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NPI 1285251132 · Bozeman, MT · Ambulatory Surgical Clinic/Center
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West Bozeman Surgery Center, LLC is a ambulatory surgical clinic/center provider located in Bozeman, Montana. This profile covers 21 Medicare and 4 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 | West Bozeman Surgery Center, LLC |
| Address | 875 S Cottonwood Rd |
| City | Bozeman |
| State | MT |
| ZIP | 59718 |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| NPI Enumerated | June 26, 2020 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $1.9M |
| Medicaid | $55K |
Business mix: As an Ambulatory Surgical Clinic/Center, the facility’s Medicare billing is dominated by ophthalmic surgery and endoscopy. The single largest Medicare code is 66984 (cataract extraction with lens insertion) at $1M revenue (56.2% of Medicare revenue), and other high-value Medicare lines include colonoscopy with polypectomy (45385) and intraocular lens-plus-drainage procedures (66991), indicating the ASC operates as a mixed ophthalmology and GI procedure center. Medicaid billing similarly concentrates on endoscopy/biopsy (43239) and colonoscopy with biopsy (45380), showing the same service lines operate across payers.
Revenue concentration: Revenue is heavily concentrated in a few codes for both payers. The top three Medicare codes (66984, 45385, 66991) account for 71.7% of the provider’s total Medicare revenue, while the top three Medicaid codes (43239, 45380, 66984) account for 89.7% of total Medicaid revenue, signaling material reliance on a small set of high-yield procedures.
Payer mix and scale: The provider is effectively Medicare-dominant on scale, reporting $1.9M in total Medicare revenue versus $55K in total Medicaid revenue; Medicaid represents only a small share of lifetime reported public-payer revenue. This makes the center heavily dependent on Medicare volume and reimbursement patterns for financial performance and capacity planning.
Top-code competitive standing (Medicare): The facility’s leading Medicare procedure 66984 is sizable at $1M (56.2% of Medicare revenue) and the provider ranks #1629 of 15965 nationally (90th percentile) but the file characterizes that rank as "typical, unremarkable volume." In contrast, the colonoscopy polypectomy code 45385 ($147.6K; 7.9% of Medicare revenue) ranks #524 of 16310 (97th percentile) and is described as "notably above typical national volume," identifying colonoscopy polypectomy as a relative area of above‑average activity compared with national peers.
Top-code competitive standing (Medicaid): Medicaid activity is concentrated in upper endoscopy biopsies (43239, $27.1K; 49.3% of Medicaid revenue) and colonoscopy biopsies (45380, $13.7K; 25.0% of Medicaid revenue). Both Medicaid codes are described as "typical, unremarkable volume" within the state (43239 ranks #22 of 29, 25th percentile; 45380 ranks #19 of 24, 22th percentile), indicating the center is not a dominant in-state provider for these Medicaid services.
Ancillary ophthalmology services and tissue handling: Medicare billing includes material revenue for corneal tissue processing (V2785, $77.4K; 4.2% of Medicare revenue) and corneal transplant (65756, $26.9K; 1.4% of Medicare revenue), suggesting the center handles both surgical ophthalmology and corneal tissue workflows rather than only routine cataract cases. The presence of codes for corneal processing and transplants implies capabilities or partnerships for ocular tissue handling that supplement cataract and anterior-segment surgery volumes.
Service breadth beyond ophthalmology: Beyond eye care, the provider bills a range of GI and ENT procedure codes (45385, 45380, 43239, 43248, 43249, 30140) as well as reconstructive eyelid procedures (15823, 15822, 67900), indicating a multi-specialty ASC model serving ophthalmology, gastroenterology, and some ENT/plastic procedures. This mix of high-value ophthalmic procedures plus steady endoscopy throughput explains the concentrated revenue profile and may reflect scheduling and equipment optimization around these specialties.
Tenure and operational vintage: The NPI was enumerated on 2020-06-26 (~6 years ago), so the center is a relatively recent entrant compared with long-established ASCs. Given the concentrated revenue pattern and the strong Medicare scale ($1.9M), the facility appears to have rapidly established a focused surgical mix since enumeration.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
21 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… | 1,350 | $780 | $1M |
| 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… | 350 | $420 | $147.6K |
| 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… | 60 | $2,360 | $141.4K |
| V2785 | Processing, preserving and transporting corneal tissue | 20 | $4,070 | $77.4K |
| 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… | 240 | $320 | $76K |
| 15823 | In this procedure, the provider surgically trims excessive skin that weighs down the upper eyelid, typically to improve the cosmetic appearance of the face and due to the interference of the tissue… | 140 | $440 | $61.5K |
| 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… | 70 | $760 | $52.7K |
| 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. | 180 | $220 | $38.4K |
| 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. | 30 | $1,340 | $33.5K |
| G0121 | Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk | 90 | $390 | $33.5K |
Showing 1–10 of 21
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 21 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
21 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| 66991 | 6 | 10 | 50 | $1,370 | $79.5K |
| 66984 | 3 | 120 | 50 | $490 | $78.1K |
| V2785 | 2 | 10 | 20 | $3,600 | $71.9K |
| 66982 | 5 | 30 | 30 | $600 | $29.6K |
| 45385 | 2 | 40 | 100 | $240 | $27.4K |
| 65820 | 1 | 10 | 30 | $990 | $24.7K |
| 15823 | 1 | 10 | 30 | $510 | $23.6K |
| 65756 | 3 | 10 | 20 | $1,180 | $22.3K |
| 15822 | 1 | 10 | 50 | $440 | $22.1K |
| 45380 | 3 | 40 | 70 | $160 | $16.2K |
Showing 1–10 of 21
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.
4 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 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. | 110 | $250 | $27.1K |
| 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… | 40 | $340 | $13.7K |
| 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… | 20 | $470 | $8.5K |
| 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… | 10 | $470 | $5.6K |
How this provider's Medicaid billing volume and revenue compare to other Montana providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Montana median
4 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… | 10 | 10 | 210 | $270 | $90.8K |
| 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. | 22 | 30 | 470 | $80 | $64.1K |
| 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… | 19 | 20 | 120 | $70 | $24.9K |
| 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… | 19 | 20 | 130 | $40 | $10K |
Other providers in the same ZIP code as West Bozeman Surgery Center, LLC, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Wojj Pediatric Dentistry | MT | Dental Clinic/Center | $0 | $3.3M |
| Smiles Across Montana | MT | Dental Hygienist | $0 | $1.9M |
| Psychiatry Associates PC | MT | Psychiatry Physician | $0 | $1.4M |
| Marc Comaratta | MT | Retina Specialist (Ophthalmology) Physician | $1.2M | $124.7K |
| Foundation Therapy Services Inc | MT | Speech-Language Pathologist | $0 | $1.1M |
| Lincare Inc. | MT | Durable Medical Equipment & Medical Supplies | $0 | $1M |
| Montana Psychiatry, PLLC | MT | Psychiatry Physician | $0 | $1M |
| Kenneth Olson | MT | Addiction Psychiatry Physician | $29.3K | $809.9K |
| Aaron Bruce | MT | Dermatology Physician | $682.7K | $0 |
| Russell Swan | MT | Ophthalmology Physician | $560K | $0 |
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