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NPI 1124091897 · Paducah, KY · Ambulatory Surgical Clinic/Center
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Paducah Ophthalmology Asc LLC is a ambulatory surgical clinic/center provider located in Paducah, Kentucky. This profile covers 6 Medicare and 2 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 | Paducah Ophthalmology Asc LLC |
| Address | 100 Medical Center Dr |
| City | Paducah |
| State | KY |
| ZIP | 42003 |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| NPI Enumerated | February 10, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $1.3M |
| Medicaid | $467.8K |
PADUCAH OPHTHALMOLOGY ASC LLC is an ambulatory surgical center focused on cataract and anterior segment ophthalmic procedures: Medicare top codes include 66984 (cataract extraction with intraocular lens), 66991 (insertion of IOL with aqueous drainage device), and 66821 (YAG laser capsulotomy), indicating the facility primarily performs cataract surgeries and related postoperative laser management rather than broad multispecialty surgery. The prominence of these procedure types on both Medicare and Medicaid suggests the ASC operates as a specialty cataract surgery center with routine use of intraocular lens implantation and follow-up laser care.
Revenue concentration on Medicare is highly focused: the precomputed top 3 Medicare codes account for 93.4% of this provider's total Medicare revenue, with 66984 alone representing $1M or 76.7% of Medicare revenue. This concentration indicates financial dependence on a small set of cataract-related services for Medicare-funded activity, which concentrates clinical volume and payer exposure in a narrow service line.
Medicaid billing is effectively single-procedure centered: top Medicaid code 66984 accounts for 100.0% of the provider's Medicaid revenue ($468.2K), and the Medicaid file shows G8907 activity with no paid revenue. This pattern implies that Medicaid encounters for this ASC are almost exclusively cataract extractions with intraocular lens implantation, making the provider effectively single-payer single-procedure for its Medicaid business.
Scale and payer mix show Medicare is the larger revenue source overall: total Medicare revenue is $1.3M versus total Medicaid revenue of $467.8K, indicating Medicare comprises a substantially larger share of lifetime revenue for this entity. The difference in scale suggests the ASC’s business is more Medicare-driven, with Medicaid representing a smaller but nontrivial portion concentrated in the same core service.
Competitive standing for key Medicare codes is generally modest to strong regionally: for 66984 the provider ranks #1610 of 15965 nationally (90th percentile), which places it well above most peers in national volume for that code and indicates higher-than-typical activity for cataract extraction. For 66991 the provider ranks #188 of 1445 nationally (86th percentile) and for 66821 it ranks #257 of 10087 (97th percentile), further supporting that the center is an active, above-typical provider of both implantation with drainage-device procedures and YAG capsulotomies compared with national peers.
Medicaid competitive position for 66984 is mid-range in-state: the provider ranks #21 of 71 in Kentucky (71st percentile) for Medicaid-paid 66984 volume, which suggests it is a meaningful but not dominant provider of Medicaid-funded cataract surgery within the state. The Medicaid rank combined with the fact that 100.0% of Medicaid revenue comes from 66984 indicates the ASC competes primarily on cataract surgery volume among in-state peers.
Tenure is long enough to suggest established operations: the NPI was enumerated on 2006-02-10 (~20 years ago), indicating two decades of registration which is consistent with an established ambulatory surgery business and likely ongoing relationships with Medicare and Medicaid. This longevity supports the inference that billing patterns observed are representative of sustained operational focus rather than a short-term anomaly.
Procedure-level utilization shows typical-volume language for most CPTs: national percentile descriptions for the listed Medicare codes use terms like “typical, unremarkable volume” or similar, and ranks for codes such as 66984 (90th percentile) and 66821 (97th percentile) indicate utilization higher than many peers but characterized in the source data as typical. There are no flagged labels such as “extreme outlier” in the provided code descriptors, so patterns should be interpreted as concentrated but within documented peer-range variation.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
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… | 1,350 | $760 | $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… | 70 | $2,300 | $153.8K |
| 66821 | The provider removes the haziness from the capsule of the eye using a laser for a patient with a secondary membranous cataract. | 440 | $160 | $70.1K |
| 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. | 40 | $1,250 | $51.2K |
| 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… | 40 | $770 | $27.1K |
| J1096 | Dexamethasone, lacrimal ophthalmic insert, 0.1 mg | 110 | $100 | $10.9K |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 6 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.
2 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… | 1,090 | $430 | $468.2K |
| 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… | 90 | $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
2 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… | 21 | 70 | 210 | $310 | $290K |
| 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… | 16 | 20 | 260 | $1 | $1 |
Other providers in the same ZIP code as Paducah Ophthalmology Asc LLC, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Baptist Healthcare System, Inc | KY | General Acute Care Hospital | $0 | $72.6M |
| Mercy Health-lourdes Hospital LLC | KY | General Acute Care Hospital | $0 | $61.9M |
| Baptist Health Medical Group Inc | KY | Family Medicine Physician | $0 | $21.9M |
| Mercy Health Physicians Kentucky LLC | KY | Family Medicine Physician | $0 | $11.9M |
| Ambulatory Surgery Center LLC | KY | Ambulatory Surgical Clinic/Center | $771.4K | $8.7M |
| Joseph Blackmon | KY | MOHS-Micrographic Surgery Physician | $6.9M | $0 |
| John Colgan Jr. | KY | Pediatric Dentistry | $0 | $5.6M |
| Mercy Health Physicians Kentucky Specialty Care LLC | KY | Surgery Physician | $0 | $4.7M |
| Justin Colgan | KY | Pediatric Dentistry | $0 | $4.6M |
| Halden Ford | KY | Dermatology Physician | $1.3M | $4.5K |
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