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NPI 1346220183 · Rapid City, SD · Ambulatory Surgical Clinic/Center
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Black Hills Regional Eye Surgery Center, LLC is a ambulatory surgical clinic/center provider located in Rapid City, South Dakota. This profile covers 27 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 | Black Hills Regional Eye Surgery Center, LLC |
| Address | 2800 3rd St |
| City | Rapid City |
| State | SD |
| ZIP | 57701 |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| NPI Enumerated | January 18, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $2.9M |
| Medicaid | $158.6K |
BLACK HILLS REGIONAL EYE SURGERY CENTER, LLC is structured as an ophthalmic ambulatory surgery center: Medicare top CPT drivers are cataract and intraocular procedures (notably 66984, 66991, 66982) and a mix of vitreoretinal and eyelid procedures, indicating the facility performs high-volume cataract surgery alongside subspecialty anterior and posterior segment operations. The presence of codes such as 67042, 67036, 67108 and 67113 shows concurrent retina/vitreous surgical capability, while eyelid and oculoplastic codes (15823, 67904, 67908) point to a blended ophthalmic surgical practice rather than a single-procedure eye clinic.
Revenue concentration is high on both payers: precomputed Medicare results show the top 3 Medicare codes by revenue account for 69.0% of total Medicare revenue, signaling dependence on a small set of procedures for the majority of Medicare income. Medicaid billing is similarly concentrated: the top 3 Medicaid codes account for 100.0% of this provider's total Medicaid revenue, demonstrating virtually all Medicaid revenue derives from the same narrow procedure set.
Scale and payer mix are skewed strongly toward Medicare: lifetime Medicare revenue is $2.9M versus total Medicaid revenue of $158.6K, indicating Medicare is the dominant payer by a wide margin and the organization operates effectively as a Medicare-focused ambulatory surgery center with limited Medicaid volume. Medicaid presence exists but represents a small fraction of overall lifetime payer receipts.
Competitive standing by code shows both local leadership and typical national volumes: for Medicare cataract code 66984 the provider generates $1.3M (44.8% of its Medicare revenue) and ranks #1375 of 15965 nationally (91st percentile), a typical but solid national footprint for cataract volume. For ophthalmic irrigation J1097 the provider is a national outlier — 6.6K claims, $502.2K (17.3% of Medicare revenue) and ranks #19 of 443 nationally (96th percentile) — suggesting a very high utilization of that supply item relative to peers.
State-level Medicaid standing for core services is strong: Medicaid 66984 has 652 claims and $142.8K (90.1% of Medicaid revenue) and ranks #2 of 8 in-state (86th percentile), indicating the center is one of the leading Medicaid cataract surgeons in South Dakota. J1097 Medicaid activity ranks #1 of 2 in-state (100th percentile), reinforcing unusually high in-state use of that ophthalmic irrigation product in their Medicaid population.
Several individual codes are statistical outliers or notably above typical volume and merit operational attention: Medicare 15823 (upper eyelid skin excision) is labeled an extreme outlier and ranks in the 99th percentile nationally, contributing $132.4K (4.6% of Medicare revenue), which suggests a much higher-than-typical cosmetic/functional blepharoplasty throughput relative to peers. Similarly, Medicare 67908 ranks in the 95th percentile and 66984 ranks highly overall, reinforcing concentrated strengths in eyelid procedures and cataract surgery.
Clinical-service implications from the code mix: the simultaneous high volumes of cataract extraction with intraocular lens placement (66984, 66982) plus affiliated device and glaucoma codes (66183, 66174) suggest the center treats routine cataract patients and also offers glaucoma-related interventions and device placement when indicated. The mix of corneal (65756, V2785), retina (67041, 67042) and reconstructive eyelid codes indicates the facility supports a broad ophthalmology service line capable of handling cornea, retina, glaucoma, and oculoplastics cases.
Tenure and stability: the provider’s NPI was enumerated on 2006-01-18 (~20 years ago), indicating long-standing presence in the market which supports accumulated referral relationships and experienced surgical throughput. This longevity, combined with concentrated revenue drivers, suggests an established surgical practice rather than a recent entrant.
Operational risk/priority areas for payers and analysts: given the high concentration of revenue in a few codes (69.0% of Medicare revenue from top 3 codes; 100.0% of Medicaid revenue from top 3 codes), audits of coding mix and utilization patterns around cataract, irrigation supply usage (J1097), and high-volume eyelid procedures (15823) would be the most efficient way to assess billing consistency and clinical alignment across Medicare and Medicaid populations.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
27 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… | 1,610 | $810 | $1.3M |
| J1097 | phenylephrine 10.16 mg/ml and ketorolac 2.88 mg/ml ophthalmic irrigation solution, 1 ml | 6,610 | $80 | $502.2K |
| 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… | 80 | $2,420 | $198.8K |
| 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… | 270 | $500 | $132.4K |
| 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… | 140 | $790 | $113.1K |
| 67042 | In this procedure, the provider removes vitreous humor, the gelatinous material that gives shape to the eye, using a mechanical cutting tool. He removes the internal limiting membrane of the retina… | 60 | $1,430 | $81.5K |
| 67036 | The provider removes vitreous fluid from the eye to access the posterior segment of the eye and introduce surgical instruments through incisions in the pars plana. | 40 | $1,460 | $62.7K |
| 66821 | The provider removes the haziness from the capsule of the eye using a laser for a patient with a secondary membranous cataract. | 330 | $180 | $58.2K |
| 67904 | The provider repairs a drooping eyelid by tightening the levator muscle that controls eyelid movement to improve cosmetic appearance or remove the obstruction to a patient’s vision. He accesses the… | 110 | $510 | $56.6K |
| 66183 | The provider inserts a small device into the anterior chamber of the eye that helps to reduce the intraocular pressure of the eye in patients with glaucoma. | 30 | $2,060 | $53.5K |
Showing 1–10 of 27
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 27 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
27 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| J1097 | 2 | 10 | 4,710 | $80 | $422.5K |
| V2785 | 3 | 10 | 20 | $3,680 | $180.5K |
| 66991 | 5 | 10 | 70 | $1,370 | $119.4K |
| 66984 | 3 | 130 | 40 | $410 | $67.7K |
| 15823 | 1 | 10 | 50 | $510 | $50.6K |
| 67042 | 1 | 10 | 30 | $1,140 | $38.6K |
| 65756 | 6 | 10 | 20 | $1,070 | $38.6K |
| 66821 | 3 | 30 | 100 | $230 | $35.6K |
| 67041 | 2 | 10 | 30 | $1,190 | $35.6K |
| 67108 | 3 | 10 | 20 | $1,180 | $34.1K |
Showing 1–10 of 27
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… | 650 | $220 | $142.8K |
| J1097 | phenylephrine 10.16 mg/ml and ketorolac 2.88 mg/ml ophthalmic irrigation solution, 1 ml | 280 | $60 | $15.7K |
| 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… | 40 | $0 | $0 |
| G8918 | Patient without preoperative order for iv antibiotic surgical site infection (ssi) prophylaxis | 50 | $0 | $0 |
How this provider's Medicaid billing volume and revenue compare to other South Dakota providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. South Dakota 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… | 2 | 10 | 100 | $250 | $60.9K |
| J1097 | phenylephrine 10.16 mg/ml and ketorolac 2.88 mg/ml ophthalmic irrigation solution, 1 ml | 1 | 10 | 160 | $60 | $8.7K |
| 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… | 2 | 10 | 20 | $0 | $0 |
| G8918 | Patient without preoperative order for iv antibiotic surgical site infection (ssi) prophylaxis | 1 | 10 | 20 | $0 | $0 |
Other providers in the same ZIP code as Black Hills Regional Eye Surgery Center, LLC, ranked by combined Medicare and Medicaid revenue.
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