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NPI 1205171295 · Sioux Falls, SD · Ambulatory Surgical Clinic/Center
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Vance Thompson Vision Surgery Center Prof LLC is a ambulatory surgical clinic/center provider located in Sioux Falls, South Dakota. This profile covers 15 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 | Vance Thompson Vision Surgery Center Prof LLC |
| Address | 3101 W 57th St |
| City | Sioux Falls |
| State | SD |
| ZIP | 57108 |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| NPI Enumerated | December 3, 2012 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $4.5M |
| Medicaid | $22.7K |
This facility is heavily Medicare-dependent: Total Medicare revenue is $4.5M while Total Medicaid revenue is $22.7K, so Medicare accounts for the overwhelming share of billed revenue and the center is effectively Medicare-dominant rather than balanced across payers. The small absolute Medicaid total indicates the provider’s business volumes and reimbursement exposure are concentrated in the Medicare population.
Medicare revenue is highly concentrated in a few cataract- and intraocular-related codes: 66984 accounts for $2.1M (46.0%), J1097 for $799.4K (17.8%), and 66991 for $509.3K (11.3%), and the precomputed top-3 share is 75.1% of this provider's total Medicare revenue. This concentration shows the bulk of Medicare dollars flow from cataract extraction with lens insertion and associated intraoperative drug use and drainage-device procedures.
The code mix and dollar amounts point to an ambulatory surgical center focused on ophthalmic surgery, particularly high-volume cataract procedures and associated intraoperative medications: J1097 appears as a major revenue driver with 10.7K claims and $799.4K revenue, reflecting routine use of phenylephrine/ketorolac irrigation during cases. The presence of V2785 ($433.5K, 9.6%) and 65756 ($143.2K, 3.2%) further indicates substantial corneal tissue processing and full-thickness corneal transplant activity in addition to routine cataract work.
This provider is a national outlier on several Medicare measures: 66984 ranks #619 of 15965 providers nationally (96th percentile; notably above typical national volume), J1097 ranks #5 of 443 providers nationally (99th percentile; extreme outlier), and 66991 ranks #4 of 1445 providers nationally (100th percentile; extreme outlier). Those ranks indicate the center is a major national-volume performer for intraoperative ophthalmic irrigation (J1097) and for combined IOL-plus-drainage procedures (66991), and well above typical national activity for cataract extraction code 66984.
Medicaid billing is minimal and fully concentrated in the same cataract-related codes: the precomputed top-3 share for Medicaid is 100.0%, with 66984 representing $21K (92.4% of Medicaid revenue, 98 claims) and J1097 representing $1.7K (7.6% of Medicaid revenue, 32 claims). In-state competitive position on Medicaid is modest — 66984 ranks #5 of 8 providers in-state (43th percentile; typical, unremarkable volume) and J1097 ranks #2 of 2 providers in-state (0th percentile) — underscoring that Medicaid is a very small, non-differentiating payer for this center.
The center’s high-ranking V2785 performance (111 claims, $433.5K; ranks #6 of 231 providers nationally, 98th percentile; notably above typical national volume) signals that corneal tissue processing and handling are a meaningful revenue line beyond routine cataract procedures. This suggests operational capabilities or partnerships that support corneal tissue procurement, processing, or transplantation workflows at scale relative to peers.
Clinical complexity beyond routine cataract work is reflected in several device and glaucoma-related codes: 66991 (combined IOL and drainage device) contributes $509.3K (11.3%) and ranks as an extreme outlier nationally, while device-insertion codes such as 0449T ($40.4K, 0.9%) and 66989 ($37.3K, 0.8%) also appear in the top codes though at lower volumes. Together these data indicate the center performs advanced anterior-segment procedures and aqueous drainage device cases in addition to high-volume cataract surgery.
The provider has an established operational history, with NPI enumeration on 2012-12-03 (~14 years ago), and sustained Medicare receipts totaling $4.5M that point to a stable, mature ambulatory surgical clinic specializing in ophthalmology. Given the combination of tenure, concentrated Medicare revenue, and national high-volume rankings on key ophthalmic procedure and supply codes, the center should be classified operationally as a specialty ambulatory surgical center with emphasis on cataract and corneal services rather than a general outpatient clinic.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
15 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… | 2,690 | $770 | $2.1M |
| J1097 | phenylephrine 10.16 mg/ml and ketorolac 2.88 mg/ml ophthalmic irrigation solution, 1 ml | 10,660 | $80 | $799.4K |
| 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… | 220 | $2,280 | $509.3K |
| V2785 | Processing, preserving and transporting corneal tissue | 110 | $3,910 | $433.5K |
| 66821 | The provider removes the haziness from the capsule of the eye using a laser for a patient with a secondary membranous cataract. | 1,140 | $150 | $170.7K |
| 65756 | During this procedure, the provider performs a complete corneal transplant to replace a damaged corneal endothelium. | 100 | $1,380 | $143.2K |
| 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… | 100 | $760 | $77.8K |
| 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… | 160 | $460 | $71.3K |
| 66988 | The provider inserts an artificial lens after endoscopic cyclophotocoagulation and removing an extracapsular cataract by aspiration or use of ultrasonic waves. | 40 | $1,330 | $47.7K |
| 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. | 40 | $1,080 | $47.7K |
Showing 1–10 of 15
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 15 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
15 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| J1097 | 1 | 10 | 4,710 | $80 | $422.5K |
| V2785 | 1 | 10 | 20 | $3,680 | $180.5K |
| 66991 | 1 | 10 | 70 | $1,370 | $119.4K |
| 66984 | 1 | 130 | 40 | $410 | $67.7K |
| 15823 | 3 | 10 | 50 | $510 | $50.6K |
| 65756 | 1 | 10 | 20 | $1,070 | $38.6K |
| 65820 | 3 | 10 | 40 | $1,010 | $37.2K |
| 66821 | 1 | 30 | 100 | $230 | $35.6K |
| 66988 | 1 | 10 | 40 | $890 | $32K |
| 66174 | 2 | 10 | 40 | $850 | $26.5K |
Showing 1–10 of 15
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 |
|---|---|---|---|---|
| 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… | 100 | $210 | $21K |
| J1097 | phenylephrine 10.16 mg/ml and ketorolac 2.88 mg/ml ophthalmic irrigation solution, 1 ml | 30 | $50 | $1.7K |
How this provider's Medicaid billing volume and revenue compare to other South Dakota providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. South Dakota median
2 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… | 5 | 10 | 100 | $250 | $60.9K |
| J1097 | phenylephrine 10.16 mg/ml and ketorolac 2.88 mg/ml ophthalmic irrigation solution, 1 ml | 2 | 10 | 160 | $60 | $8.7K |
Other providers in the same ZIP code as Vance Thompson Vision Surgery Center Prof LLC, ranked by combined Medicare and Medicaid revenue.
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