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NPI 1164472031 · Tupelo, MS · Ophthalmologic Surgery Clinic/Center
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Tupelo Surgery Center, L.L.C. is a ophthalmologic surgery clinic/center provider located in Tupelo, Mississippi. This profile covers 11 Medicare and 9 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 | Tupelo Surgery Center, L.L.C. |
| Address | 3353 N Gloster St |
| City | Tupelo |
| State | MS |
| ZIP | 38804 |
| Taxonomy | Ophthalmologic Surgery Clinic/Center |
| NPI Enumerated | May 11, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $1.5M |
| Medicaid | $345.6K |
Clinical and service-line profile: The CPT/HCPCS mix is dominated by cataract- and anterior-segment procedures and associated intraoperative ophthalmic drugs, with the leading Medicare codes being 66984 (cataract extraction with IOL), J1096 (dexamethasone lacrimal insert), and J1097 (phenylephrine/ketorolac irrigation). Additional codes such as 66821 (YAG capsulotomy), 66991 (IOL + aqueous drainage device), and several glaucoma-related codes indicate the facility operates as an ophthalmologic surgery center focused on high-volume cataract care and routine post‑op procedures rather than a broad multispecialty surgical portfolio.
Medicare revenue concentration: The provider’s top three Medicare codes account for 77.8% of its total Medicare revenue, led by 66984 at 40.8%, followed by J1096 at 20.8% and J1097 at 16.1%. This level of concentration indicates that a small set of cataract surgery and intraoperative drug codes drive most Medicare receipts and that reimbursement changes to these codes would materially affect Medicare revenue.
Medicaid revenue concentration: The provider’s top three Medicaid codes make up 98.1% of its total Medicaid revenue, overwhelmingly driven by 66984 at 90.3%, with 66821 (YAG capsulotomy) contributing 6.4% and J1096 1.5%. For Medicaid beneficiaries the facility is effectively a cataract surgery provider where one procedure dominates the payer mix, leaving little diversification in Medicaid-driven services.
Payer mix and scale: Lifetime Medicare revenue is $1.5M versus total Medicaid revenue of $345.6K, signaling a Medicare-dominant practice where Medicare represents the primary revenue base and Medicaid is a distant second. The absolute revenue figures suggest a modestly sized ambulatory surgery operation rather than a large regional center or hospital-based department.
Competitive standing — Medicare: For key Medicare codes the provider is a solid but not dominant national participant: 66984 ranks #2132 of 15965 (87th percentile; typical, unremarkable volume), J1096 ranks #23 of 282 (92th percentile; typical, unremarkable volume), and J1097 ranks #88 of 443 (80th percentile; typical, unremarkable volume). One notable exception is 15823 (upper eyelid skin excision) which ranks #101 of 1718 (94th percentile) and is described as notably above typical national volume, indicating a higher-than-normal regional or specialty focus on blepharoplasty-type procedures.
Competitive standing — Medicaid and in-state context: Medicaid rankings show the provider is a meaningful but not dominant in-state cataract provider — 66984 ranks #11 of 42 in-state (76th percentile; typical, unremarkable volume) and 66821 ranks #5 of 12 in-state (64th percentile; typical, unremarkable volume). A few Medicaid codes show idiosyncratic reporting patterns (for example J1095 ranks #1 of 2 in-state at 100th percentile but is labeled typical, unremarkable volume), which reflects small peer denominators and cautions against interpreting single-code rank as market dominance.
Tenure and market presence: The NPI was enumerated on 2006-05-11 (~20 years ago), indicating an established presence in the market and sustained billing activity over multiple Medicare/Medicaid payment cycles. That longevity supports interpretation of these patterns as persistent business lines rather than short-term anomalies.
Operational and payer-risk implications: High utilization of intraoperative drug codes (Medicare avg paid/claim J1096 = $99 and J1097 = $76) alongside the dominance of 66984 (Medicaid avg paid/claim $242) means payers should expect most per-case spend to be concentrated in the cataract procedure plus consumables/drugs. Given the reported concentration (77.8% of Medicare and 98.1% of Medicaid revenue in top-three codes), the provider’s revenue is sensitive to reimbursement or utilization changes for a handful of cataract and ophthalmic drug codes; zero-dollar-paid Medicaid codes such as C9447 and G8907 appear in the file but have no material revenue impact.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
11 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 | $720 | $627K |
| J1096 | Dexamethasone, lacrimal ophthalmic insert, 0.1 mg | 3,230 | $100 | $319.6K |
| J1097 | phenylephrine 10.16 mg/ml and ketorolac 2.88 mg/ml ophthalmic irrigation solution, 1 ml | 3,260 | $80 | $247.7K |
| 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… | 60 | $2,140 | $119.6K |
| 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… | 150 | $440 | $67K |
| 66821 | The provider removes the haziness from the capsule of the eye using a laser for a patient with a secondary membranous cataract. | 370 | $170 | $64K |
| 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… | 50 | $710 | $33.3K |
| 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… | 20 | $1,730 | $32.9K |
| 67908 | The provider performs a procedure such as the Fasanella–Servat procedure, which involves resection and plication of the levator/Muller muscles along with the tarsus and the conjunctiva to treat… | 20 | $500 | $9.4K |
| 66710 | The provider destroys a portion of ciliary body using a laser beam. This procedure decreases the fluid production in the eye, thereby decreasing intraocular pressure. | 30 | $340 | $8.7K |
Showing 1–10 of 11
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 11 CPT/HCPCS codes.
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Full comparison — all codes billed, vs. state median
11 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| J1097 | 6 | 10 | 3,040 | $80 | $244.1K |
| J1096 | 2 | 10 | 840 | $100 | $150.6K |
| 66984 | 12 | 240 | 70 | $470 | $90.5K |
| 66991 | 7 | 20 | 40 | $1,300 | $62.6K |
| 66180 | 3 | 10 | 20 | $1,320 | $26.3K |
| 15823 | 1 | 40 | 40 | $460 | $25.2K |
| 66982 | 10 | 50 | 30 | $590 | $21.4K |
| 66821 | 7 | 160 | 50 | $200 | $17.6K |
| 66710 | 3 | 10 | 30 | $380 | $12.9K |
| 67908 | 1 | 10 | 20 | $460 | $7.3K |
Showing 1–10 of 11
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.
9 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… | 1,290 | $240 | $312.4K |
| 66821 | The provider removes the haziness from the capsule of the eye using a laser for a patient with a secondary membranous cataract. | 430 | $50 | $22K |
| J1096 | Dexamethasone, lacrimal ophthalmic insert, 0.1 mg | 70 | $70 | $5.1K |
| J2403 | Chloroprocaine hcl ophthalmic, 3% gel, 1 mg | 40 | $70 | $2.7K |
| J1097 | phenylephrine 10.16 mg/ml and ketorolac 2.88 mg/ml ophthalmic irrigation solution, 1 ml | 360 | $10 | $2.1K |
| J1095 | Injection, dexamethasone 9 percent, intraocular, 1 microgram | 240 | $10 | $1.6K |
| C9447 | Injection, phenylephrine and ketorolac, 4 ml vial | 240 | $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… | 450 | $0 | $0 |
| G8918 | Patient without preoperative order for iv antibiotic surgical site infection (ssi) prophylaxis | 20 | $0 | $0 |
How this provider's Medicaid billing volume and revenue compare to other Mississippi providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Mississippi median
9 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… | 11 | 40 | 300 | $180 | $191.9K |
| 66821 | The provider removes the haziness from the capsule of the eye using a laser for a patient with a secondary membranous cataract. | 5 | 10 | 160 | $50 | $18.3K |
| J1097 | phenylephrine 10.16 mg/ml and ketorolac 2.88 mg/ml ophthalmic irrigation solution, 1 ml | 5 | 10 | 190 | $20 | $12.9K |
| J2403 | Chloroprocaine hcl ophthalmic, 3% gel, 1 mg | 2 | 10 | 140 | $70 | $9.2K |
| J1096 | Dexamethasone, lacrimal ophthalmic insert, 0.1 mg | 2 | 10 | 120 | $30 | $3.9K |
| C9447 | Injection, phenylephrine and ketorolac, 4 ml vial | 2 | 10 | 130 | $10 | $1.9K |
| J1095 | Injection, dexamethasone 9 percent, intraocular, 1 microgram | 1 | 10 | 130 | $10 | $850 |
| G8918 | Patient without preoperative order for iv antibiotic surgical site infection (ssi) prophylaxis | 30 | 40 | 140 | $1 | $590 |
| 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… | 32 | 60 | 520 | $1 | $200 |
Other providers in the same ZIP code as Tupelo Surgery Center, L.L.C., ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Northeast Mental Health/mental Retardation Commission | MS | Mental Health Clinic/Center (Including Community Mental Health Center) | $0 | $65.7M |
| North Mississippi Ground Ambulance, LLC | MS | Land Ambulance | $4.7M | $12.9M |
| A&a Home Health Equipment, Inc. | MS | Durable Medical Equipment & Medical Supplies | $0 | $10.5M |
| North Mississippi Medical Center Inc. | MS | Rural Health Clinic/Center | $0 | $7.7M |
| Tri-vista Rehab, Inc | MS | Physical Therapist | $0 | $2.8M |
| Kenneth Johnson | MS | Pediatric Dentistry | $0 | $2.8M |
| Sonya Miles | MS | Ophthalmology Physician | $539.5K | $0 |
| Ruben Jones | MS | Family Medicine Physician | $369.9K | $0 |
| Edmund Miller | MS | Family Medicine Physician | $309.3K | $0 |
| Dax Eckard | MS | Optometrist | $241.4K | $24.7K |
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