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NPI 1467629147 · Tacoma, WA · Ambulatory Surgical Clinic/Center
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Pacific Cataract And Laser Institute, Inc., P.C. is a ambulatory surgical clinic/center provider located in Tacoma, Washington. This profile covers 5 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 | Pacific Cataract And Laser Institute, Inc., P.C. |
| Address | 2915 S Alder St |
| City | Tacoma |
| State | WA |
| ZIP | 98409 |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| NPI Enumerated | May 13, 2008 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $1.5M |
| Medicaid | $655.1K |
PACIFIC CATARACT AND LASER INSTITUTE, INC., P.C. operates as an Ambulatory Surgical Clinic/Center with its billing dominated by cataract and intraocular lens procedures. Medicare top codes include 66984 (primary cataract extraction with IOL insertion), 66991 (IOL with anterior segment aqueous drainage device), and 66821 (YAG capsulotomy), and Medicaid activity is almost exclusively 66984, which is consistent with an ASC focused on high-volume cataract surgery and post‑op laser capsulotomy services.
Revenue is highly concentrated within a few codes on Medicare: the provider’s top 3 Medicare codes (66984, 66991, 66821) account for 96.5% of its total Medicare revenue, indicating the practice’s Medicare financial performance is driven almost entirely by cataract- and lens-related procedures. This concentration suggests limited Medicare service-line diversification beyond those surgical ophthalmology codes.
On Medicaid the provider is effectively single-code dependent: code 66984 represents $653.9K and 3.2K claims, accounting for 100.0% of this provider’s total Medicaid revenue. That Medicaid revenue is concentrated in high procedural volume for a single cataract procedure, with ancillary Medicaid codes (00142, G8907) contributing negligible revenue.
Payer mix shows Medicare scale exceeding Medicaid: total Medicare revenue is $1.5M while total Medicaid revenue is $655.1K, so Medicare represents the larger payer source for this provider. At the same time Medicaid shows much higher procedural volume for 66984 (3.2K claims at $203 avg paid/claim) versus Medicare volume for 66984 (1.4K claims at $916 avg paid/claim), reflecting lower Medicaid unit payments but heavier Medicaid utilization for that code.
Competitive standing is mixed by payer and code. For Medicare, 66984 ranks #1605 of 15965 providers nationally (90th percentile; typical, unremarkable volume for this code) while 66821 ranks #303 of 10087 providers (97th percentile; typical, unremarkable volume for this code) and 66991 ranks #340 of 1445 providers (75th percentile; typical, unremarkable volume for this code), indicating respectable national placement on key ophthalmology procedures but characterized in the source labels as typical volumes. For Medicaid, 66984 ranks #5 of 51 providers in-state (92th percentile; notably above typical state volume for this code), signaling above-typical statewide market share for Medicaid cataract procedures.
The provider’s billing mix shows a notable asymmetry between payer unit economics and volume: Medicare pays $916 avg/claim for 66984 (1.4K claims) while Medicaid pays $203 avg/claim for 66984 (3.2K claims). This pattern implies the practice derives more Medicare revenue per procedure while relying on Medicaid for higher procedure counts, an operational profile that affects revenue sensitivity to payer reimbursement changes.
Tenure and stability are evident: the NPI was enumerated on 2008-05-13 (~18 years ago), indicating long-standing enrollment and an established presence in the Tacoma, WA market. That multi‑year presence aligns with concentrated specialty billing and the high in-state rank on Medicaid 66984.
High revenue concentration metrics (96.5% of Medicare revenue from the top 3 codes and 100.0% of Medicaid revenue from the top 3 codes) create business risk if reimbursement or patient volume for cataract/IOL procedures shifts. Analysts should view this provider as procedurally specialized with limited revenue diversification outside cataract and related ophthalmic procedures, and prioritize monitoring of cataract procedure utilization and payer reimbursement trends.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
5 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… | 1,350 | $920 | $1.2M |
| 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… | 50 | $2,760 | $135.1K |
| 66821 | The provider removes the haziness from the capsule of the eye using a laser for a patient with a secondary membranous cataract. | 390 | $190 | $76K |
| 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… | 60 | $930 | $51.1K |
| 65855 | In this procedure, the provider uses a laser to burn the trabecular meshwork, the tissue of mesh where the iris meets the sclera, to drain aqueous humor from the anterior chamber and treat glaucoma. | 10 | $110 | $1.2K |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 5 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.
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… | 3,220 | $200 | $653.9K |
| 00142 | The provider performs anesthesia services for a patient undergoing an eye lens procedure. | 20 | $20 | $270 |
| 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… | 30 | $0 | $0 |
How this provider's Medicaid billing volume and revenue compare to other Washington providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Washington 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… | 5 | 50 | 410 | $180 | $154K |
| 00142 | The provider performs anesthesia services for a patient undergoing an eye lens procedure. | 18 | 20 | 370 | $50 | $43.5K |
| 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… | 38 | 50 | 90 | $1 | $1 |
Other providers in the same ZIP code as Pacific Cataract And Laser Institute, Inc., P.C., ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Arris Health Services LLC | WA | Oxygen Equipment & Supplies (DME) | $0 | $41.5M |
| Sound Integrated Health LLC | WA | Addiction Medicine (Internal Medicine) Physician | $0 | $12.2M |
| Sea Mar Community Health Centers | WA | Federally Qualified Health Center (FQHC) | $0 | $5.3M |
| Sea Mar Community Health Centers | WA | Federally Qualified Health Center (FQHC) | $0 | $4.1M |
| Renal Care Group Northwest, Inc. | WA | End-Stage Renal Disease (ESRD) Treatment Clinic/Center | $0 | $3.3M |
| Patrick Hogan | WA | Neurology Physician | $814K | $0 |
| Eden Yoon | WA | Ophthalmology Physician | $597.7K | $0 |
| Barry Huse | WA | Optometrist | $29.7K | $426.8K |
| Jay Haynie | WA | Optometrist | $394.5K | $0 |
| Michael Seward | WA | Ophthalmology Physician | $146K | $0 |
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