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NPI 1265609945 · Tualatin, OR · Ambulatory Surgical Clinic/Center
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Pacific Cataract And Laser Institute, Inc., P.C. is a ambulatory surgical clinic/center provider located in Tualatin, Oregon. 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 | Pacific Cataract And Laser Institute, Inc., P.C. |
| Address | 19801 Sw 72nd Ave |
| City | Tualatin |
| State | OR |
| ZIP | 97062 |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| NPI Enumerated | May 13, 2008 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $1M |
| Medicaid | $66.9K |
PACIFIC CATARACT AND LASER INSTITUTE, INC., P.C. operates as an Ambulatory Surgical Clinic/Center and its billing mix is dominated by cataract-related procedures; Medicare shows 66984 with 890 claims, $946 avg paid/claim and $841.9K revenue (83.8% of this provider's total Medicare revenue), while Medicaid shows 66984 with 265 claims, $249 avg paid/claim and $66K revenue (98.8% of this provider's total Medicaid revenue). The presence of 66821 (YAG capsulotomy) and intraocular lens insertion codes confirms a service line focused on both primary cataract surgery and common post‑operative laser management. The pattern of codes supports a high-volume cataract surgical clinic rather than a broad multispecialty ambulatory center.
Revenue concentration on Medicare is extremely high: the precomputed top-three Medicare codes account for 95.9% of this provider's total Medicare revenue. Within that concentration, 66984 alone accounts for $841.9K (83.8% of Medicare revenue), indicating most Medicare dollars flow from standard extracapsular cataract extraction with lens insertion rather than ancillary ophthalmologic services.
Medicaid billing is effectively single‑line for surgical eye care: the precomputed top-three Medicaid codes account for 100.0% of Medicaid revenue, and 66984 represents $66K (98.8% of the provider's Medicaid revenue) with 265 claims and a $249 avg paid/claim. The remaining Medicaid activity is minimal (00142 at $810, 1.2% of Medicaid revenue), so Medicaid net revenue and service diversity are both very limited compared with Medicare.
Payer mix is heavily Medicare‑weighted in scale: reported lifetime Medicare revenue is $1M versus Medicaid revenue of $66.9K, signifying Medicare is the dominant payer by an order of magnitude for this provider. This imbalance implies strategic reliance on Medicare fee schedules and beneficiary volume for financial performance, with Medicaid contributing a small fraction of total public payer revenue.
National competitive standing on key Medicare codes is mixed but generally within typical ranges: 66984 ranks #2107 of 15965 (87th percentile) and is described as typical, unremarkable volume for this code, 66821 ranks #574 of 10087 (94th percentile) and is described as typical, unremarkable volume for this code, while 66991 ranks #930 of 1445 (33th percentile) and is described as typical, unremarkable volume for this code. In plain terms, the clinic shows above‑median activity on standard cataract and capsulotomy services nationally but is not an extreme outlier or dominant national center for more complex combined procedures.
State-level competitive signals for Medicaid are modest: Medicaid 66984 ranks #18 of 39 providers in-state (55th percentile) and is described as typical, unremarkable volume for this code, while anesthesia-related Medicaid billing 00142 ranks #19 of 20 (5th percentile) and is described as typical, unremarkable volume for this code. These rankings indicate the provider is an average to below-average Medicaid participant in-state for ophthalmic surgical services, with limited Medicaid anesthesia billing relative to peers.
The provider has an established operating history, with NPI enumeration on 2008-05-13 (~18 years ago), which supports interpreting these patterns as the product of a stable ambulatory surgical practice rather than a short‑term anomaly. Given the long tenure and concentrated procedure mix, payer negotiations or network decisions should consider this entity primarily as a cataract surgery center with predictable Medicare-driven revenue streams.
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… | 890 | $950 | $841.9K |
| 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… | 20 | $2,860 | $68.7K |
| 66821 | The provider removes the haziness from the capsule of the eye using a laser for a patient with a secondary membranous cataract. | 260 | $200 | $52.3K |
| 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… | 40 | $940 | $41.4K |
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… | 270 | $250 | $66K |
| 00142 | The provider performs anesthesia services for a patient undergoing an eye lens procedure. | 20 | $50 | $810 |
How this provider's Medicaid billing volume and revenue compare to other Oregon providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Oregon 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… | 18 | 40 | 120 | $330 | $175.5K |
| 00142 | The provider performs anesthesia services for a patient undergoing an eye lens procedure. | 19 | 20 | 60 | $50 | $13.7K |
Other providers in the same ZIP code as Pacific Cataract And Laser Institute, Inc., P.C., ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Legacy Meridian Park Hospital | OR | General Acute Care Hospital | $0 | $13.3M |
| Danny Sadakah | OR | Dentist | $0 | $11.8M |
| United Seating And Mobility LLC | OR | Durable Medical Equipment & Medical Supplies | $0 | $6.1M |
| Tualatin Imaging P C | OR | Diagnostic Radiology Physician | $0 | $2.8M |
| Legacy Meridian Park Hospital | OR | Hospitalist Physician | $0 | $2.4M |
| Gso Equipment Corp | OR | Endoscopy Clinic/Center | $528K | $1.2M |
| Or Krew, LLC | OR | Home Health Agency | $0 | $1.4M |
| Oregon Pediatrics- Meridian Park, LLC | OR | Pediatrics Physician | $0 | $1.2M |
| Cascade Spine Center, LLC | OR | Ambulatory Surgical Clinic/Center | $1.1M | $0 |
| Ian Schnadig | OR | Hematology & Oncology Physician | $721K | $0 |
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