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NPI 1306079330 · Richmond, IN · Ambulatory Surgical Clinic/Center
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Whitewater Surgery Center LLC is a ambulatory surgical clinic/center provider located in Richmond, Indiana. This profile covers 14 Medicare and 6 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 | Whitewater Surgery Center LLC |
| Address | 1900 Chester Blvd |
| City | Richmond |
| State | IN |
| ZIP | 47374 |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| NPI Enumerated | August 25, 2009 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $2M |
| Medicaid | $194.8K |
Clinical focus and service mix: WHITEWATER SURGERY CENTER LLC operates as an Ambulatory Surgical Clinic/Center with a clear ophthalmology and cataract surgery orientation — its Medicare top codes are dominated by 66984, J1097, and 66982, and Medicaid billing is likewise concentrated on 66984 and related ophthalmic laser codes. The presence of J1097 (ophthalmic irrigation solution) as a top Medicare revenue code alongside high-volume intraocular lens implantation (66984, 66982) indicates routine cataract procedures with associated supply/drug billing. This code mix is consistent with a dedicated cataract/ophthalmic ambulatory surgery practice rather than a multi-specialty ASC.
Revenue concentration by payer: Medicare revenue is concentrated in a very small set of procedures — the precomputed top 3 Medicare codes account for 87.5% of this provider's total Medicare revenue. The Medicaid portfolio is even more concentrated, with the precomputed top 3 Medicaid codes accounting for 98.5% of the provider's total Medicaid revenue. These figures show the business is highly dependent on a narrow set of ophthalmic procedures for both payers.
Payer mix and scale: The provider’s Medicare revenue ($2M) is an order of magnitude larger than its Medicaid revenue ($194.8K), indicating Medicare is the dominant commercial driver for this facility and the center is effectively Medicare-focused in scale. Operational and reimbursement sensitivity will therefore be driven primarily by Medicare payment policy and utilization trends in cataract-related codes.
Medicare competitive standing by code: The single largest Medicare contributor is 66984 ($1.3M, 62.5% of Medicare revenue) where the provider ranks #1479 of 15965 nationally (91th percentile), a solid but not unusual national position that reflects substantial volume without being an extreme outlier. J1097 ($364.6K, 18.2%) ranks #45 of 443 (90th percentile), supporting unusually concentrated billing for ophthalmic irrigation in the provider’s peer group, while 66982 ($134.6K, 6.7%) ranks #140 of 4580 (97th percentile), indicating this center performs complex lens-implant cases at a notably high national percentile for that procedure. Additionally, 66821 is noted as "notably above typical national volume" (rank #177 of 10087, 98th percentile), suggesting elevated use of laser capsulotomy in its Medicare mix.
Medicaid competitive standing and state-level outliers: On Medicaid the vast majority of revenue comes from 66984 ($184.9K, 95.1% of Medicaid revenue) where the provider ranks #20 of 62 in-state (69th percentile), indicating solid in-state activity for standard cataract extraction with lens insertion. 66982 appears as #1 of 2 in-state (100th percentile) but contributes a small share of Medicaid dollars ($2.9K, 1.5%), so while the rank is high it represents a limited Medicaid volume. Notably, G8918 is reported as an "extreme outlier, far above typical state volume" (1.9K claims, $0), and G8907 is also unusually frequent in-state; these zero-paid codes are process/quality-related indicators rather than revenue drivers but are statistically notable at the state level.
Operational and margin implications: High reliance on 66984 and the prominent presence of J1097 imply a business model centered on high-volume cataract cases with significant consumable/supply billing (ophthalmic irrigation and injected medications). Given the Medicare-heavy payer mix ($2M vs $194.8K Medicaid) and concentration in a few codes (87.5% Medicare top-3; 98.5% Medicaid top-3), reimbursement changes to those specific codes or to billed supplies could materially affect overall revenue and margins.
Documentation and process signal from Medicaid zero-paid codes: The Medicaid dataset shows 1.9K claims for both G8907 and G8918 with $0 average paid and G8918 explicitly labeled an "extreme outlier, far above typical state volume." While these codes do not contribute revenue, their high frequency is a distinct operational signal and may reflect local documentation, quality reporting, or billing-practice patterns that differ from peers and warrant a focused review by analysts.
Tenure and market position: The provider's NPI was enumerated on 2009-08-25 (~17 years ago), indicating an established ambulatory surgery operation in Richmond, IN. Combined with the revenue scale ($2M Medicare) and concentrated ophthalmic case mix, this tenure supports characterization as a longstanding, specialty-focused ASC with notable cataract surgery throughput in its market.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
14 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… | 1,510 | $830 | $1.3M |
| J1097 | phenylephrine 10.16 mg/ml and ketorolac 2.88 mg/ml ophthalmic irrigation solution, 1 ml | 4,800 | $80 | $364.6K |
| 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… | 160 | $830 | $134.6K |
| 66821 | The provider removes the haziness from the capsule of the eye using a laser for a patient with a secondary membranous cataract. | 580 | $210 | $122K |
| 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. | 40 | $1,150 | $40.2K |
| 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… | 30 | $680 | $20.4K |
| 67908 | The provider performs a procedure such as the Fasanella–Servat procedure, which involves resection and plication of the levator/Muller muscles along with the tarsus and the conjunctiva to treat… | 20 | $690 | $14.4K |
| 14060 | The provider replaces the lesions in the eyelids, nose, ears, or lips, with the healthy tissues from an adjacent site. This code represents a defect of 10 cm2 or less. | 20 | $580 | $13.4K |
| 67917 | During this procedure, the provider performs an extensive repair of an ectropion, which is an outward turning of the lower eyelid and eyelashes, which can lead to excessive tearing and irritation of… | 20 | $670 | $11.4K |
| 67228 | In retinopathy, tiny new vessels grow profusely and fibrous tissue proliferates in between the layers of the retina, which may extend into the optic nerve and vitreous, clear gel that fills the space… | 80 | $140 | $10.9K |
Showing 1–10 of 14
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 14 CPT/HCPCS codes.
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Full comparison — all codes billed, vs. state median
14 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| J1097 | 1 | 10 | 1,890 | $80 | $180.2K |
| 66984 | 11 | 450 | 50 | $480 | $87.5K |
| 65820 | 14 | 30 | 30 | $840 | $38.6K |
| 66982 | 3 | 120 | 30 | $600 | $29.4K |
| 15823 | 10 | 20 | 30 | $540 | $28.3K |
| 66821 | 7 | 240 | 60 | $200 | $23.1K |
| 67908 | 5 | 10 | 30 | $500 | $17.5K |
| 14060 | 25 | 50 | 20 | $510 | $15.9K |
| 67917 | 10 | 10 | 20 | $400 | $15.8K |
| 67228 | 3 | 20 | 30 | $230 | $9.8K |
Showing 1–10 of 14
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.
6 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… | 860 | $210 | $184.9K |
| 66821 | The provider removes the haziness from the capsule of the eye using a laser for a patient with a secondary membranous cataract. | 80 | $50 | $3.8K |
| 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 | $190 | $2.9K |
| 67228 | In retinopathy, tiny new vessels grow profusely and fibrous tissue proliferates in between the layers of the retina, which may extend into the optic nerve and vitreous, clear gel that fills the space… | 20 | $190 | $2.9K |
| 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… | 1,880 | $0 | $0 |
| G8918 | Patient without preoperative order for iv antibiotic surgical site infection (ssi) prophylaxis | 1,870 | $0 | $0 |
How this provider's Medicaid billing volume and revenue compare to other Indiana providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Indiana median
6 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… | 20 | 60 | 350 | $270 | $229.7K |
| 67228 | In retinopathy, tiny new vessels grow profusely and fibrous tissue proliferates in between the layers of the retina, which may extend into the optic nerve and vitreous, clear gel that fills the space… | 6 | 10 | 20 | $280 | $67.2K |
| 66821 | The provider removes the haziness from the capsule of the eye using a laser for a patient with a secondary membranous cataract. | 12 | 20 | 80 | $90 | $23K |
| 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… | 1 | 10 | 10 | $170 | $2.3K |
| 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… | 3 | 70 | 320 | $0 | $0 |
| G8918 | Patient without preoperative order for iv antibiotic surgical site infection (ssi) prophylaxis | 1 | 40 | 240 | $0 | $0 |
Other providers in the same ZIP code as Whitewater Surgery Center LLC, ranked by combined Medicare and Medicaid revenue.
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