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NPI 1184871485 · Guaynabo, PR · Ambulatory Surgical Clinic/Center
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Guaynabo Ambulatory Surgical Group, Inc is a ambulatory surgical clinic/center provider located in Guaynabo, Puerto Rico. This profile covers 3 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 | Guaynabo Ambulatory Surgical Group, Inc |
| Address | Carr 165 # Km1 |
| City | Guaynabo |
| State | PR |
| ZIP | 00968 |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| NPI Enumerated | August 19, 2008 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $275K |
| Medicaid | $53.4K |
GUAYNABO AMBULATORY SURGICAL GROUP, INC operates as an Ambulatory Surgical Clinic/Center with a procedure mix concentrated in ophthalmic surgery and oculoplastic work: the Medicare top codes are 66984 (cataract extraction with intraocular lens), 67900 (eyebrow repair), and 15823 (upper eyelid skin excision), which aligns with a focused ambulatory eye-surgery practice rather than a broad multispecialty surgical center. The code descriptions and the provider taxonomy together indicate the facility primarily delivers cataract and related eyelid procedures on an outpatient basis.
Medicare revenue is highly concentrated: the precomputed top 3 Medicare codes account for 100.0% of the provider’s total Medicare revenue, and 66984 alone represents $258.4K or 94.0% of Medicare revenue (438 claims at $590 avg paid/claim). This concentration shows most Medicare receipts derive from a single ophthalmic procedure.
Medicaid billing is effectively single-procedure: total Medicaid revenue is $53.4K and 66984 accounts for 100.0% of that Medicaid revenue (122 claims at $438 avg paid/claim). For Medicaid payers the provider appears to be functionally a cataract surgery supplier with no material Medicaid revenue from other procedure lines.
Payer mix is Medicare-dominant in scale: lifetime Medicare revenue is $275K compared with lifetime Medicaid revenue of $53.4K, indicating the provider’s gross billing footprint is centered on Medicare rather than Medicaid. The absolute figures show Medicare is the principal revenue source while Medicaid contributes a smaller but non-negligible share.
Nationally for Medicare cataract surgery (66984) the provider ranks #3178 of 15965 (80th percentile) and is described as "typical, unremarkable volume for this code," which positions the clinic as a modest but not leading national participant in cataract procedures. The two supplemental Medicare codes (67900 and 15823) also show unremarkable volumes: 67900 ranks #234 of 444 (46th percentile) and 15823 ranks #1023 of 1718 (38th percentile), consistent with a modest regional footprint for oculoplastic cases.
Within Puerto Rico Medicaid for 66984 the practice ranks #33 of 59 in-state (45th percentile) and is likewise labeled "typical, unremarkable volume for this code," indicating it is not a dominant Medicaid cataract provider in-state but is an active participant. The Medicaid ranking reinforces that the clinic’s Medicaid presence is limited to routine cataract volume rather than market leadership.
Tenure data show the provider’s NPI was enumerated on 2008-08-19 (~18 years ago), indicating an established operating history in the market; this longevity, combined with a tightly focused code mix, suggests sustained specialization in outpatient ophthalmic surgery over many years. The combination of long tenure and concentrated procedures may reflect a stable specialty practice rather than a recently diversified operation.
The billing pattern exhibits operational concentration: both the precomputed top-3 Medicare codes and top-3 Medicaid codes account for 100.0% of revenue for their respective payers, and 66984 dominates across payers (94.0% of Medicare revenue and 100.0% of Medicaid revenue). This dependence on a single procedure line implies sensitivity of overall revenue to changes in cataract surgery volume, reimbursement, or referral patterns, making procedure-level volume trends particularly important for payer/provider analysts monitoring this entity.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
3 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… | 440 | $590 | $258.4K |
| 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… | 30 | $340 | $8.4K |
| 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… | 30 | $290 | $8.1K |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 3 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.
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… | 120 | $440 | $53.4K |
How this provider's Medicaid billing volume and revenue compare to other Puerto Rico providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Puerto Rico 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… | 33 | 60 | 160 | $380 | $270.5K |
Other providers in the same ZIP code as Guaynabo Ambulatory Surgical Group, Inc, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Alivia Specialty, LLC | PR | Specialty Pharmacy | $0 | $189M |
| Medtronic Puerto Rico Operations | PR | Durable Medical Equipment & Medical Supplies | $0 | $19.7M |
| Cuerpo De Emergencias Medicas De | PR | Land Ambulance | $108.2K | $9.4M |
| Ortho & Surgical Solutions, Inc | PR | Prosthetic/Orthotic Supplier | $0 | $7.8M |
| Santa Merle | PR | Hematology & Oncology Physician | $4.5K | $2M |
| Bard Shannon Limited | PR | Prosthetic/Orthotic Supplier | $0 | $1.2M |
| Ricardo Hernandez-castillo | PR | Pulmonary Disease Physician | $28.6K | $211.9K |
| Maria De Aranzazu Villamil Jarauta | PR | Endocrinology, Diabetes & Metabolism Physician | $42.3K | $151.8K |
| Juan Malpica-santiago | PR | Pulmonary Disease Physician | $33.2K | $148.3K |
| Fernando Zalduondo | PR | Diagnostic Radiology Physician | $125.9K | $0 |
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