Loading...
NPI 1205454626 · Oak Creek, WI · Ambulatory Surgical Clinic/Center
Customize your policy alerts
Get alerted when relevant policies change without checking for updates manually.
Monitor payer policy activity
Eye Surgery Center Of Wisconsin, LLC is a ambulatory surgical clinic/center provider located in Oak Creek, Wisconsin. This profile covers 14 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 | Eye Surgery Center Of Wisconsin, LLC |
| Address | 10148 S 27th St |
| City | Oak Creek |
| State | WI |
| ZIP | 53154 |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| NPI Enumerated | July 13, 2020 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $1.6M |
| Medicaid | $348.9K |
EYE SURGERY CENTER OF WISCONSIN, LLC is an ambulatory surgical clinic/center whose Medicare and Medicaid billing mix is dominated by cataract surgery and perioperative ophthalmic drugs. The prominence of 66984 (cataract extraction with intraocular lens insertion) together with high-volume ophthalmic drug supplies J1096 (dexamethasone lacrimal insert) and J1097 (phenylephrine/ketorolac irrigation) indicates an operation centered on high-throughput cataract cases with intraoperative medication usage and irrigation support. Ancillary procedure codes (66991, 66982) and glaucoma canal/span expansion codes (66174, 66183) further suggest the center performs a range of anterior segment and minimally invasive glaucoma surgical procedures in addition to corneal services (65756, V2785).
Medicare revenue is highly concentrated in a small number of codes: the provider’s top 3 Medicare codes account for 73.5% of its total Medicare revenue, driven principally by 66984 ($840.6K, 51.4% of Medicare revenue), J1096 ($203.6K, 12.5%), and J1097 ($156.6K, 9.6%). This concentration implies that cataract procedures and associated intraoperative medications are the primary drivers of the $1.6M Medicare revenue base.
Medicaid revenue is even more concentrated: the top 3 Medicaid codes account for 99.9% of the provider’s Medicaid revenue, with 66984 alone representing $331.8K (95.2% of Medicaid revenue). Smaller Medicaid contributions come from J1096 ($13.2K, 3.8%) and J2403 ($3.2K, 0.9%), showing that Medicaid activity is effectively dominated by cataract surgery billing.
On payer mix, Medicare ($1.6M) is the clear revenue leader compared with Medicaid ($348.9K), so the practice’s overall revenue footprint is primarily Medicare-driven rather than Medicaid-driven. The presence of both payers indicates mixed coverage access, but the scale difference shows Medicare services form the bulk of billed activity.
National and state benchmarking characterizes the provider as a competent, not dominant, participant for its core services. For Medicare, 66984 ranks #1935 of 15965 providers (88th percentile), J1096 ranks #53 of 282 (81th percentile), and J1097 ranks #143 of 443 (68th percentile) — each labeled as "typical, unremarkable volume" in national comparisons, indicating steady volume but not an outsized national share.
State-level Medicaid benchmarking shows relatively strong in-state standing for cataract surgery: 66984 ranks #6 of 33 providers in-state (84th percentile; labeled "typical, unremarkable volume"), which supports the view that the center is a meaningful Medicaid cataract provider regionally. However, several Medicaid drug codes (J1096, J2403) are recorded with "no state peer volume comparison available," so benchmarking those lines against peers is not possible from the available data.
Procedure-level payment and service mix point to specific operational nuances: high average paid/claim amounts on select Medicare items (for example, V2785 at $3670 avg paid/claim and 66991 at $2449 avg paid/claim) show the practice also bills for higher-cost corneal processing and combined IOL/drainage device procedures, contributing meaningful non-cataract revenue. Conversely, some device insertion codes such as 66183 rank lower (20th percentile; labeled "typical, unremarkable volume"), indicating less emphasis on certain implantable glaucoma devices relative to national peers.
The provider’s enrollment history (NPI enumerated 2020-07-13, ~6 years ago) indicates a relatively recent establishment compared with many long-standing centers, which may contextualize current volume growth and the concentration of services observed in both Medicare and Medicaid billing.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
14 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… | 1,030 | $810 | $840.6K |
| J1096 | Dexamethasone, lacrimal ophthalmic insert, 0.1 mg | 2,060 | $100 | $203.6K |
| J1097 | phenylephrine 10.16 mg/ml and ketorolac 2.88 mg/ml ophthalmic irrigation solution, 1 ml | 2,060 | $80 | $156.6K |
| 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… | 40 | $2,450 | $107.8K |
| V2785 | Processing, preserving and transporting corneal tissue | 20 | $3,670 | $77.1K |
| 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… | 60 | $820 | $46.5K |
| 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 | $1,270 | $45.6K |
| 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. | 30 | $1,410 | $40.9K |
| 66183 | The provider inserts a small device into the anterior chamber of the eye that helps to reduce the intraocular pressure of the eye in patients with glaucoma. | 20 | $2,240 | $33.6K |
| 65756 | During this procedure, the provider performs a complete corneal transplant to replace a damaged corneal endothelium. | 20 | $1,510 | $31.8K |
Showing 1–10 of 14
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 14 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
14 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| J1097 | 2 | 10 | 1,030 | $80 | $88.9K |
| J1096 | 2 | 10 | 410 | $100 | $80.8K |
| V2785 | 3 | 10 | 20 | $3,940 | $78.7K |
| 66984 | 132 | 310 | 350 | $50 | $66.4K |
| 66991 | 9 | 30 | 30 | $1,270 | $53.3K |
| 66174 | 3 | 10 | 30 | $920 | $31.2K |
| 66183 | 6 | 10 | 20 | $1,250 | $27.4K |
| 65820 | 5 | 20 | 20 | $870 | $25.2K |
| 66982 | 14 | 80 | 20 | $490 | $21.7K |
| 65756 | 5 | 10 | 20 | $1,030 | $21.7K |
Showing 1–10 of 14
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… | 1,110 | $300 | $331.8K |
| J1096 | Dexamethasone, lacrimal ophthalmic insert, 0.1 mg | 570 | $20 | $13.2K |
| J2403 | Chloroprocaine hcl ophthalmic, 3% gel, 1 mg | 150 | $20 | $3.2K |
| 68841 | The provider inserts an implant that delivers a drug at a controlled rate into the lacrimal ducts of the eye to treat inflammation, glaucoma, or other conditions. The provider may also dilate the… | 60 | $10 | $480 |
How this provider's Medicaid billing volume and revenue compare to other Wisconsin providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Wisconsin 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… | 6 | 30 | 210 | $310 | $207.3K |
| J1096 | Dexamethasone, lacrimal ophthalmic insert, 0.1 mg | 1 | 10 | 570 | $20 | $13.2K |
| J2403 | Chloroprocaine hcl ophthalmic, 3% gel, 1 mg | 1 | 10 | 150 | $20 | $3.1K |
| 68841 | The provider inserts an implant that delivers a drug at a controlled rate into the lacrimal ducts of the eye to treat inflammation, glaucoma, or other conditions. The provider may also dilate the… | 1 | 10 | 50 | $10 | $430 |
Other providers in the same ZIP code as Eye Surgery Center Of Wisconsin, LLC, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Fresenius Medical Care Midwest Dialysis, LLC | WI | End-Stage Renal Disease (ESRD) Treatment Clinic/Center | $0 | $1.5M |
| Oak Creek-franklin Jt. School District | WI | Local Education Agency (LEA) | $0 | $1.4M |
| Laboratory Corporation Of America | WI | Clinical Medical Laboratory | $624.5K | $776.1K |
| Children's Medical Group | WI | Pediatrics Physician | $0 | $1.3M |
| City Of Oak Creek | WI | Land Ambulance | $305.2K | $911.2K |
| Duy-bao Dinh | WI | Family Medicine Physician | $568.1K | $0 |
| Drexel Town Square Surgery Center, LLC | WI | Ambulatory Surgical Clinic/Center | $236.3K | $0 |
| Denise Abernethy | WI | Phlebology Physician | $222.9K | $0 |
| Christopher Lee | WI | Otolaryngology Physician | $174.6K | $22.2K |
| Nawras Alshoubaki | WI | Nephrology Physician | $169.7K | $0 |
Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.