Loading...
NPI 1346331329 · Charleston, SC · Ambulatory Surgical Clinic/Center
Customize your policy alerts
Get alerted when relevant policies change without checking for updates manually.
Monitor payer policy activity
Physicians Eye Surgery Center LLC is a ambulatory surgical clinic/center provider located in Charleston, South Carolina. This profile covers 25 Medicare and 1 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 | Physicians Eye Surgery Center LLC |
| Address | 2060 Charlie Hall Blvd |
| City | Charleston |
| State | SC |
| ZIP | 29414 |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| NPI Enumerated | September 27, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $3.9M |
| Medicaid | $70.1K |
This entity operates as an ophthalmic ambulatory surgical center: the Medicare code mix is dominated by cataract and intraocular procedures (notably 66984, 66821 and J1097) and includes a high volume of oculoplastic and retina/vitreous procedures, which is consistent with the listed taxonomy of Ambulatory Surgical Clinic/Center. The top Medicare procedure 66984 alone represents a major production line with 2.8K Medicare claims and $2.2M in revenue, and multiple other high-revenue codes are specific to eye surgery rather than general surgery or internal medicine.
Revenue concentration on Medicare is high: the precomputed top 3 Medicare codes account for 68.3% of this provider's total Medicare revenue, with 66984 at 56.7%, J1097 at 6.1%, and 66821 at 5.5%. On Medicaid the provider is effectively single-procedure driven—precomputed data show the top 3 Medicaid codes account for 100.0% of Medicaid revenue, and Medicaid revenue is entirely from 66984 (836 claims, $70.2K revenue).
Payer mix is heavily Medicare-weighted: the provider reports $3.9M in total Medicare revenue versus $70.1K in total Medicaid revenue, indicating Medicare is the dominant payer by scale for this ASC and Medicaid represents a very small share of overall billing. Given that Medicaid revenue is concentrated entirely in 66984, the center’s public-payer exposure is narrowly focused on cataract surgery.
The provider ranks as a high-volume national participant on key ophthalmic codes. 66984 ranks #580 of 15965 providers nationally (96th percentile; notably above typical national volume for this code), and 66821 ranks #99 of 10087 providers nationally (99th percentile; extreme outlier), showing national-level scale for cataract-related procedures and YAG capsulotomy.
Several oculoplastic and eyelid repair codes are extreme outliers relative to national peers: 15823 (upper eyelid skin trimming) ranks #7 of 1718 providers nationally (100th percentile; extreme outlier) and 67904 (levator tightening) ranks #4 of 991 providers nationally (100th percentile; extreme outlier). These rankings indicate the center performs eyelid/plastic procedures at volumes far above typical national practice patterns, which suggests a meaningful cosmetic/functional eyelid surgery component to its case mix.
The center also shows notably above-typical volume for multiple subspecialty ophthalmic procedures: 65820 (glaucoma-related drainage incision) ranks #24 of 1249 (98th percentile; notably above typical), and vitreoretinal procedures such as 67042 and 67036 rank in the 97th percentile range (29 of 1087 and 27 of 832, respectively; both noted as notably above typical national volume). This mix demonstrates the ASC manages a broad ophthalmic scope beyond routine cataract extraction, including glaucoma and retina surgery.
State-level Medicaid competitive standing for cataract is solid but not dominant: Medicaid 66984 ranks #5 of 39 providers in-state (89th percentile; typical, unremarkable volume for this code), meaning the center is a meaningful Medicaid cataract provider within South Carolina but Medicaid activity remains small in dollar terms. The Medicaid claim count (836) shows the facility bills Medicaid for routine cataract procedures, but the dollar impact is limited compared with Medicare.
The practice is long-tenured in federal enrollment, which supports an established outpatient surgical presence: the NPI was enumerated on 2006-09-27 (~20 years ago). Long tenure combined with concentrated high-volume ophthalmic billing suggests an established ASC specializing in eye surgery rather than a recently formed or transient operator.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
25 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… | 2,770 | $800 | $2.2M |
| J1097 | phenylephrine 10.16 mg/ml and ketorolac 2.88 mg/ml ophthalmic irrigation solution, 1 ml | 3,130 | $80 | $237.7K |
| 66821 | The provider removes the haziness from the capsule of the eye using a laser for a patient with a secondary membranous cataract. | 1,050 | $200 | $214.6K |
| 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… | 430 | $480 | $205.3K |
| 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. | 130 | $1,460 | $195.6K |
| 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… | 370 | $510 | $187.4K |
| 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… | 100 | $1,460 | $140.5K |
| 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. | 80 | $1,440 | $113.8K |
| 62323 | The provider injects a diagnostic or a therapeutic substance, such as pain medication or a steroid, into the space around the spinal nerves of the lumbar (lower back) or sacral (caudal, or tailbone)… | 350 | $240 | $84.2K |
| 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… | 100 | $560 | $53.4K |
Showing 1–10 of 25
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 25 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
25 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| J1097 | 4 | 10 | 2,610 | $80 | $208.9K |
| 66984 | 21 | 270 | 210 | $170 | $141.3K |
| 65820 | 1 | 40 | 30 | $980 | $40.4K |
| 67036 | 3 | 20 | 20 | $1,110 | $40.1K |
| 15823 | 1 | 40 | 40 | $520 | $33.1K |
| 64483 | 124 | 130 | 90 | $190 | $33K |
| 67042 | 1 | 30 | 20 | $1,150 | $32.3K |
| 67904 | 1 | 30 | 40 | $550 | $30.3K |
| 62323 | 18 | 130 | 80 | $160 | $28.8K |
| 66821 | 8 | 170 | 70 | $100 | $25.3K |
Showing 1–10 of 25
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.
1 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… | 840 | $80 | $70.2K |
How this provider's Medicaid billing volume and revenue compare to other South Carolina providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. South Carolina median
1 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… | 5 | 40 | 110 | $120 | $48K |
Other providers in the same ZIP code as Physicians Eye Surgery Center LLC, ranked by combined Medicare and Medicaid revenue.
Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.