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NPI 1336144617 · Rock Springs, WY · Ambulatory Surgical Clinic/Center
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Sweetwater Surgery Center LLC is a ambulatory surgical clinic/center provider located in Rock Springs, Wyoming. This profile covers 13 Medicare and 2 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 | Sweetwater Surgery Center LLC |
| Address | 2761 Commercial Way |
| City | Rock Springs |
| State | WY |
| ZIP | 82901 |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| NPI Enumerated | June 14, 2005 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $494.4K |
| Medicaid | $212.1K |
The provider’s code mix is consistent with its Ambulatory Surgical Clinic/Center taxonomy: high-volume ophthalmologic procedures (66984, 66982, 66821, 65820), GI endoscopy and colorectal screening (45380, 43239, G0121, 43249, 45385), and some ENT/otologic work (30930, 69436). Medicaid billing is concentrated in a large unspecified dental/procedural category (41899) and tympanostomy (69436), suggesting the center also bills for cases requiring general anesthesia or OR-level dental procedures under Medicaid. This mix indicates a multi-specialty ASC model centered on cataract surgery and endoscopy with episodic ENT and dental-related cases.
Medicare revenue is concentrated: the precomputed top-3 Medicare codes account for 57.3% of this provider’s total Medicare revenue, driven primarily by 66984 ($181.5K, 36.7% of Medicare revenue), 45380 ($54.6K, 11.0%), and 43239 ($47.4K, 9.6%). This concentration shows that a small number of surgical and endoscopic procedures generate the majority of Medicare payments to the facility, which has implications for revenue risk if volume shifts in those service lines.
Medicaid revenue is highly concentrated: the precomputed top-3 Medicaid codes account for 100.0% of this provider’s total Medicaid revenue, with 41899 responsible for $183.1K (86.4% of Medicaid revenue) and 69436 contributing $28.9K (13.6%). In practical terms, Medicaid payments to the center are dominated by a single unspecified dental/procedural code and tympanostomy services, indicating a narrow set of Medicaid-funded activities.
Payer mix shows Medicare scale exceeds Medicaid: the provider reports $494.4K in total Medicare revenue versus $212.1K in total Medicaid revenue. Medicare is the larger revenue stream for this entity, though Medicaid still represents a meaningful secondary payer line that is focused on a small number of high-dollar codes.
Competitive standing on Medicare is mixed: the center ranks highly on several GI and screening codes—G0121 ranks #251 of 7750 (97th percentile; notably above typical national volume) and 43239 ranks #1036 of 17140 (94th percentile; typical, unremarkable volume)—while its cataract surgery code 66984 ranks #4903 of 15965 (69th percentile; typical, unremarkable volume). This pattern indicates pockets of above-typical national activity in colorectal screening and upper endoscopy, but no uniform dominance across its major Medicare procedures.
Competitive standing on Medicaid is modest within-state: 41899 ranks #4 of 8 in-state (57th percentile; typical, unremarkable volume) and 69436 ranks #2 of 3 in-state (50th percentile; typical, unremarkable volume). These placements suggest the center is a modest participant in the state Medicaid market for its top Medicaid procedures rather than a leading statewide provider.
Operational longevity is established: the NPI was enumerated on 2005-06-14 (~21 years ago), indicating the center has been on file for two decades. This tenure supports the likelihood of established referral relationships and operational stability relevant to network and contracting discussions.
Most high-revenue codes are described as typical or unremarkable in national comparisons, with the notable exception of G0121 which is explicitly described as notably above typical national volume. Other top codes such as 66984 (69th percentile; typical, unremarkable volume), 45380 (89th percentile; typical, unremarkable volume), and 43239 (94th percentile; typical, unremarkable volume) show that while some specific screening and endoscopy services are relatively concentrated, overall utilization sits within the expected national range for an ASC of this profile.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
13 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… | 230 | $790 | $181.5K |
| 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… | 150 | $360 | $54.6K |
| 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. | 250 | $190 | $47.4K |
| G0121 | Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk | 110 | $390 | $43.1K |
| 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 | $1,490 | $35.8K |
| 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… | 40 | $830 | $34.6K |
| 43249 | The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum and dilates (widens) the esophagus with a balloon less than 30 mm in diameter. | 50 | $560 | $29.1K |
| 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… | 60 | $410 | $23.8K |
| 66821 | The provider removes the haziness from the capsule of the eye using a laser for a patient with a secondary membranous cataract. | 60 | $200 | $10.9K |
| 30930 | In this procedure, the provider fractures one or more inferior turbinates to correct the overgrowth of the inferior turbinates and release the nasal airway obstruction. | 20 | $650 | $10.5K |
Showing 1–10 of 13
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 13 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
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.
2 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 41899 | Use this code to report a procedure on the teeth and adjoining alveolar structures for which there is no specific code available. | 130 | $1,400 | $183.1K |
| 69436 | This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia. | 70 | $430 | $28.9K |
How this provider's Medicaid billing volume and revenue compare to other Wyoming providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Wyoming median
2 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 41899 | Use this code to report a procedure on the teeth and adjoining alveolar structures for which there is no specific code available. | 4 | 10 | 110 | $1,770 | $828.4K |
| 69436 | This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia. | 2 | 10 | 70 | $110 | $42.8K |
Other providers in the same ZIP code as Sweetwater Surgery Center LLC, ranked by combined Medicare and Medicaid revenue.
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