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NPI 1255510525 · Troy, MI · Ambulatory Surgical Clinic/Center
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Eye Surgery Center Of Michigan LLC is a ambulatory surgical clinic/center provider located in Troy, Michigan. This profile covers 11 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 | Eye Surgery Center Of Michigan LLC |
| Address | 3455 Livernois |
| City | Troy |
| State | MI |
| ZIP | 48083 |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| NPI Enumerated | November 2, 2007 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $1.7M |
| Medicaid | $163.2K |
This entity is an ambulatory surgical clinic/center focused on ophthalmic procedures, with Medicare billing dominated by cataract extraction and intraocular lens insertion codes. The top Medicare code 66984 alone accounts for $1.1M in revenue from 1.3K claims with a $809 avg paid/claim and represents 62.5% of the provider's Medicare revenue, while complementary cataract and complex IOL codes 66988 and 66982 together explain an additional portion of activity and revenue concentration. These code-level patterns indicate the center primarily operates as a high-volume cataract surgery practice with ancillary glaucoma procedures in its service mix.
Revenue concentration on Medicare is high: the precomputed top 3 Medicare codes account for 84.0% of the provider's total Medicare revenue, signaling dependence on a narrow set of high-value ophthalmic procedures. On Medicaid the concentration is even more extreme — the top 3 Medicaid codes account for 100.0% of Medicaid revenue — and Medicaid billing is effectively composed entirely of 66984 (372 claims, $439 avg paid/claim, $163.3K revenue).
Payer mix is skewed strongly toward Medicare at scale: lifetime Medicare revenue is $1.7M versus lifetime Medicaid revenue of $163.2K, so Medicare represents the dominant source of public payer revenue while Medicaid plays a much smaller role. Operationally this suggests the center’s business is driven by the Medicare-aged population receiving cataract surgery, with Medicaid patients contributing only a modest share of throughput.
Competitive standing is mixed by code: for 66988 the provider ranks #1 of 115 providers nationally (100th percentile) and is labeled an extreme outlier, indicating it is an unusually large national performer for this specific endoscopic cyclophotocoagulation plus IOL insertion procedure. By contrast, for the main volume driver 66984 the provider ranks #1638 of 15965 (90th percentile) which the data characterizes as typical, unremarkable volume nationally despite 66984 producing the majority of revenue.
Other Medicare codes show pockets of above-typical activity in glaucoma procedures, supporting a secondary service line beyond routine cataract surgery. For example, 66710 has 62 claims and $39.4K revenue and is described as notably above typical national volume (97th percentile), while 66183 and 66180 each contribute smaller but meaningful revenue tied to glaucoma device implantation and shunt procedures.
Tenure and stability: the provider’s NPI was enumerated on 2007-11-02 (~19 years ago), indicating long-established participation in Medicare and Medicaid markets which supports the observed sustained concentration in cataract and glaucoma interventions. This duration is consistent with a mature ambulatory surgical center focused on outpatient ophthalmic procedures.
From a payer-management perspective, the center presents a concentrated risk/reward profile where interventions to manage costs, negotiate rates, or design value-based arrangements should focus on cataract code 66984 and the high-impact 66988 procedure. Given that 66984 drives both Medicare and all Medicaid revenue reported here, any policy or contract changes affecting cataract reimbursements could materially affect the provider’s overall public-payer revenue position.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
11 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… | 1,340 | $810 | $1.1M |
| 66988 | The provider inserts an artificial lens after endoscopic cyclophotocoagulation and removing an extracapsular cataract by aspiration or use of ultrasonic waves. | 190 | $1,450 | $277.5K |
| 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… | 120 | $790 | $95.8K |
| 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. | 80 | $800 | $63.6K |
| 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 | $2,150 | $47.3K |
| 66180 | The provider implants a shunt in the anterior chamber of the eye to facilitate drainage of aqueous humor, or fluid, in order to reduce intraocular pressure. He uses a graft to reinforce the tissue… | 20 | $1,930 | $40.5K |
| 66710 | The provider destroys a portion of ciliary body using a laser beam. This procedure decreases the fluid production in the eye, thereby decreasing intraocular pressure. | 60 | $640 | $39.4K |
| 66987 | The provider inserts an intraocular lens prosthesis after extracapsular cataract extraction using complex techniques and devices such as an iris expansion device or by providing suture support to… | 20 | $1,470 | $30.8K |
| 66172 | In this procedure, the provider creates a fistula and removes part of the trabecular meshwork from a previous surgery to treat glaucoma and relieve intraocular pressure. He injects antifibrotic… | 40 | $810 | $28.5K |
| 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. | 20 | $970 | $21.3K |
Showing 1–10 of 11
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 11 CPT/HCPCS codes.
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Full comparison — all codes billed, vs. state median
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… | 370 | $440 | $163.3K |
How this provider's Medicaid billing volume and revenue compare to other Michigan providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Michigan 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… | 24 | 50 | 310 | $400 | $267.7K |
Other providers in the same ZIP code as Eye Surgery Center Of Michigan LLC, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Rhb Laboratories Inc | MI | Clinical Medical Laboratory | $2.9M | $25.3M |
| Vibra Of Southeastern Michigan, LLC | MI | Clinical Medical Laboratory | $1.4M | $25.7M |
| Pcor LLC | MI | Optometrist | $0 | $25.4M |
| Children's Dental Specialists PLLC | MI | Pediatric Dentistry | $0 | $9.8M |
| National Seating & Mobility Inc | MI | Durable Medical Equipment & Medical Supplies | $0 | $8M |
| Laboratory Corporation Of America | MI | Clinical Medical Laboratory | $1.8M | $3M |
| Alliance Mobile Health Inc | MI | Ambulance | $1.1M | $3.6M |
| Total Lab Solutions LLC | MI | Clinical Medical Laboratory | $638.6K | $768.5K |
| Bernardo Rojas | MI | Internal Medicine Physician | $1.2M | $0 |
| Troy Sc Center LLC | MI | Ambulatory Surgical Clinic/Center | $421.1K | $0 |
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