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NPI 1346349164 · Dothan, AL · Ambulatory Surgical Clinic/Center
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Southern Alabama Surgery Center LLC is a ambulatory surgical clinic/center provider located in Dothan, Alabama. This profile covers 52 Medicare and 11 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 | Southern Alabama Surgery Center LLC |
| Address | 2800 Ross Clark Cir |
| City | Dothan |
| State | AL |
| ZIP | 36301 |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| NPI Enumerated | September 21, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $3.8M |
| Medicaid | $94.3K |
This facility operates as an ambulatory surgical center with a strong ophthalmology orientation: its largest Medicare revenue drivers are ophthalmic procedures and products such as 66984 (cataract extraction with intraocular lens), J1097 (phenylephrine/ketorolac ophthalmic irrigation), and procedures to address posterior capsular opacification (66821). The high volume of J1097 (7.2K claims) and substantial revenue from 66984 ($1.1M, 29.6% of Medicare revenue) indicate routine, high-throughput eye surgery sessions supported by disposables and intraoperative medications.
Medicare revenue is highly concentrated: the precomputed top-3 Medicare codes by revenue account for 51.2% of this provider’s total Medicare revenue, with the leading contributors being 66984, J1097, and 64590. That concentration implies that fluctuations in ophthalmic surgical volume or drug supply/use for those specific codes would meaningfully affect the provider’s Medicare revenue stream.
On Medicaid the revenue mix is even more concentrated: the precomputed top-3 Medicaid codes account for 82.9% of the provider’s total Medicaid revenue, led by 43239 (60.6% of Medicaid revenue), 00142 (12.9%), and 00731 (9.4%). This pattern shows Medicaid activity is dominated by a single service line (upper endoscopy biopsies under 43239) plus anesthesia-related billing tied to eye procedures, so Medicaid revenue is concentrated in a few procedural and anesthesia codes.
The payer mix is effectively Medicare-driven: total Medicare revenue of $3.8M dwarfs total Medicaid revenue of $94.3K, indicating the center’s financial scale depends primarily on Medicare patients and services. Given that asymmetry, strategic or operational changes that affect Medicare surgical referrals will have a larger financial impact than equivalent changes in Medicaid volume.
Competitive standing is mixed across codes: the provider is a notable national outlier on several ophthalmic items—J1097 ranks #14 of 443 providers nationally (97th percentile; notably above typical national volume) and 66821 ranks in the 99th percentile—while its cataract surgery code 66984 ranks #1472 of 15965 (91st percentile) and is characterized as typical volume for that code. In addition, 15823 (upper eyelid skin trimming) is a pronounced national outlier (rank #25 of 1718, 99th percentile; extreme outlier), suggesting a local specialization or referral draw for blepharoplasty.
Medicaid-level competitive signals include extreme in-state concentration on certain anesthesia and quality/encounter codes: 00142 is ranked #1 of 11 in-state (100th percentile; extreme outlier) for anesthesia tied to eye-lens procedures, while G8907 and G8918 show very high claim counts but $0 revenue and rank #1 in-state (100th percentile; extreme outlier). These zero-dollar, high-volume encounter/quality codes suggest routine reporting of perioperative quality measures and anesthesia claims practices that are unusually voluminous relative to state peers, even though they do not contribute direct revenue.
The provider’s procedure mix extends beyond ophthalmology into neuromodulation and vascular access work: Medicare-paid codes for pulse generator implantation and sacral/spinal electrode placement (64590, 64561, 63650) and dialysis access interventions (36902, 36905) generate meaningful individual payments, although their national percentiles are generally modest to typical. This breadth indicates the ASC offers ancillary pain-management and interventional vascular services in addition to its core eye surgery workload, but those lines are not the primary revenue engines based on listed revenues and percentiles.
The practice has an established presence in the market: the NPI was enumerated on 2006-09-21 (~20 years ago), and the lifetime Medicare revenue of $3.8M combined with recurring, high-volume ophthalmic supply and procedure claims suggests sustained surgical throughput and an entrenched operational footprint in Dothan, AL.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
52 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… | 1,510 | $700 | $1.1M |
| J1097 | phenylephrine 10.16 mg/ml and ketorolac 2.88 mg/ml ophthalmic irrigation solution, 1 ml | 7,180 | $80 | $545.5K |
| 64590 | The provider inserts or replaces a peripheral, sacral, or gastric neurostimulator pulse generator or receiver. The system is one that requires surgical creation of a pocket for placement and that… | 20 | $12,710 | $228.7K |
| J2403 | Chloroprocaine hcl ophthalmic, 3% gel, 1 mg | 208,800 | $1 | $208.8K |
| 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… | 70 | $2,110 | $151.6K |
| 66821 | The provider removes the haziness from the capsule of the eye using a laser for a patient with a secondary membranous cataract. | 820 | $160 | $133.3K |
| 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… | 190 | $690 | $130.8K |
| 36902 | The provider introduces a needle and/or catheter under fluoroscopic guidance (live X–rays that can be viewed on a monitor) and injects contrast material into the dialysis access point to visualize… | 70 | $1,520 | $112.3K |
| 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 | $410 | $108.3K |
| 37229 | N/A | 20 | $7,060 | $106K |
Showing 1–10 of 52
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 52 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
52 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| 64590 | 3 | 10 | 30 | $6,660 | $159.9K |
| J1097 | 1 | 10 | 1,650 | $80 | $158.3K |
| J2403 | 1 | 10 | 208,800 | $1 | $118.9K |
| 37229 | 11 | 10 | 20 | $5,260 | $115.7K |
| V2785 | 1 | 10 | 30 | $3,480 | $87.1K |
| J7351 | 5 | 10 | 220 | $160 | $82.7K |
| 37225 | 16 | 20 | 20 | $3,620 | $75.9K |
| 66991 | 4 | 10 | 40 | $1,250 | $73.9K |
| 66984 | 83 | 280 | 230 | $70 | $65.2K |
| 64561 | 3 | 10 | 30 | $2,060 | $63.9K |
Showing 1–10 of 52
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.
11 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 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. | 440 | $130 | $57.8K |
| 00142 | The provider performs anesthesia services for a patient undergoing an eye lens procedure. | 1,750 | $10 | $12.3K |
| 00731 | The anesthesia provider performs anesthesia services for an unspecified type of upper gastrointestinal endoscopic procedure during which another provider introduces the endoscope to but not beyond… | 350 | $30 | $9K |
| 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… | 640 | $10 | $8.9K |
| 66821 | The provider removes the haziness from the capsule of the eye using a laser for a patient with a secondary membranous cataract. | 60 | $80 | $4.7K |
| J1097 | phenylephrine 10.16 mg/ml and ketorolac 2.88 mg/ml ophthalmic irrigation solution, 1 ml | 350 | $10 | $2.1K |
| 00811 | The provider performs anesthesia services for a patient undergoing an unspecified lower intestinal endoscopic procedure where the surgical provider introduces an endoscope into the intestines up to… | 10 | $20 | $280 |
| 01844 | The provider performs anesthesia services for a patient undergoing a vascular shunt procedure, or shunt revision of any type, such as for dialysis. | 20 | $20 | $270 |
| C9447 | Injection, phenylephrine and ketorolac, 4 ml vial | 260 | $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… | 2,400 | $0 | $0 |
Showing 1–10 of 11
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
11 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 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. | 14 | 60 | 110 | $190 | $74.7K |
| 00731 | The anesthesia provider performs anesthesia services for an unspecified type of upper gastrointestinal endoscopic procedure during which another provider introduces the endoscope to but not beyond… | 8 | 30 | 100 | $50 | $16.9K |
| 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… | 3 | 30 | 70 | $60 | $10.2K |
| 66821 | The provider removes the haziness from the capsule of the eye using a laser for a patient with a secondary membranous cataract. | 1 | 10 | 60 | $80 | $4.7K |
| 00811 | The provider performs anesthesia services for a patient undergoing an unspecified lower intestinal endoscopic procedure where the surgical provider introduces an endoscope into the intestines up to… | 5 | 10 | 90 | $10 | $2.7K |
| 01844 | The provider performs anesthesia services for a patient undergoing a vascular shunt procedure, or shunt revision of any type, such as for dialysis. | 2 | 10 | 150 | $10 | $2.1K |
| J1097 | phenylephrine 10.16 mg/ml and ketorolac 2.88 mg/ml ophthalmic irrigation solution, 1 ml | 1 | 10 | 190 | $10 | $2K |
| 00142 | The provider performs anesthesia services for a patient undergoing an eye lens procedure. | 1 | 10 | 20 | $10 | $1.5K |
| C9447 | Injection, phenylephrine and ketorolac, 4 ml vial | 1 | 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… | 1 | 30 | 220 | $0 | $0 |
Showing 1–10 of 11
Other providers in the same ZIP code as Southern Alabama Surgery Center LLC, ranked by combined Medicare and Medicaid revenue.
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