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NPI 1376536417 · Fair Lawn, NJ · Ophthalmologic Surgery Clinic/Center
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Bergen-passaic Cataract Laser And Surgery Center, LLC is a ophthalmologic surgery clinic/center provider located in Fair Lawn, New Jersey. This profile covers 12 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 | Bergen-passaic Cataract Laser And Surgery Center, LLC |
| Address | 18-01 Pollitt Dr |
| City | Fair Lawn |
| State | NJ |
| ZIP | 07410 |
| Taxonomy | Ophthalmologic Surgery Clinic/Center |
| NPI Enumerated | August 24, 2005 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $3.2M |
| Medicaid | $1.1M |
The provider’s taxonomy as an Ophthalmologic Surgery Clinic/Center and its procedure mix (dominant cataract and intraocular lens insertion codes such as 66984, 66991 and 66982 plus ophthalmic drug supplies J1096 and J1097) indicate this operation functions primarily as a high-volume cataract surgery and IOL implantation center with ancillary use of perioperative ophthalmic medications. The presence of both anterior and some posterior procedure codes suggests an ambulatory surgical practice that also manages select complex cases in-house rather than referring all retinal or corneal work elsewhere.
Medicare revenue is highly concentrated: the precomputed top 3 Medicare codes by revenue account for 85.2% of the provider’s Medicare receipts, with 66984 responsible for 68.9% of Medicare revenue, 66991 for 10.5%, and J1096 for 5.8%. This concentration underscores that a small set of cataract and related ophthalmic supply codes drive the vast majority of Medicare dollars.
Medicaid activity is effectively single-code driven: the precomputed top 3 Medicaid codes account for 100.0% of Medicaid revenue, and that revenue is entirely attributed to 66984 (2.6K claims, $428 avg paid/claim, $1.1M revenue). Other Medicaid-listed codes (for example V2632 with 2K claims but $0 avg paid/claim and $0 revenue) suggest heavy implant-related coding or documentation claims that did not generate paid Medicaid revenue during the reporting period.
On Medicare competitive standing the practice is a high-volume national performer for its headline cataract services: 66984 ranks #806 of 15965 providers nationally (95th percentile; notably above typical national volume for this code) and 66991 ranks #47 of 1445 providers nationally (97th percentile; notably above typical national volume for this code). These ranks position the center well above typical national activity for core cataract procedures, consistent with a regional/national referral presence for cataract work.
Within the state Medicaid market the center also shows strong standing for cataract implants: 66984 ranks #4 of 63 providers in-state (95th percentile) and V2632 ranks #1 of 24 providers in-state (100th percentile; notably above typical state volume for this code), signaling it is a leading local provider of posterior chamber intraocular lens services even though some of those claims reported $0 paid amount. The Medicaid coding footprint reflects dominant cataract implant activity but also suggests payer-specific reimbursement or billing practices for implant supply lines.
Payer mix favors Medicare in scale: lifetime revenue on file shows Total Medicare revenue of $3.2M versus Total Medicaid revenue of $1.1M, indicating Medicare is the larger revenue source for this center while Medicaid contributes a meaningful but smaller share. Given the revenue concentration in cataract codes on both payers, the practice’s financial performance appears closely tied to continued cataract case volume from Medicare beneficiaries.
The practice performs a limited number of posterior-segment and corneal procedures in addition to cataract work: codes such as 67042 (24 claims, $1790 avg paid/claim, $43K revenue) and 67036 (24 claims, $1688 avg paid/claim, $40.5K revenue) appear at modest volumes and mid-range percentiles, and corneal transplant code 65756 appears at low volume (12 claims, $1799 avg paid/claim, $21.6K revenue). These lower volumes relative to cataract codes indicate occasional management of more complex retinal or corneal cases rather than these being core revenue drivers.
The provider has an established operating history, with NPI enumerated on 2005-08-24 (~21 years ago), which supports interpretation of the current high cataract volumes and payer relationships as the result of a sustained clinical footprint rather than a recent practice change. Tenure combined with pronounced Medicare cataract volume suggests stable referral relationships and operational experience in ambulatory cataract surgery workflows.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
12 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… | 2,270 | $980 | $2.2M |
| 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… | 120 | $2,950 | $339.6K |
| J1096 | Dexamethasone, lacrimal ophthalmic insert, 0.1 mg | 1,900 | $100 | $188.1K |
| 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 | $990 | $137.3K |
| 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. | 60 | $1,770 | $109.7K |
| J1097 | phenylephrine 10.16 mg/ml and ketorolac 2.88 mg/ml ophthalmic irrigation solution, 1 ml | 760 | $80 | $57.8K |
| 66821 | The provider removes the haziness from the capsule of the eye using a laser for a patient with a secondary membranous cataract. | 240 | $240 | $57.6K |
| 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… | 20 | $1,790 | $43K |
| 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. | 20 | $1,690 | $40.5K |
| 65756 | During this procedure, the provider performs a complete corneal transplant to replace a damaged corneal endothelium. | 10 | $1,800 | $21.6K |
Showing 1–10 of 12
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 12 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
12 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| J1096 | 8 | 20 | 860 | $100 | $162.9K |
| 66984 | 6 | 370 | 100 | $670 | $141.2K |
| J1097 | 11 | 20 | 860 | $80 | $123.6K |
| 66991 | 3 | 50 | 30 | $2,020 | $82.9K |
| 65820 | 10 | 60 | 30 | $1,130 | $50.9K |
| 66982 | 11 | 160 | 30 | $740 | $40.7K |
| 65756 | 9 | 10 | 20 | $1,450 | $39.1K |
| 67042 | 7 | 20 | 20 | $1,250 | $30.1K |
| 67036 | 9 | 20 | 20 | $950 | $19.9K |
| 66821 | 9 | 290 | 40 | $270 | $16.7K |
Showing 1–10 of 12
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… | 2,550 | $430 | $1.1M |
| 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… | 180 | $0 | $0 |
| G8918 | Patient without preoperative order for iv antibiotic surgical site infection (ssi) prophylaxis | 20 | $0 | $0 |
| V2632 | Posterior chamber intraocular lens | 1,980 | $0 | $0 |
How this provider's Medicaid billing volume and revenue compare to other New Jersey providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. New Jersey 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… | 4 | 60 | 110 | $370 | $327.3K |
| V2632 | Posterior chamber intraocular lens | 1 | 20 | 40 | $20 | $5.5K |
| 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… | 8 | 30 | 80 | $1 | $20 |
| G8918 | Patient without preoperative order for iv antibiotic surgical site infection (ssi) prophylaxis | 14 | 20 | 40 | $1 | $1 |
Other providers in the same ZIP code as Bergen-passaic Cataract Laser And Surgery Center, LLC, ranked by combined Medicare and Medicaid revenue.
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