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NPI 1174568810 · Indianapolis, IN · Ambulatory Surgical Clinic/Center
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Surgical Care Center, Inc. is a ambulatory surgical clinic/center provider located in Indianapolis, Indiana. This profile covers 9 Medicare and 4 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 | Surgical Care Center, Inc. |
| Address | 9202 N Meridian St Ste 150 |
| City | Indianapolis |
| State | IN |
| ZIP | 46260 |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| NPI Enumerated | June 17, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $3.1M |
| Medicaid | $1.7M |
Service-line profile: The taxonomy and code mix indicate this facility operates as an ophthalmology-focused ambulatory surgical center with a heavy emphasis on cataract surgery and related anterior-segment procedures. High-revenue codes include cataract extraction with intraocular lens insertion (66984, 66991), glaucoma-related incisions (65820, 65855) and secondary membranous cataract laser capsulotomy (66821), and the roster also includes corneal tissue processing and transplant codes (V2785, 65756), signaling a breadth of outpatient eye surgery services rather than general ambulatory surgery.
Medicare revenue concentration: This provider’s Medicare revenue is highly concentrated, with the precomputed top three Medicare codes (66984, 66991, 65820) accounting for 88.6% of total Medicare revenue. Those individual contributions are $2.2M (69.5%) from 66984, $403.5K (12.9%) from 66991, and $193.5K (6.2%) from 65820, indicating that a small set of ophthalmic procedures drive the bulk of Medicare receipts.
Medicaid revenue concentration: Medicaid billing is effectively monocultural for this provider, with the top three Medicaid codes accounting for 100.0% of Medicaid revenue and 66984 alone contributing $1.7M (98.9%). The next-largest Medicaid code is 66821 at $18.5K (1.1%), and two listed safety/quality G-codes show $0 revenue, reinforcing that Medicaid receipts are overwhelmingly from routine cataract surgery.
Payer mix and scale: Both payers are active for this ASC, with total Medicare revenue of $3.1M and total Medicaid revenue of $1.7M on file. Medicare represents the larger revenue source in scale, but Medicaid is still material and is almost entirely driven by high-volume cataract cases under code 66984, so strategic decisions should account for both payer relationships and volume sensitivity.
Competitive standing — Medicare: The provider ranks well above typical national volumes for multiple high-value Medicare ophthalmology codes, with 66984 at #646 of 15965 (96th percentile, notably above typical national volume), 66991 at #19 of 1445 (99th percentile, extreme outlier), and 65820 at #12 of 1249 (99th percentile, extreme outlier). These placements suggest the facility is a nationally significant outlier for complex cataract and pediatric glaucoma procedures and likely draws referrals or maintains capacity uncommon among peers.
Competitive standing — Medicaid (state): For Medicaid cataract surgery this center is the clear in-state leader: 66984 ranks #1 of 62 providers in-state (100th percentile, extreme outlier). That dominance in Medicaid for 66984 means the facility is a primary destination for state-insured cataract volume, which has implications for market share, network negotiations, and access planning.
Price and contract implications: The per-claim paid rates differ markedly across payers for the same service—66984 shows an avg paid/claim of $835 in Medicare and $315 in Medicaid—while the provider still generates substantial revenue from Medicaid through sheer volume ($1.7M). These published averages suggest contracting and payer-rate sensitivity: small changes in reimbursement or shifts in payer mix could meaningfully affect total revenue given the volume concentration on a single procedure.
Operational tenure and stability: The provider’s NPI was enumerated on 2006-06-17 (~20 years ago) and is classified as an Ambulatory Surgical Clinic/Center, indicating long-standing operation and established referral or operational relationships. Combined with the sustained high volumes on core ophthalmic codes, the tenure supports a stable, specialized ASC business model rather than a new or transient entrant.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
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… | 2,600 | $840 | $2.2M |
| 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… | 160 | $2,540 | $403.5K |
| 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. | 200 | $990 | $193.5K |
| 66821 | The provider removes the haziness from the capsule of the eye using a laser for a patient with a secondary membranous cataract. | 520 | $210 | $111.1K |
| V2785 | Processing, preserving and transporting corneal tissue | 30 | $3,140 | $84.9K |
| 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… | 90 | $820 | $77K |
| 65756 | During this procedure, the provider performs a complete corneal transplant to replace a damaged corneal endothelium. | 30 | $1,490 | $38.7K |
| J1096 | Dexamethasone, lacrimal ophthalmic insert, 0.1 mg | 300 | $100 | $29.4K |
| 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. | 140 | $100 | $14.9K |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 9 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.
4 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… | 5,450 | $320 | $1.7M |
| 66821 | The provider removes the haziness from the capsule of the eye using a laser for a patient with a secondary membranous cataract. | 130 | $140 | $18.5K |
| 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… | 180 | $0 | $0 |
| G8918 | Patient without preoperative order for iv antibiotic surgical site infection (ssi) prophylaxis | 180 | $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
4 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… | 1 | 60 | 350 | $270 | $229.7K |
| 66821 | The provider removes the haziness from the capsule of the eye using a laser for a patient with a secondary membranous cataract. | 7 | 20 | 80 | $90 | $23K |
| 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… | 42 | 70 | 320 | $0 | $0 |
| G8918 | Patient without preoperative order for iv antibiotic surgical site infection (ssi) prophylaxis | 25 | 40 | 240 | $0 | $0 |
Other providers in the same ZIP code as Surgical Care Center, Inc., ranked by combined Medicare and Medicaid revenue.
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