 1st Avenue Se |
| City | Cedar Rapids |
| State | IA |
| ZIP | 52402 |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| NPI Enumerated | June 13, 2005 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $1.2M |
| Medicaid | $586.3K |
THE OUTPATIENT SURGERY CENTER OF CEDAR RAPIDS reports $1.2M in lifetime Medicare revenue and $586.3K in lifetime Medicaid revenue, indicating Medicare is the larger payer by scale for this facility. Its NPI was enumerated on 2005-06-13 (~21 years ago), consistent with a long-standing ambulatory surgical clinic that has had time to build referral relationships across multiple specialties.
Medicare revenue is moderately concentrated: the provider’s top three Medicare codes account for 48.0% of total Medicare revenue, driven by 66984 (31.7%), 27130 (9.5%), and 64721 (6.7%). This concentration shows a roughly balanced reliance on high-volume ophthalmology (cataract extraction and lens insertion), orthopedic joint replacement, and carpal tunnel surgery for Medicare payor dollars.
The code mix demonstrates a multi-specialty ambulatory surgery model rather than a single-specialty clinic: high Medicare revenues include ophthalmology (66984, 66982, 66991), orthopedics/arthroplasty (27130), hand surgery (64721, 26055), podiatry/forefoot procedures (28750, 28285, 28308), endoscopy/colorectal work (45385, 45380), and urology (52356). This breadth suggests the center handles both adult ophthalmic and musculoskeletal cases for Medicare while also supporting endoscopy and urology procedures.
Several Medicare codes place the provider as an above-typical national performer in specific niches: 64721 ranks #56 of 3206 providers nationally (98th percentile; extreme outlier, far above typical national volume for this code) and 28285 ranks #20 of 955 providers nationally (98th percentile; extreme outlier, far above typical national volume for this code). By contrast, high-revenue cataract code 66984 ranks #3090 of 15965 (81th percentile; typical, unremarkable volume for this code), indicating national prominence is concentrated in hand and forefoot procedures rather than in ophthalmology.
Medicaid billing is highly concentrated and pediatric-focused: the top three Medicaid codes account for 99.1% of Medicaid revenue, with 69436 (tympanostomy with tube insertion) alone representing $547.1K or 93.4% of Medicaid revenue. That pattern—69436 ranked #4 of 52 in-state (94th percentile; typical, unremarkable volume for this code)—indicates the facility’s Medicaid business is overwhelmingly driven by tympanostomy procedures, consistent with pediatric ENT volume.
State-level Medicaid data also show unusually large counts of zero-paid implant/supply line items: L8699 appears with 1.7K claims at $0 avg paid/claim and C1713 with 525 claims at $0 avg paid/claim, both noted as notably above typical state volume for those codes. These zero-dollar entries suggest extensive reporting of implants or device items to Medicaid (or bundled/recipient-paid arrangements) that materially inflate claim counts even though they do not contribute to reported Medicaid revenue.
The juxtaposition of a Medicaid practice dominated by high-volume tympanostomy and a Medicare practice driven by cataract, joint replacement, and high-volume hand/forefoot procedures has operational implications: the center likely staffs pediatric ENT teams (to support 69436 volume on Medicaid) while maintaining adult ophthalmology and orthopedic/hand/podiatry capacity for Medicare referrals. That mixed-service strategy aligns with the ambulatory surgical clinic/center taxonomy and the diverse top CPT list.
Overall, the facility shows long tenure (NPI enumerated 2005-06-13 (~21 years ago)) and a differentiated competitive position: it is a routine-volume provider for some common Medicare procedures (e.g., 66984) but a national outlier in specific surgical niches (e.g., 64721 and 28285), while on Medicaid it is functionally a major tympanostomy provider in-state given the 93.4% share of Medicaid revenue concentrated in 69436. Analysts should treat the provider as a multi-specialty ambulatory surgery center with concentrated payer-specific lines of business rather than a single-service clinic.
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… | 460 | $800 | $368.7K |
| 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 | $6,930 | $110.9K |
| 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… | 130 | $610 | $78.3K |
| 28750 | In this procedure, the provider surgically immobilizes the metatarsophalangeal joint of the great toe. A metatarsophalangeal joint is a joint between the first metatarsal of the foot and the first… | 20 | $3,230 | $77.5K |
| 28285 | The provider repairs a hammertoe deformity, a painful condition in which the toe remains permanently bent in a downward position. | 90 | $610 | $55.2K |
| 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 | $790 | $46.6K |
| 52356 | The provider performs a cystourethroscopy, the inspection of the interior of the bladder, the urethra, prostatic urethra, and ureteric openings using a cystoscope passed through the urethra and into… | 30 | $1,650 | $46.3K |
| 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… | 20 | $2,390 | $43K |
| 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… | 100 | $420 | $40.2K |
| 28308 | The provider performs an osteotomy of any metatarsal bone other than the first. He may or may not lengthen, shorten, or correct an angular deformity of the metatarsal. He performs the procedure to… | 50 | $730 | $35.6K |
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.
View: State1 / 2
Full comparison — all codes billed, vs. state median
31 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| 66984 | 26 | 340 | 50 | $340 | $50.4K |
| 66991 | 14 | 20 | 30 | $1,360 | $50.2K |
| 66982 | 21 | 60 | 40 | $450 | $39K |
| 28750 | 5 | 10 | 20 | $1,790 | $37.5K |
| 45385 | 59 | 150 | 80 | $250 | $29.6K |
| 15823 | 8 | 20 | 30 | $520 | $29.4K |
| 27130 | 108 | 140 | 30 | $790 | $25.4K |
| 64721 | 3 | 50 | 30 | $430 | $20.5K |
| 29827 | 22 | 40 | 20 | $950 | $18.1K |
| 28285 | 2 | 20 | 30 | $430 | $17.6K |
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.
View: By Year1 / 3
Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
10 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. | 890 | $610 | $547.1K |
| 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. | 100 | $270 | $25.8K |
| 42820 | The provider removes the tonsils and adenoids in a patient younger than 12 years old. | 10 | $630 | $7.6K |
| 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… | 10 | $320 | $3.9K |
| 64415 | The provider injects one or more anesthetic agents and/or a steroid into the brachial plexus area, a group of nerves in the arm that originates in the neck. Report this code for one or more… | 30 | $50 | $1.4K |
| C1713 | Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) | 530 | $0 | $0 |
| 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… | 30 | $0 | $0 |
| G8916 | Patient with preoperative order for iv antibiotic surgical site infection (ssi) prophylaxis, antibiotic initiated on time | 30 | $0 | $0 |
| L8699 | Prosthetic implant, not otherwise specified | 1,650 | $0 | $0 |
| V2632 | Posterior chamber intraocular lens | 50 | $0 | $0 |
How this provider's Medicaid billing volume and revenue compare to other Iowa providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Iowa median
10 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. | 4 | 50 | 170 | $410 | $153.8K |
| 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. | 35 | 60 | 260 | $210 | $109.2K |
| 42820 | The provider removes the tonsils and adenoids in a patient younger than 12 years old. | 24 | 30 | 60 | $750 | $96.1K |
| 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… | 3 | 10 | 30 | $300 | $45.4K |
| 64415 | The provider injects one or more anesthetic agents and/or a steroid into the brachial plexus area, a group of nerves in the arm that originates in the neck. Report this code for one or more… | 2 | 10 | 90 | $20 | $2.2K |
| V2632 | Posterior chamber intraocular lens | 2 | 10 | 30 | $1 | $130 |
| L8699 | Prosthetic implant, not otherwise specified | 1 | 10 | 120 | $1 | $1 |
| C1713 | Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) | 1 | 10 | 160 | $0 | $0 |
| 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… | 8 | 10 | 50 | $0 | $0 |
| G8916 | Patient with preoperative order for iv antibiotic surgical site infection (ssi) prophylaxis, antibiotic initiated on time | 1 | 10 | 30 | $0 | $0 |
Other providers in the same ZIP code as The Outpatient Surgery Center Of Cedar Rapids, LLC, ranked by combined Medicare and Medicaid revenue.
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