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NPI 1255500781 · Iowa City, IA · Ambulatory Surgical Clinic/Center
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Iowa City Ambulatory Surgical Center, LLC is a ambulatory surgical clinic/center provider located in Iowa City, Iowa. This profile covers 31 Medicare and 3 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 | Iowa City Ambulatory Surgical Center, LLC |
| Address | 2963 Northgate Dr |
| City | Iowa City |
| State | IA |
| ZIP | 52245 |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| NPI Enumerated | February 28, 2008 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $1.7M |
| Medicaid | $437.9K |
Service-line profile: Medicare billing is concentrated in a mix of specialty ambulatory procedures—ophthalmology (notably 66984 and 66982), podiatric/orthopedic reconstruction (28750, 28740, 28285, 27130), and hand surgery (64721, 26055). This code mix is consistent with an Ambulatory Surgical Clinic/Center that houses multiple surgical specialties under one roof rather than a single-procedure center, with both high-volume cataract work and a substantive orthopedic/hand surgery footprint.
Medicare revenue concentration: the top three Medicare codes by revenue (66984, 28750, 27130) account for 52.0% of this provider's total Medicare revenue, indicating material dependence on a small set of high-revenue procedures. This level of concentration suggests that changes in referral patterns, reimbursement, or capacity for these specific codes could meaningfully affect total Medicare revenue.
Medicaid revenue concentration: the top three Medicaid codes by revenue account for 100.0% of this provider's total Medicaid revenue, with code 69436 (tympanostomy with tube) alone representing 89.5% of Medicaid revenue and 42820 (tonsil/adenoid removal) representing 10.5%. Medicaid activity is therefore tightly focused on pediatric ENT procedures rather than reflecting the broader surgical mix seen in Medicare.
Payer-scale comparison: the provider reports Medicare revenue of $1.7M versus Medicaid revenue of $437.9K, so Medicare constitutes the larger revenue source in absolute dollars. Medicaid activity appears to be an important but smaller, concentrated revenue stream tied to discrete pediatric surgical services rather than a balanced payer mix.
National competitive standing (Medicare): the facility is a clear national outlier on select orthopedic foot procedures—28750 ranks #1 of 311 providers nationally (100th percentile; extreme outlier) and 28740 ranks #1 of 20 providers nationally (100th percentile; notably above typical). By contrast, the large Medicare cataract code 66984 is at the 85th percentile (rank #2442 of 15965) and is described as typical, unremarkable volume for that code nationally, indicating leadership in niche orthopedic procedures but standard cataract volumes relative to peers.
State competitive standing (Medicaid): for Medicaid, 69436 ranks #7 of 52 providers in-state (88th percentile) and is labeled typical, unremarkable volume, which positions the center as a meaningful but not dominant regional provider of pediatric tympanostomy. The presence of 42820 at rank #10 of 25 in-state (63rd percentile) reinforces that Medicaid work is focused on routine pediatric ENT cases without extreme statewide concentration.
Tenure and operating stability: the provider's NPI was enumerated on 2008-02-28 (~18 years ago), reflecting a long-standing ambulatory surgical presence in its market. That tenure, combined with a diversified procedural mix across ophthalmology, orthopedics, hand surgery, and ENT, is consistent with an established ASC that likely maintains long-term referral relationships and multi-specialty scheduling.
Statistical outliers and operational implications: beyond the extreme outlier status of 28750, several codes are flagged as notably above typical—64721 (97th percentile), 28285 (97th percentile), and 26055 (95th percentile)—which supports the interpretation of a comparatively strong hand and foot surgery practice. Additionally, high-percentile pain/spine injection codes such as 62321 and 64490 (both in the 80s percentile range) suggest the ASC also accommodates interventional pain services, adding to its multi-specialty operational complexity.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
31 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… | 680 | $820 | $558.8K |
| 28750 | In this procedure, the provider surgically immobilizes the metatarsophalangeal joint of the great toe. A metatarsophalangeal joint is a joint between the first metatarsal of the foot and the first… | 40 | $3,360 | $147.9K |
| 27130 | In this procedure, the provider surgically replaces the hip joint by prosthesis, or artificial hip joint. He replaces both the femoral and acetabular components with or without using an autograft or… | 20 | $7,170 | $143.3K |
| 63650 | In this procedure, the provider places electrodes in the epidural space to relieve pain and reduce or eliminate spasms. | 30 | $3,690 | $92.2K |
| 28740 | In this procedure, the provider surgically immobilizes a single midtarsal or tarsometatarsal joint with the help of fixation devices. Midtarsal joints are combined joints of either the talus with the… | 30 | $3,300 | $82.4K |
| 64721 | Neuroplasty or transposition of the median nerve at the carpal tunnel is done to treat a condition called carpal tunnel syndrome (CTS). The carpal tunnel is a narrow tunnel in the wrist through which… | 120 | $610 | $70.6K |
| 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… | 70 | $830 | $58.2K |
| 28285 | The provider repairs a hammertoe deformity, a painful condition in which the toe remains permanently bent in a downward position. | 80 | $620 | $51.8K |
| 26055 | Trigger finger, or stenosing tenosynovitis, is when a finger remains in a bent position. It is painful to open or close the finger. A swollen tendon or formation of knots or nodules in the tendon may… | 100 | $460 | $47.3K |
| 28298 | The provider removes bone from a bunion, a foot deformity that causes a bump near where the big toe joins the foot. The procedure includes proximal phalanx osteotomy, cutting and realigning a toe… | 20 | $1,960 | $47K |
Showing 1–10 of 31
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 31 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
31 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| 63650 | 6 | 10 | 40 | $2,330 | $93.3K |
| 66984 | 20 | 340 | 50 | $340 | $50.4K |
| 66982 | 20 | 60 | 40 | $450 | $39K |
| 28750 | 1 | 10 | 20 | $1,790 | $37.5K |
| 28740 | 1 | 10 | 20 | $1,680 | $31.9K |
| 67042 | 10 | 20 | 20 | $900 | $28.8K |
| 27130 | 91 | 140 | 30 | $790 | $25.4K |
| 64721 | 5 | 50 | 30 | $430 | $20.5K |
| 23412 | 10 | 10 | 20 | $960 | $20.1K |
| 29827 | 18 | 40 | 20 | $950 | $18.1K |
Showing 1–10 of 31
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.
3 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 69436 | This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia. | 840 | $470 | $392.1K |
| 42820 | The provider removes the tonsils and adenoids in a patient younger than 12 years old. | 80 | $570 | $46K |
| L8699 | Prosthetic implant, not otherwise specified | 30 | $0 | $0 |
How this provider's Medicaid billing volume and revenue compare to other Iowa providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Iowa median
3 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 69436 | This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia. | 7 | 50 | 170 | $410 | $153.8K |
| 42820 | The provider removes the tonsils and adenoids in a patient younger than 12 years old. | 10 | 30 | 60 | $750 | $96.1K |
| L8699 | Prosthetic implant, not otherwise specified | 6 | 10 | 120 | $1 | $1 |
Other providers in the same ZIP code as Iowa City Ambulatory Surgical Center, LLC, ranked by combined Medicare and Medicaid revenue.
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