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NPI 1306877261 · Gadsden, AL · Ambulatory Surgical Clinic/Center
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Northeast Alabama Eye Surgery Center is a ambulatory surgical clinic/center provider located in Gadsden, Alabama. This profile covers 7 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 | Northeast Alabama Eye Surgery Center |
| Address | 314 S 5th St |
| City | Gadsden |
| State | AL |
| ZIP | 35901 |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| NPI Enumerated | July 6, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $1.3M |
| Medicaid | $6.4K |
This facility is Medicare-dominant: reported total Medicare revenue of $1.3M versus total Medicaid revenue of $6.4K, making Medicaid de minimis in scale relative to Medicare for this provider. The Medicaid book of business is effectively negligible compared with Medicare, so payer-focused analyses should treat this as a primarily Medicare outpatient surgery center.
Medicare revenue is highly concentrated in a trio of ophthalmology-related items: the top three Medicare codes (66984, J1096, J1097) account for 85.7% of this provider's total Medicare revenue. Individually, 66984 generated $708.8K (52.9%), J1096 generated $249.6K (18.6%), and J1097 generated $189.9K (14.2%), indicating that cataract surgery and associated intraoperative ophthalmic drugs drive the bulk of Medicare receipts.
The code mix aligns with an ambulatory ophthalmic surgical model: as an Ambulatory Surgical Clinic/Center, the provider bills high volumes of cataract extraction with intraocular lens procedures (66984) alongside intraoperative ophthalmic inserts and irrigation drugs (J1096, J1097). This combination of surgical CPT and injectable/implantable ophthalmic products is typical for an outpatient cataract surgery center that routinely uses adjunct pharmacologic products during procedures.
National competitive standing on Medicare shows a solid but not outsized footprint for core cataract services: 66984 ranks #1969 of 15965 providers nationally (88th percentile; typical, unremarkable volume), while the ophthalmic insert J1096 ranks #33 of 282 providers nationally (89th percentile; typical, unremarkable volume) and the irrigation solution J1097 ranks #120 of 443 providers nationally (typical, unremarkable volume). The provider also posts a high relative position on laser capsulotomy (66821 ranked #308 of 10087, 97th percentile), suggesting above-average use of that follow-up procedure among peers.
On Medicaid the picture is concentrated and regionally prominent: Medicaid revenue is entirely attributable to 66984 (912 claims, $7 avg paid/claim, $6.4K revenue) and that code ranks #1 of 25 providers in-state (100th percentile; notably above typical state volume). Despite the low absolute Medicaid dollars, the provider is the top in-state reporter of Medicaid 66984 volume, implying a unique local role in delivering Medicaid-covered cataract procedures even though reimbursement per claim is very low.
Several Medicaid-listed codes show reported claims with $0 average paid/claim (G8907, G8918, C9447), which indicates the provider is recording certain administrative or quality-related codes in Medicaid billing without associated paid revenue. Analysts should treat those zero-paid entries as non-revenue operational reporting rather than as material contributors to Medicaid cashflow.
The provider has long tenure in the Medicare/Medicaid ecosystem, with an NPI enumerated on 2006-07-06 (~20 years ago). This long-standing enrollment supports interpretation of observed patterns as established practice behavior rather than a brief or transient billing profile.
The prominent revenue contribution from intraoperative drug codes (J1096 and J1097) alongside 66984 suggests that pharmacologic adjuncts are a consistent part of the clinical workflow and billing mix. Given that J1096 and J1097 together are two of the three codes driving 85.7% of Medicare revenue, payers and competitive analysts should consider both surgical volume and drug utilization when modeling reimbursement, supply procurement, or local market share for outpatient cataract care.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
7 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… | 1,000 | $710 | $708.8K |
| J1096 | Dexamethasone, lacrimal ophthalmic insert, 0.1 mg | 2,520 | $100 | $249.6K |
| J1097 | phenylephrine 10.16 mg/ml and ketorolac 2.88 mg/ml ophthalmic irrigation solution, 1 ml | 2,500 | $80 | $189.9K |
| 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… | 50 | $2,080 | $108K |
| 66821 | The provider removes the haziness from the capsule of the eye using a laser for a patient with a secondary membranous cataract. | 390 | $160 | $63.5K |
| 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… | 30 | $730 | $18.1K |
| J9035 | Injection, bevacizumab, 10 mg | 40 | $60 | $2K |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 7 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.
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… | 910 | $10 | $6.4K |
| C9447 | Injection, phenylephrine and ketorolac, 4 ml vial | 80 | $0 | $0 |
| 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… | 610 | $0 | $0 |
| G8918 | Patient without preoperative order for iv antibiotic surgical site infection (ssi) prophylaxis | 610 | $0 | $0 |
How this provider's Medicaid billing volume and revenue compare to other Alabama providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Alabama 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… | 1 | 30 | 70 | $60 | $10.2K |
| C9447 | Injection, phenylephrine and ketorolac, 4 ml vial | 3 | 10 | 130 | $0 | $0 |
| 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… | 4 | 30 | 220 | $0 | $0 |
| G8918 | Patient without preoperative order for iv antibiotic surgical site infection (ssi) prophylaxis | 4 | 20 | 150 | $0 | $0 |
Other providers in the same ZIP code as Northeast Alabama Eye Surgery Center, ranked by combined Medicare and Medicaid revenue.
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