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NPI 1437138500 · Concord, NH · Ambulatory Surgical Clinic/Center
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Concord Eye Surgery LLC is a ambulatory surgical clinic/center provider located in Concord, New Hampshire. This profile covers 19 Medicare and 3 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 | Concord Eye Surgery LLC |
| Address | 246 Pleasant St |
| City | Concord |
| State | NH |
| ZIP | 03301 |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| NPI Enumerated | January 17, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $2.1M |
| Medicaid | $23.5K |
CONCORD EYE SURGERY LLC’s billing profile is concentrated in ophthalmic surgical care consistent with its Ambulatory Surgical Clinic/Center taxonomy: Medicare revenue is dominated by cataract and intraoperative ophthalmic services, led by 66984 (extracapsular cataract extraction with lens insertion) and supported by J1097 (ophthalmic irrigation with phenylephrine/ketorolac) and 66821 (YAG posterior capsulotomy). The top three Medicare codes account for 76.3% of the provider’s total Medicare revenue, indicating a high dependence on a narrow set of surgical and procedure-related lines.
Medicare is by far the dominant payer: lifetime Medicare revenue is reported as $2.1M versus Medicaid revenue of $23.5K, so the practice operates effectively as a Medicare-focused surgical center with minimal Medicaid volume. On Medicaid the provider’s entire recorded revenue comes from 66984 (112 claims, $210 avg paid/claim, $23.5K revenue), while Medicare shows a broader but still concentrated mix.
Revenue concentration on Medicare is acute: the single code 66984 generates $1.1M (54.5% of this provider’s Medicare revenue) and, together with J1097 ($354.2K, 16.8%) and 66821 ($105.7K, 5.0%), explains the precomputed 76.3% concentration. This pattern signals that cataract extraction and associated intraoperative products/medications are the primary service and revenue driver for the business.
Competitive standing on key Medicare codes is mixed. The provider ranks #1643 of 15965 nationally for 66984 (90th percentile), indicating a relatively high-but-not-dominant national volume for cataract surgery, and ranks #54 of 443 for J1097 (88th percentile), showing strong utilization of the ophthalmic irrigation product among peers; by contrast, several specialty codes (for example V2785 processing corneal tissue) sit at lower percentile ranks (V2785 at the 21st percentile), suggesting more modest activity in ancillary transplant-related services.
One notable statistical outlier on Medicare is 66821, which ranks #226 of 10087 (98th percentile) and is described as "notably above typical national volume" — this suggests the practice performs posterior capsulotomy at a much higher relative rate than most peers, consistent with substantial postoperative or follow-up laser activity associated with high cataract throughput. Other glaucoma- and retina-related procedure codes (e.g., 66180, 67042, 66991) appear at mid-percentile positions (typical, unremarkable volumes), indicating some diversification into related ophthalmic subspecialty procedures but not dominance.
Medicaid reporting shows unusual administrative/quality measure activity: G8907 and G8918 appear with high claim counts (1.5K each) but $0 average paid/claim and $0 revenue, and are flagged as "notably above typical state volume" (100th percentile). These entries reflect heavy documentation/quality-code submission on Medicaid records without associated revenue and should be interpreted as administrative/measure reporting rather than a revenue stream.
The provider’s small Medicaid footprint relative to Medicare also has competitive implications in-state: Medicaid cataract billing (66984) is $23.5K and ranks #3 of 3 in-state (0th percentile), indicating the provider is a marginal Medicaid cataract biller within a very small statewide peer set. Combined with the Medicare scale, this suggests the practice targets commercially insured and Medicare surgical volumes rather than Medicaid-dominant populations.
Tenure is long-established: the NPI was enumerated on 2006-01-17 (~20 years ago), supporting the interpretation that observed patterns reflect an established ambulatory ophthalmic surgery operation with sustained specialization in cataract surgery and associated intraoperative products and follow-up laser procedures.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
19 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… | 1,340 | $860 | $1.1M |
| J1097 | phenylephrine 10.16 mg/ml and ketorolac 2.88 mg/ml ophthalmic irrigation solution, 1 ml | 4,660 | $80 | $354.2K |
| 66821 | The provider removes the haziness from the capsule of the eye using a laser for a patient with a secondary membranous cataract. | 490 | $210 | $105.7K |
| 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… | 40 | $2,600 | $91.1K |
| V2785 | Processing, preserving and transporting corneal tissue | 20 | $4,140 | $70.3K |
| 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. | 30 | $1,550 | $51.1K |
| 67950 | Canthoplasty (median or lateral) is often referred to as a corner eye lift or eye tendon surgery. The ophthalmologist uses this technique to strengthen the lateral canthal tendon or orbicularis… | 70 | $600 | $42.7K |
| 66180 | The provider implants a shunt in the anterior chamber of the eye to facilitate drainage of aqueous humor, or fluid, in order to reduce intraocular pressure. He uses a graft to reinforce the tissue… | 20 | $2,080 | $41.5K |
| 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 | $1,570 | $37.6K |
| 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 | $820 | $35.9K |
Showing 1–10 of 19
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 19 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
19 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| J1097 | 1 | 10 | 4,240 | $80 | $324.9K |
| 66984 | 7 | 60 | 220 | $310 | $144.6K |
| 66991 | 7 | 10 | 40 | $1,590 | $74.7K |
| V2785 | 1 | 10 | 20 | $4,140 | $70.3K |
| 65820 | 6 | 10 | 50 | $1,080 | $57.4K |
| 67042 | 1 | 10 | 20 | $1,570 | $37.6K |
| 15823 | 5 | 10 | 40 | $540 | $28.8K |
| 66982 | 8 | 30 | 30 | $660 | $26.5K |
| 66180 | 1 | 10 | 20 | $1,270 | $24.2K |
| 67041 | 1 | 10 | 20 | $1,490 | $23.9K |
Showing 1–10 of 19
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.
3 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… | 110 | $210 | $23.5K |
| 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… | 1,540 | $0 | $0 |
| G8918 | Patient without preoperative order for iv antibiotic surgical site infection (ssi) prophylaxis | 1,540 | $0 | $0 |
How this provider's Medicaid billing volume and revenue compare to other New Hampshire providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. New Hampshire median
3 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… | 3 | 10 | 160 | $200 | $68.7K |
| 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… | 1 | 10 | 120 | $0 | $0 |
| G8918 | Patient without preoperative order for iv antibiotic surgical site infection (ssi) prophylaxis | 1 | 10 | 40 | $0 | $0 |
Other providers in the same ZIP code as Concord Eye Surgery LLC, ranked by combined Medicare and Medicaid revenue.
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