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NPI 1275629081 · Bangor, ME · Ambulatory Surgical Clinic/Center
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Vision Care Of Maine LLC is a ambulatory surgical clinic/center provider located in Bangor, Maine. This profile covers 8 Medicare and 5 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 | Vision Care Of Maine LLC |
| Address | 1 Ridgewood Dr |
| City | Bangor |
| State | ME |
| ZIP | 04401 |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| NPI Enumerated | October 5, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $481.2K |
| Medicare | $362.1K |
Business/service-line profile: VISION CARE OF MAINE LLC is operating as an ambulatory surgical clinic/center with a procedure mix dominated by cataract and intraocular lens work, led by CPT 66984 and 66991 and supported by laser capsulotomy code 66821. The Medicare top codes (66984, 66991, 66821) and the Medicaid billing concentrated in 66984 point to a surgical ophthalmology focus—primarily cataract extraction with lens implantation and follow-up laser procedures—consistent with an ASCs service line rather than broad multispecialty outpatient care.
Medicare revenue concentration: The provider reports Total Medicare revenue of $362.1K, with the precomputed top three Medicare codes accounting for 85.8% of that Medicare revenue. In particular, 66984 generates $211.1K (58.3% of Medicare revenue) and 66991 contributes $78.2K (21.6%), indicating that a small set of surgical ophthalmology codes drive the bulk of Medicare payments.
Medicaid revenue concentration and single-service footprint: Total Medicaid revenue is $481.2K and is almost entirely driven by a single procedure mix—the precomputed top three Medicaid codes account for 100.0% of Medicaid revenue, while 66984 alone represents $475.1K (98.6%). This indicates an effectively single-service Medicaid footprint dominated by cataract surgery billing rather than a diversified set of outpatient services.
Payer mix and scale: The practice’s Medicaid revenue ($481.2K) modestly exceeds its Medicare revenue ($362.1K), so it is not single-payer but has a heavier Medicaid dollar volume. Medicaid work appears particularly volume-driven (1.3K claims for 66984) versus Medicare cataract volume (261 claims for 66984), suggesting payer-specific volume dynamics and patient-mix differences.
Competitive standing — Medicare: For its largest Medicare code 66984 the provider ranks #4445 of 15965 nationally at the 72th percentile with a characterization of "typical, unremarkable volume," and 66991 ranks at the 59th percentile nationally. Those placements indicate the provider is a modest, typical participant in national Medicare cataract surgery markets rather than a dominant national center for these procedures.
Competitive standing — Medicaid (in-state): In Medicaid cataract volume the provider is comparatively stronger in-state: 66984 ranks #5 of 26 providers in Maine at the 84th percentile, indicating a leading regional position for Medicaid cataract procedures. However, other Medicaid codes (66821, J2403) show minimal revenue and rank low in-state (#3 of 3, 0th percentile), reinforcing that the provider’s Medicaid presence is concentrated on one high-volume procedure.
Operational nuance and procedure mix breadth: Beyond cataract extraction and lens insertion, the Medicare CPT list includes glaucoma-related and laser procedures such as 66174 and 66821, showing the center performs some drainage and posterior capsule management work; those codes, however, represent much smaller shares of Medicare revenue (66174 $19.7K, 66821 $21.4K). This suggests ancillary ophthalmic services are offered to support the core cataract surgery line but are not primary revenue drivers.
Tenure and administrative coding notes: The NPI was enumerated on 2006-10-05 (~20 years ago), indicating long-standing operation in the market. Administrative/quality codes G8918 and G8907 appear with 446 claims each and $0 revenue on the Medicaid side, signaling routine capture of non-reimbursed quality or reporting codes alongside paid surgical claims rather than additional revenue sources.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
8 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… | 260 | $810 | $211.1K |
| 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… | 40 | $2,240 | $78.2K |
| 66821 | The provider removes the haziness from the capsule of the eye using a laser for a patient with a secondary membranous cataract. | 110 | $200 | $21.4K |
| 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 | $900 | $19.7K |
| 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… | 20 | $820 | $15.6K |
| 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. | 20 | $770 | $11.6K |
| 67210 | The provider destroys a lesion of the retina using a laser beam that heats up the tissue. | 20 | $200 | $3.2K |
| 67145 | The provider prevents the detachment of the retina in the presence of small tears or thinning of the edges (lattice degeneration) by applying an intense light (such as a laser) to create scar tissue… | 10 | $100 | $1.4K |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 8 CPT/HCPCS codes.
View: State1 / 2
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.
5 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… | 1,280 | $370 | $475.1K |
| 66821 | The provider removes the haziness from the capsule of the eye using a laser for a patient with a secondary membranous cataract. | 60 | $70 | $4.1K |
| J2403 | Chloroprocaine hcl ophthalmic, 3% gel, 1 mg | 30 | $80 | $2.4K |
| 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… | 450 | $0 | $0 |
| G8918 | Patient without preoperative order for iv antibiotic surgical site infection (ssi) prophylaxis | 450 | $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
5 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… | 5 | 30 | 220 | $280 | $186.7K |
| 66821 | The provider removes the haziness from the capsule of the eye using a laser for a patient with a secondary membranous cataract. | 3 | 10 | 100 | $80 | $21.8K |
| J2403 | Chloroprocaine hcl ophthalmic, 3% gel, 1 mg | 3 | 10 | 150 | $30 | $5.7K |
| 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… | 6 | 10 | 270 | $1 | $1 |
| G8918 | Patient without preoperative order for iv antibiotic surgical site infection (ssi) prophylaxis | 4 | 10 | 260 | $0 | $0 |
Other providers in the same ZIP code as Vision Care Of Maine LLC, ranked by combined Medicare and Medicaid revenue.
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