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NPI 1275530271 · Dubuque, IA · Ambulatory Surgical Clinic/Center
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Tri-state Surgery Center, L.L.C. is a ambulatory surgical clinic/center provider located in Dubuque, Iowa. This profile covers 34 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 | Tri-state Surgery Center, L.L.C. |
| Address | 1500 Associates Dr |
| City | Dubuque |
| State | IA |
| ZIP | 52002 |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| NPI Enumerated | July 5, 2005 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $2.3M |
| Medicaid | $0 |
TRI-STATE SURGERY CENTER, L.L.C. is an ambulatory surgical clinic-style operation with a strong procedural focus on ophthalmology, endoscopy, and interventional pain/urology services; its top CPTs include 66984 (cataract extraction with IOL), multiple colonoscopy/therapeutic colonoscopy codes (45385, 45380, G0105, G0121), and high-cost device/implant codes (64590, 64561), indicating a mix of same-day surgical ophthalmic cases, endoscopic GI throughput, and outpatient neurostimulator/implant procedures.
Medicare is effectively the sole public payer on file: lifetime Medicare revenue is $2.3M while reported Medicaid revenue is $0, so this facility is functionally single-payer (Medicare) in the available dataset and likely relies predominantly on Medicare-age patients or Medicare-covered procedures.
Revenue concentration is material: the precomputed top-3 Medicare codes account for 55.3% of total Medicare revenue, with 66984 alone representing $814.3K (36.4% of Medicare revenue). This level of concentration suggests the center’s financial performance is highly dependent on a small set of high-volume procedures, particularly cataract surgery.
Procedure-level competitive standing is mixed. For cataract extraction 66984 the provider ranks #1926 of 15965 nationally (88th percentile), reflecting a typical but above-average volume for that code; by contrast, colonoscopic polypectomy 45385 ranks #260 of 16310 (98th percentile) and is labeled an extreme outlier, indicating the center performs colonoscopic therapeutic work at volumes far above typical peers.
Several device- and implant-related codes show outsized per-claim reimbursement and meaningful revenue shares: 64590 averages $13943 per claim and generated $195.2K (8.7% of Medicare revenue), and 64561 contributed $115.2K (5.2%). Although national ranks for these codes are not top-tier (64590 rank #343 of 561, 64561 rank #208 of 564), the presence of these high-dollar device codes indicates the center undertakes specialized implant procedures that drive revenue despite modest claim counts.
Operational breadth is evident from the long tail of procedural codes across multiple specialties: ophthalmology (66984, 66991, 66183), gastroenterology (45385, 45380, 43239, 43249), orthopedics/hand surgery (64721, 23412, 29827), and urology (C9740, 52356). This diverse mix suggests the center functions as a multi-specialty ambulatory surgery center capturing a range of same-day surgical services rather than a single-specialty clinic.
The provider’s enrollment tenure is established: NPI was enumerated on 2005-07-05 (~21 years ago), implying longstanding participation in Medicare which can support steady referral relationships and procedural volume over time.
Several codes show volumes that are notably above typical national peers beyond cataract work: 45380 ranks in the 96th percentile, 43239 in the 95th percentile, and G0121/G0105 colonoscopy screening codes are both in the mid-90s percentiles; collectively these signal that endoscopy/colonoscopy is a high-throughput service line for this center relative to national peers, reinforcing the business dependence on GI procedural throughput.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
34 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… | 1,040 | $780 | $814.3K |
| 45385 | The provider examines the colon and rectum using a colonoscope, a long, thin flexible tubular instrument with a light source and camera. He removes one or more tumors, polyps, or other lesions with a… | 560 | $410 | $228.5K |
| 64590 | The provider inserts or replaces a peripheral, sacral, or gastric neurostimulator pulse generator or receiver. The system is one that requires surgical creation of a pocket for placement and that… | 10 | $13,940 | $195.2K |
| 64561 | The provider, under imaging guidance, implants electrodes around nerves in the sacral region to reduce the pain along the path of the nerve. | 30 | $3,600 | $115.2K |
| 45380 | The provider examines the rectum and colon using a flexible colonoscope, a tubular instrument with a light source and camera, to look for the cause of a patient's symptoms, which may include… | 280 | $320 | $89.7K |
| J1096 | Dexamethasone, lacrimal ophthalmic insert, 0.1 mg | 740 | $100 | $73.7K |
| C9740 | Cystourethroscopy, with insertion of transprostatic implant; 4 or more implants | 10 | $5,210 | $72.9K |
| 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… | 110 | $610 | $66.3K |
| 43239 | The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis. | 280 | $230 | $63.9K |
| G0105 | Colorectal cancer screening; colonoscopy on individual at high risk | 150 | $390 | $58.2K |
Showing 1–10 of 34
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 34 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
34 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| J1096 | 2 | 10 | 740 | $100 | $161.9K |
| 64590 | 4 | 10 | 10 | $5,600 | $83.9K |
| C9740 | 1 | 10 | 10 | $4,960 | $69.5K |
| 64561 | 3 | 10 | 30 | $2,190 | $65.6K |
| 66984 | 13 | 340 | 50 | $340 | $50.4K |
| 66991 | 11 | 20 | 30 | $1,360 | $50.2K |
| 66982 | 36 | 60 | 40 | $450 | $39K |
| 66183 | 1 | 10 | 20 | $2,100 | $35.7K |
| C9771 | 1 | 10 | 10 | $2,630 | $34.2K |
| 45385 | 4 | 150 | 80 | $250 | $29.6K |
Showing 1–10 of 34
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 |
|---|---|---|---|---|
| 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… | 30 | $0 | $0 |
| J3010 | Injection, fentanyl citrate, 0.1 mg | 120 | $0 | $0 |
| L8699 | Prosthetic implant, not otherwise specified | 10 | $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 |
|---|---|---|---|---|---|---|
| J3010 | Injection, fentanyl citrate, 0.1 mg | 24 | 40 | 140 | $1 | $760 |
| L8699 | Prosthetic implant, not otherwise specified | 8 | 10 | 120 | $1 | $1 |
| 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… | 9 | 10 | 50 | $0 | $0 |
Other providers in the same ZIP code as Tri-state Surgery Center, L.L.C., ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Unified Therapy Services, Inc | IA | Physical Therapist | $0 | $11.1M |
| Medical Associates Clinic P C | IA | Multi-Specialty Clinic/Center | $0 | $6.4M |
| Peckosh Pediatric Dentistry, P.C. | IA | Dentist | $0 | $1.4M |
| Steven Leifker | IA | Pediatric Dentistry | $0 | $1.3M |
| Hills And Dales Child Development Center | IA | Behavior Analyst | $0 | $1.2M |
| Justin Risma | IA | Ophthalmology Physician | $377.5K | $0 |
| Juan Nieto | IA | Ophthalmology Physician | $279.9K | $0 |
| George Isaac | IA | Specialist | $251K | $0 |
| Jennifer Schope | IA | Dermatology Physician | $232.8K | $0 |
| Hy-vee Inc | IA | Community/Retail Pharmacy | $192.2K | $10.4K |
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