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NPI 1306260815 · Indianapolis, IN · Ambulatory Surgical Clinic/Center
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Surgery Center Of Eye Specialists Of Indiana, PC is a ambulatory surgical clinic/center provider located in Indianapolis, Indiana. This profile covers 4 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 | Surgery Center Of Eye Specialists Of Indiana, PC |
| Address | 1950 W 86th St |
| City | Indianapolis |
| State | IN |
| ZIP | 46260 |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| NPI Enumerated | February 5, 2014 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $2.6M |
| Medicaid | $439.4K |
This entity operates as an ambulatory surgical clinic/center centered on cataract care: its highest-volume procedures are cataract extraction with intraocular lens insertion and post‑op laser capsulotomy (codes 66984, 66982, 66821), consistent with an ASC focused on high-throughput ophthalmic surgery. The provider’s lifetime Medicare revenue of $2.6M and Medicaid revenue of $439.4K indicate these surgical services are the core business line across both payers.
Medicare revenue is highly concentrated: the precomputed top three Medicare codes (66984, 66821, 66982) account for 97.9% of the provider’s total Medicare revenue. Individually, 66984 generated $2.1M (79.5% of Medicare revenue), 66821 generated $273.4K (10.4%), and 66982 generated $210K (8.0%), underscoring reliance on a narrow set of cataract-related procedures for Medicare income.
Medicaid billing is effectively single-service driven: the precomputed top three Medicaid codes account for 100.0% of Medicaid revenue, with 66984 alone responsible for $435.1K (98.8% of Medicaid revenue). Other Medicaid codes contribute only marginally—66821 accounted for $5.1K (1.2%)—indicating Medicaid activity is almost entirely the same cataract insertion procedure that dominates Medicare.
Payer mix is Medicare-dominant in scale: lifetime Medicare revenue is $2.6M versus Medicaid revenue of $439.4K, so Medicare billing is the primary revenue source while Medicaid represents a smaller, secondary payer pool. This asymmetric payer mix suggests reimbursement and utilization analyses should prioritize Medicare trends when projecting financial or capacity impacts.
On national competitive standing for Medicare cataract services this provider ranks well above typical volume for several codes: 66821 ranks #64 of 10087 providers nationally (99th percentile) and is labeled an extreme outlier for volume, while 66982 ranks #59 of 4580 (99th percentile) and 66984 ranks #682 of 15965 (96th percentile), both described as notably above typical national volume. These rankings position the center as a high-volume national performer for key cataract and capsulotomy procedures, rather than a modest or average operator.
By contrast, the provider’s in-state competitive position on Medicaid is more typical: 66984 ranks #7 of 62 providers in-state (90th percentile) and is described as typical, unremarkable volume for the code at the state level, while 66821 ranks #13 of 20 (37th percentile). This pattern indicates strong Medicare market penetration nationally but only a solid—rather than dominant—footprint in Medicaid cataract care within Indiana.
There are non-revenue encounter/quality codes present in Medicaid reporting that generate no paid dollars: G8918 (25 claims, $0), G8907 (81 claims, $0), and G9390 (20 claims, $0). Their presence in the Medicaid volume mix indicates administrative or quality-event reporting accompanies surgical activity, but these lines do not contribute to billed Medicaid revenue.
The practice has an established operational tenure with NPI enumeration on 2014-02-05 (~12 years ago), suggesting sustained specialty surgery operations over a multi-year period. Combined with concentrated procedure volumes and national percentile rankings, this tenure supports characterization as an experienced, cataract-focused ambulatory surgical center rather than a new or generalist outpatient clinic.
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… | 2,510 | $840 | $2.1M |
| 66821 | The provider removes the haziness from the capsule of the eye using a laser for a patient with a secondary membranous cataract. | 1,380 | $200 | $273.4K |
| 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… | 250 | $840 | $210K |
| 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 | $2,530 | $55.6K |
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.
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… | 2,090 | $210 | $435.1K |
| 66821 | The provider removes the haziness from the capsule of the eye using a laser for a patient with a secondary membranous cataract. | 70 | $70 | $5.1K |
| 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… | 80 | $0 | $0 |
| G8918 | Patient without preoperative order for iv antibiotic surgical site infection (ssi) prophylaxis | 30 | $0 | $0 |
| G9390 | No unplanned rupture of the posterior capsule requiring vitrectomy during cataract surgery | 20 | $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
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… | 7 | 60 | 350 | $270 | $229.7K |
| 66821 | The provider removes the haziness from the capsule of the eye using a laser for a patient with a secondary membranous cataract. | 13 | 20 | 80 | $90 | $23K |
| 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… | 51 | 70 | 320 | $0 | $0 |
| G8918 | Patient without preoperative order for iv antibiotic surgical site infection (ssi) prophylaxis | 39 | 40 | 240 | $0 | $0 |
| G9390 | No unplanned rupture of the posterior capsule requiring vitrectomy during cataract surgery | 2 | 10 | 40 | $0 | $0 |
Other providers in the same ZIP code as Surgery Center Of Eye Specialists Of Indiana, PC, ranked by combined Medicare and Medicaid revenue.
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