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NPI 1134259179 · Warsaw, IN · Ophthalmologic Surgery Clinic/Center
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Grossnickle Eye Center, Inc. is a ophthalmologic surgery clinic/center provider located in Warsaw, Indiana. This profile covers 10 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 | Grossnickle Eye Center, Inc. |
| Address | 2251 Dubois Dr |
| City | Warsaw |
| State | IN |
| ZIP | 46580 |
| Taxonomy | Ophthalmologic Surgery Clinic/Center |
| NPI Enumerated | March 7, 2007 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $1.8M |
| Medicaid | $0 |
GROSSNICKLE EYE CENTER, INC. is effectively a Medicare-focused ophthalmologic surgery center: the provider reports Total Medicare revenue of $1.8M and Total Medicaid revenue of $0, indicating a single-payer (Medicare) revenue footprint rather than a mixed payer profile. The NPI was enumerated 2007-03-07 (~19 years ago), showing long-standing Medicare enrollment and continuity in billing activity.
Revenue is highly concentrated in a narrow set of cataract- and glaucoma-related procedures: the precomputed top 3 Medicare codes (66984, 66991, 65820) account for 82.2% of the provider’s total Medicare revenue. In particular, 66984 alone contributes $1.2M (64.2% of Medicare revenue, 1.5K claims, $768 avg paid/claim), signaling heavy reliance on routine extracapsular cataract extraction with intraocular lens placement.
The provider shows above-typical national standing on two of its top surgical codes: 66991 (94th percentile) and 65820 (96th percentile) are described as "notably above typical national volume," suggesting the practice performs a higher-than-average share of complex cataract/IOL-plus-device procedures and pediatric glaucoma incisional work relative to peers. 66991 generated $221.5K (12.1% of Medicare revenue, 94 claims, $2356 avg paid/claim) and 65820 generated $107.5K (5.9% of Medicare revenue, 107 claims, $1005 avg paid/claim).
Despite the concentration in a few high-revenue codes, several ancillary ophthalmic services also contribute meaningfully to Medicare receipts: J1096 (dexamethasone lacrimal insert) produced $92.4K (5.1% of Medicare revenue, 924 claims, $100 avg paid/claim) and 66821 (YAG capsulotomy) produced $64K (3.5%, 342 claims, $187 avg paid/claim). These codes indicate the practice provides postoperative and procedure-based in-office services in addition to operating-room cataract care.
Competitive posture on the flagship cataract code 66984 is consistent with a busy but not dominant national position: the provider ranks #1451 of 15965 providers nationally (91th percentile) for 66984 and is characterized as "typical, unremarkable volume for this code," implying steady, market-typical cataract surgical throughput rather than national dominance. Conversely, the very high percentile ranks for 66991 and 65820 point to niche strength in more complex cataract/IOL-plus-device cases and pediatric glaucoma incisions.
There is heterogeneity across other glaucoma and microinvasive procedures: 66183 (implanting an anterior chamber device) and 66174 (canaloplasty without stent) are present but smaller revenue contributors ($43.8K and $22K respectively) with middling-to-low national rankings (66183 at 52th percentile, 66174 at 10th percentile). This mix suggests the center offers some glaucoma surgical options but does not consistently lead nationally across all MIGS or non-implant canal procedures.
From a payer-analytics perspective, the combination of high concentration in three codes (82.2% of Medicare revenue) and zero Medicaid billing highlights both risk and predictability: payers and network managers should treat this entity as a Medicare-centric cataract surgery specialist whose financial performance is tightly tied to volume and reimbursement for a few principal ophthalmic procedures. Monitoring utilization trends in 66984, 66991, and 65820 will capture the majority of revenue movement for this provider.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
10 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… | 1,530 | $770 | $1.2M |
| 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… | 90 | $2,360 | $221.5K |
| 65820 | The provider incises the limbus to improve drainage of aqueous humor in the eye. This procedure is typically performed on children, usually to treat congenital glaucoma. | 110 | $1,010 | $107.5K |
| J1096 | Dexamethasone, lacrimal ophthalmic insert, 0.1 mg | 920 | $100 | $92.4K |
| 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… | 120 | $770 | $89.4K |
| 66821 | The provider removes the haziness from the capsule of the eye using a laser for a patient with a secondary membranous cataract. | 340 | $190 | $64K |
| 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 | $2,090 | $43.8K |
| 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. | 20 | $1,290 | $22K |
| 65855 | In this procedure, the provider uses a laser to burn the trabecular meshwork, the tissue of mesh where the iris meets the sclera, to drain aqueous humor from the anterior chamber and treat glaucoma. | 90 | $90 | $7.7K |
| 65400 | In this procedure, the provider excises a thin layer from the surface of the cornea, the front portion of the eye that focuses light on the lens, to remove a mass, scar tissue, or other lesion,… | 20 | $300 | $5.4K |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 10 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.
2 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 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… | 40 | $0 | $0 |
| G8918 | Patient without preoperative order for iv antibiotic surgical site infection (ssi) prophylaxis | 40 | $0 | $0 |
How this provider's Medicaid billing volume and revenue compare to other Indiana providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Indiana median
2 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 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… | 56 | 70 | 320 | $0 | $0 |
| G8918 | Patient without preoperative order for iv antibiotic surgical site infection (ssi) prophylaxis | 37 | 40 | 240 | $0 | $0 |
Other providers in the same ZIP code as Grossnickle Eye Center, Inc., ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Bowen Health Inc | IN | Adult Mental Health Clinic/Center | $0 | $508.6M |
| Forte Residential, Inc | IN | Developmentally Disabled Services Day Training Agency | $0 | $44.8M |
| Warsaw Health System LLC | IN | General Acute Care Hospital | $0 | $10M |
| Kosciusko Medical Group LLC | IN | Family Medicine Physician | $0 | $8.8M |
| Joes Kids Inc | IN | Physical Therapist | $0 | $2.9M |
| Adria Ford | IN | Surgery Physician | $128.9K | $0 |
| Irene Ponce | IN | Certified Registered Nurse Anesthetist | $63.8K | $670 |
| David Ryser | IN | Ophthalmology Physician | $43.3K | $0 |
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