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NPI 1154840064 · Edina, MN · Ambulatory Surgical Clinic/Center
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Southhealth Asc, LLC is a ambulatory surgical clinic/center provider located in Edina, Minnesota. This profile covers 23 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 | Southhealth Asc, LLC |
| Address | 4100 Minnesota Drive |
| City | Edina |
| State | MN |
| ZIP | 55435 |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| NPI Enumerated | September 12, 2017 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $1.4M |
| Medicaid | $19.9K |
SOUTHHEALTH ASC, LLC is operating as an Ambulatory Surgical Clinic/Center in EDINA, MN with an NPI enumerated on 2017-09-12 (~9 years ago), indicating it is a relatively recent but established ASC. The code mix is heavily ophthalmology-focused (cataract extraction, intraocular lens placement, vitreoretinal work) with meaningful oculoplastic activity and some GI procedures present at lower volumes, which aligns with a multi-specialty ASC that is staffed and equipped for eye surgeries as a primary service line.
Medicare revenue is concentrated in a small set of ophthalmic procedures: the precomputed top 3 Medicare codes by revenue account for 64.9% of this provider's total Medicare revenue. In particular, 66984 alone represents $762.1K (54.9% of Medicare revenue) across 872 claims with $874 avg paid/claim, highlighting a dominant reliance on routine cataract extraction as the core revenue driver.
Medicaid activity is effectively single-code and minimal in scale: total Medicaid revenue is $19.9K and is entirely driven by 66984 (31 claims, $642 avg paid/claim), with the precomputed top 3 Medicaid codes by revenue accounting for 100.0% of Medicaid revenue. This makes the provider effectively Medicare-driven at scale and Medicaid-de minimis, with all Medicaid billing concentrated in the same cataract code that dominates Medicare revenue.
The provider’s competitive standing varies by code. For 66984 the Medicare rank is #2124 of 15965 nationally (87th percentile) and is described as "typical, unremarkable volume," which suggests above-median national activity but not an extreme outlier; by contrast, oculoplastic codes 15823 (rank #72 of 1718, 96th percentile) and 67900 (rank #15 of 444, 97th percentile) are characterized as "notably above typical national volume," indicating the ASC is a regional high-volume performer for eyelid procedures.
Although cataract extraction (66984) dominates revenue, the ASC also bills for higher-complexity intraocular/retinal procedures at lower volumes—examples include 66991 with $2663 avg paid/claim and 67041 with $1602 avg paid/claim. These high average payments combined with smaller claim counts suggest the center handles occasional complex ophthalmic cases in addition to high-volume routine cataract surgery, implying infrastructure and staffing to support a range of ophthalmic acuity levels.
The revenue mix shows potential operational risk from concentration: 66984 accounts for 54.9% of Medicare revenue and the precomputed top 3 Medicare codes account for 64.9% of Medicare revenue, while Medicaid revenue is 100.0% concentrated in 66984. Any shifts in cataract volumes, reimbursement, or coverage policies for 66984 would therefore materially affect overall facility revenue.
National and in-state rank descriptors indicate different competitive implications by payer and code. For Medicare 66984 is "typical, unremarkable volume" nationally despite a high percentile, signaling broad participation among peers, whereas 15823 and 67900 are "notably above typical national volume," marking the ASC as a notable provider of oculoplastic services. For Medicaid the same cataract code (66984) ranks #9 of 15 in-state (43th percentile; "typical, unremarkable volume"), confirming Medicaid presence is limited and not dominant relative to in-state peers.
From a payer-mix perspective the scale imbalance is stark: total Medicare revenue is $1.4M versus total Medicaid revenue of $19.9K. This provider should be considered essentially Medicare-dominant in terms of revenue exposure and payer negotiation leverage, with Medicaid representing a negligible share of billed revenue.
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… | 870 | $870 | $762.1K |
| 15823 | In this procedure, the provider surgically trims excessive skin that weighs down the upper eyelid, typically to improve the cosmetic appearance of the face and due to the interference of the tissue… | 170 | $430 | $74.8K |
| 67900 | The provider repairs a drooping eyebrow due to muscle weakness or paralysis, to improve cosmetic appearance or remove the obstruction to a patient’s vision. He makes an incision immediately above the… | 130 | $500 | $64.5K |
| 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 | $2,660 | $53.3K |
| 67041 | In this procedure, the provider removes scar tissue from the retinal membrane that obscures vision. He removes vitreous humor, the gelatinous material that gives shape to the eye, using a mechanical… | 30 | $1,600 | $44.9K |
| 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… | 90 | $440 | $40.3K |
| 45380 | The provider examines the rectum and colon using a flexible colonoscope, a tubular instrument with a light source and camera, to look for the cause of a patient's symptoms, which may include… | 120 | $350 | $40.1K |
| 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 | $1,600 | $38.4K |
| 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… | 40 | $870 | $37.2K |
| 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. | 20 | $1,600 | $36.8K |
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 |
|---|---|---|---|---|---|
| 66984 | 107 | 300 | 190 | $50 | $56K |
| 66991 | 23 | 30 | 30 | $1,460 | $53.9K |
| 67042 | 13 | 10 | 20 | $1,300 | $48K |
| 67036 | 3 | 10 | 20 | $1,140 | $37.5K |
| 65820 | 12 | 20 | 30 | $1,010 | $31.2K |
| 67041 | 3 | 10 | 20 | $1,090 | $25.1K |
| 15823 | 2 | 40 | 30 | $530 | $25K |
| 67039 | 4 | 10 | 20 | $1,250 | $23.8K |
| 19318 | 1 | 10 | 20 | $1,370 | $23.3K |
| 66982 | 18 | 70 | 30 | $610 | $23.2K |
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.
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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… | 30 | $640 | $19.9K |
How this provider's Medicaid billing volume and revenue compare to other Minnesota providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Minnesota 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… | 9 | 20 | 40 | $410 | $69K |
Other providers in the same ZIP code as Southhealth Asc, LLC, ranked by combined Medicare and Medicaid revenue.
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