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NPI 1467407833 · Latham, NY · Ophthalmologic Surgery Clinic/Center
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Albany Regional Eye Surgery Center, LLC is a ophthalmologic surgery clinic/center provider located in Latham, New York. This profile covers 22 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 | Albany Regional Eye Surgery Center, LLC |
| Address | 5 Johnson Rd |
| City | Latham |
| State | NY |
| ZIP | 12110 |
| Taxonomy | Ophthalmologic Surgery Clinic/Center |
| NPI Enumerated | May 24, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $3.5M |
| Medicaid | $1.9M |
ALBANY REGIONAL EYE SURGERY CENTER, LLC reports $3.5M in lifetime Medicare revenue and $1.9M in lifetime Medicaid revenue, indicating Medicare is the larger payer relationship on file but Medicaid is also a material revenue stream. The practice has been NPI-enumerated since 2006-05-24 (~20 years ago), signaling long-standing operation in the Latham, NY market.
Revenue concentration is high on both payers: the top three Medicare codes account for 72.4% of this provider’s total Medicare revenue, and the top three Medicaid codes account for 100.0% of its total Medicaid revenue. For Medicaid the concentration is especially acute, with 66984 alone representing 94.6% of the provider’s Medicaid revenue.
The provider’s code mix and highest-revenue procedures identify it clearly as a cataract- and anterior-segment–focused ophthalmologic surgery center: 66984 (cataract extraction with intraocular lens) is the single largest revenue driver on both Medicare (52.8% of Medicare revenue) and Medicaid (94.6% of Medicaid revenue). High utilization of intraocular lens implantation codes (66984, 66982) together with ophthalmic irrigation (J1097) and ophthalmic steroid insert (J1096) support an operational profile built around high-volume cataract surgery plus routine perioperative ophthalmic medication use.
Competitive standing for core cataract services is strong at both national and state levels. On Medicare, 66984 ranks #701 of 15965 providers nationally (96th percentile) and 66982 ranks #31 of 4580 (99th percentile), characterizing the center as a major national-volume provider for these cataract procedures; on Medicaid 66984 ranks #12 of 156 in-state (93rd percentile), indicating a similarly prominent position within New York for that code.
Several codes are flagged as “notably above typical” or outliers relative to peers, which highlights areas of exceptional volume: J1097 ranks #29 of 443 providers nationally (94th percentile, notably above typical), 66183 ranks #18 of 289 (93rd percentile, notably above typical), and 67036 ranks #38 of 832 (95th percentile, notably above typical). Additionally, code 66761 is an extreme outlier on Medicare (125 claims; ranks #9 of 671 providers, 99th percentile), which suggests unusually high laser peripheral iridotomy volume relative to peers and may reflect a local clinical focus on certain glaucoma procedures.
Beyond cataract operations, the presence of codes for glaucoma drainage devices and shunts (e.g., 66991, 66989, 66180, 66183) and posterior-segment work (e.g., 67036, 67041, 67108) indicates the center performs a nontrivial mix of glaucoma and vitreoretinal procedures in addition to high-volume cataract surgery. These mid- and higher-acuity procedures together with stent/shunt implant codes contribute smaller shares of revenue but broaden the service capability beyond purely routine cataract cases.
The payer mix and code concentration suggest operational and reimbursement sensitivity: reliance on a small set of high-volume cataract codes (top three Medicare codes = 72.4% of Medicare revenue; top three Medicaid codes = 100.0% of Medicaid revenue) concentrates financial performance around cataract case volume and associated supply/medication billing (e.g., J1097, J1096). Any changes in cataract demand, payer coverage, or per-claim payments for these dominant codes would therefore meaningfully affect total revenue.
Practice longevity and high national/state code rankings together paint a picture of an established, procedure-centric ambulatory surgery center that competes at scale for cataract services. The combination of long tenure (NPI since 2006-05-24 ~20 years) and multiple codes ranking in the upper percentiles nationally/statewide supports characterization as a significant regional provider for cataract and related anterior-segment procedures rather than a low-volume or exclusively general ophthalmology practice.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
22 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… | 2,460 | $760 | $1.9M |
| J1097 | phenylephrine 10.16 mg/ml and ketorolac 2.88 mg/ml ophthalmic irrigation solution, 1 ml | 5,670 | $80 | $430.9K |
| 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… | 350 | $750 | $262.9K |
| 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… | 80 | $2,310 | $189.6K |
| J1096 | Dexamethasone, lacrimal ophthalmic insert, 0.1 mg | 1,550 | $100 | $154.5K |
| 66183 | The provider inserts a small device into the anterior chamber of the eye that helps to reduce the intraocular pressure of the eye in patients with glaucoma. | 60 | $2,050 | $124.9K |
| 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. | 70 | $1,380 | $93.8K |
| 66989 | The provider inserts an intraocular lens prosthesis during the same session as extracapsular cataract extraction using complex techniques and devices. The provider also inserts one or more anterior… | 30 | $2,310 | $69.3K |
| 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 | $1,000 | $59.9K |
| 66821 | The provider removes the haziness from the capsule of the eye using a laser for a patient with a secondary membranous cataract. | 320 | $190 | $59.9K |
Showing 1–10 of 22
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 22 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
22 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| J1096 | 3 | 10 | 740 | $100 | $227.3K |
| J1097 | 3 | 20 | 500 | $80 | $200.1K |
| 66984 | 12 | 680 | 90 | $430 | $104.3K |
| 66991 | 4 | 50 | 30 | $1,830 | $65.9K |
| 65820 | 17 | 90 | 30 | $1,170 | $48K |
| 67904 | 21 | 30 | 40 | $570 | $45.2K |
| 66989 | 1 | 10 | 20 | $2,100 | $39.8K |
| 66183 | 1 | 10 | 20 | $1,480 | $36.9K |
| 66982 | 4 | 280 | 30 | $760 | $35.6K |
| 66174 | 22 | 20 | 30 | $1,020 | $30.5K |
Showing 1–10 of 22
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… | 2,640 | $680 | $1.8M |
| 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… | 130 | $820 | $103.6K |
| 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… | 530 | $0 | $0 |
| G8918 | Patient without preoperative order for iv antibiotic surgical site infection (ssi) prophylaxis | 530 | $0 | $0 |
How this provider's Medicaid billing volume and revenue compare to other New York providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. New York 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… | 12 | 160 | 140 | $720 | $423.8K |
| 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… | 11 | 30 | 70 | $570 | $128.4K |
| 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 | 90 | $1 | $50 |
| G8918 | Patient without preoperative order for iv antibiotic surgical site infection (ssi) prophylaxis | 4 | 20 | 60 | $1 | $40 |
Other providers in the same ZIP code as Albany Regional Eye Surgery Center, LLC, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Public Partnerships LLC | NY | Supports Brokerage Agency | $0 | $7.2B |
| Community Care Physicians, PLLC | NY | Internal Medicine Physician | $0 | $41.8M |
| Town Of Colonie | NY | Ambulance | $975.4K | $3.6M |
| Colonie Asc LLC | NY | Ambulatory Surgical Clinic/Center | $1.5M | $101.7K |
| Manish Mehta | NY | Vascular Surgery Physician | $1.4M | $320 |
| Mobile Imaging Ltd. | NY | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | $515.7K | $85.1K |
| Natalie Lopasic | NY | Ophthalmology Physician | $432.5K | $4.9K |
| Philip Paty | NY | Vascular Surgery Physician | $422.9K | $0 |
| Shirish Parikh | NY | Diagnostic Radiology Physician | $298.7K | $1.1K |
| Samit Shah | NY | Diagnostic Radiology Physician | $207.4K | $800 |
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