Loading...
NPI 1215309653 · Bangor, ME · Ambulatory Surgical Clinic/Center
Customize your policy alerts
Get alerted when relevant policies change without checking for updates manually.
Monitor payer policy activity
Bangor Eye Surgery, PA is a ambulatory surgical clinic/center provider located in Bangor, Maine. This profile covers 4 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 | Bangor Eye Surgery, PA |
| Address | 900-a Hammond Street |
| City | Bangor |
| State | ME |
| ZIP | 04401 |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| NPI Enumerated | October 26, 2015 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $400.7K |
| Medicaid | $82.7K |
The provider operates as an ophthalmic ambulatory surgical clinic/center: the Medicare and Medicaid top CPTs are dominated by cataract extraction and intraocular lens procedures (codes 66984 and 66982) plus posterior capsulotomy (66821) and a limbal glaucoma procedure (65820), which together indicate a surgical practice focused on cataract surgery and related anterior-segment procedures rather than broad multispecialty services.
Medicare revenue is highly concentrated in a small set of procedures: the precomputed top 3 Medicare codes account for 90.9% of this provider's Medicare revenue, led by 66984 at $287.6K (71.7% of Medicare revenue), followed by 65820 at $40K (10.0%) and 66821 at $36.8K (9.2%). This concentration implies the practice’s Medicare business relies heavily on routine cataract and related procedures.
The single largest Medicare code, 66984, shows consistent procedural volume: 364 claims at $790 avg paid/claim producing $287.6K in revenue and ranking #3552 of 15965 providers nationally (78th percentile), described in the source data as a typical, unremarkable volume. That profile suggests steady cataract surgery throughput but not market dominance on a national scale.
On the Medicaid side the practice is effectively single-service: the precomputed top 3 Medicaid codes account for 100.0% of Medicaid revenue and 66984 alone represents the entirety of reported Medicaid revenue at $82.9K from 453 claims ($183 avg paid/claim). The Medicaid rank for 66984 is #11 of 26 in-state (60th percentile), again characterized as typical, indicating Medicaid activity is concentrated and mid-ranked among in-state peers.
Payer mix is Medicare-dominant in scale: reported lifetime Medicare revenue is $400.7K versus Medicaid revenue of $82.7K, so Medicare is the principal revenue source while Medicaid represents a smaller, focused portion of volume. The provider is therefore not single-payer but relies materially more on Medicare-funded cataract procedures.
There are no pronounced statistical outliers in the supplied rankings: the listed Medicare codes are labeled as typical or unremarkable volume (66984 at the 78th percentile, 65820 at the 56th, 66821 at the 90th, 66982 at the 75th), and the Medicaid 66984 is similarly described as typical (60th percentile). The 90th-percentile placement for 66821 does indicate relatively stronger use of posterior capsulotomy compared with national peers, but the data source still characterizes that volume as typical.
The Medicaid dataset includes a reporting/quality code, G8907, with 230 claims but $0 avg paid/claim and $0 revenue, ranked #10 of 13 in-state (25th percentile). This pattern reflects non-reimbursed quality or safety reporting activity submitted alongside surgical billing rather than a revenue-driving service line.
The provider has an established enrollment history, with NPI enumerated on 2015-10-26 (~11 years ago), consistent with an established ambulatory surgical practice profile that concentrates on a narrow set of ophthalmic surgical CPTs and maintains steady, mid-ranked volumes against both national Medicare and in-state Medicaid peers.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
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… | 360 | $790 | $287.6K |
| 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 | $1,290 | $40K |
| 66821 | The provider removes the haziness from the capsule of the eye using a laser for a patient with a secondary membranous cataract. | 190 | $200 | $36.8K |
| 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 | $760 | $36.5K |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 4 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.
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… | 450 | $180 | $82.9K |
| 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… | 230 | $0 | $0 |
How this provider's Medicaid billing volume and revenue compare to other Maine providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Maine 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… | 11 | 30 | 220 | $280 | $186.7K |
| 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… | 10 | 10 | 270 | $1 | $1 |
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.