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NPI 1386794980 · Norwalk, CT · Ambulatory Surgical Clinic/Center
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New Vision Cataract Center LLC is a ambulatory surgical clinic/center provider located in Norwalk, Connecticut. This profile covers 7 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 | New Vision Cataract Center LLC |
| Address | 605 West Ave |
| City | Norwalk |
| State | CT |
| ZIP | 06850 |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| NPI Enumerated | January 12, 2007 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $1.1M |
| Medicaid | $802.1K |
NEW VISION CATARACT CENTER LLC is operated as an Ambulatory Surgical Clinic/Center and its billed services are concentrated in ophthalmic surgery and intraoperative ophthalmic medications. The Medicare top codes include cataract extraction with intraocular lens placement (66984) and combined lens/aqueous drainage device insertion (66991), while high volumes of ophthalmic drug supplies appear through J1096 and J1097, indicating an integrated surgical practice that bills both procedures and associated ophthalmic pharmaceuticals for operative cases.
Medicare revenue is highly concentrated: the precomputed top three Medicare codes account for 75.5% of the provider's total Medicare revenue. Those three codes are 66984 ($432K, 38.6% of Medicare revenue), J1096 ($206.7K, 18.5%), and 66991 ($206.5K, 18.4%), showing that a small set of surgical and drug codes drive the majority of Medicare receipts.
Medicaid billing is effectively dominated by a single procedure: the precomputed top three Medicaid codes account for 100.0% of Medicaid revenue, and 66984 alone represents $800.4K or 99.8% of the provider's Medicaid revenue. This indicates near-total reliance on cataract extraction with lens insertion for Medicaid-covered activity and little Medicaid revenue diversification beyond that procedure.
On payer mix and scale, the provider reports $1.1M in total Medicare revenue versus $802.1K in total Medicaid revenue, so it draws meaningful business from both payers with Medicare larger in absolute dollars. The dual-payer footprint — sizable Medicaid revenue alongside Medicare — suggests the center serves a mixed payer population rather than being effectively single-payer.
Competitive standing is modest-to-strong depending on the code: for the core Medicare cataract code 66984 the provider ranks #3063 of 15965 nationally (81th percentile) which is consistent with a typical, unremarkable national volume for cataract surgery, while 66991 ranks #148 of 1445 (90th percentile) indicating a stronger-than-average national position for combined IOL plus aqueous drainage procedures. In-state for Medicaid, 66984 ranks #9 of 39 (79th percentile), signaling a meaningful presence in Connecticut Medicaid cataract surgical capacity but not outright dominance.
The provider shows service-line specialization beyond routine cataract work: code 65820 (limbal incision typically used in pediatric congenital glaucoma) accounts for $68.8K and 6.1% of Medicare revenue and ranks #91 of 1249 (93th percentile), suggesting this center performs certain less-common anterior-segment procedures at a higher-than-typical rate relative to peers. That pattern points to capability in specialized ophthalmic surgery in addition to high-volume adult cataract cases.
Drug and supply billing is a material part of the surgical episode mix: J1096 (dexamethasone lacrimal insert) appears as a top Medicare revenue driver ($206.7K, 18.5%), and J1097 (phenylephrine/ketorolac irrigation) generates $158.2K (14.1% of Medicare revenue) on Medicare claims. On Medicaid J1097 is present but minimal ($1.5K, 0.2% of Medicaid revenue) and ranks #3 of 3 in-state (0th percentile), indicating that while ophthalmic drug billing is integral to their Medicare surgical episodes, those same drug revenues are not a material Medicaid revenue source.
The provider has a long tenure in the enrollment data, with an NPI enumerated on 2007-01-12 (~19 years ago), which supports interpretation of these patterns as established practice behavior rather than transient billing activity. This longevity, combined with concentrated surgical revenue and targeted higher-percentile activity on certain complex codes, suggests an established ambulatory surgical center with a consistent cataract and anterior-segment surgery focus.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
7 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… | 470 | $930 | $432K |
| J1096 | Dexamethasone, lacrimal ophthalmic insert, 0.1 mg | 2,090 | $100 | $206.7K |
| 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 | $2,790 | $206.5K |
| J1097 | phenylephrine 10.16 mg/ml and ketorolac 2.88 mg/ml ophthalmic irrigation solution, 1 ml | 2,080 | $80 | $158.2K |
| 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. | 80 | $870 | $68.8K |
| 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 | $920 | $36.7K |
| 66821 | The provider removes the haziness from the capsule of the eye using a laser for a patient with a secondary membranous cataract. | 50 | $220 | $10.8K |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 7 CPT/HCPCS codes.
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 |
|---|---|---|---|---|
| 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… | 1,670 | $480 | $800.4K |
| J1097 | phenylephrine 10.16 mg/ml and ketorolac 2.88 mg/ml ophthalmic irrigation solution, 1 ml | 40 | $40 | $1.5K |
How this provider's Medicaid billing volume and revenue compare to other Connecticut providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Connecticut median
2 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… | 9 | 40 | 380 | $310 | $334K |
| J1097 | phenylephrine 10.16 mg/ml and ketorolac 2.88 mg/ml ophthalmic irrigation solution, 1 ml | 3 | 10 | 50 | $50 | $2.7K |
Other providers in the same ZIP code as New Vision Cataract Center LLC, ranked by combined Medicare and Medicaid revenue.
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