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NPI 1518003516 · Coeur D Alene, ID · Ambulatory Surgical Clinic/Center
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North Idaho Cataract & Laser Ctr is a ambulatory surgical clinic/center provider located in Coeur D Alene, Idaho. This profile covers 8 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 | North Idaho Cataract & Laser Ctr |
| Address | 1814 Lincoln Way |
| City | Coeur D Alene |
| State | ID |
| ZIP | 83814 |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| NPI Enumerated | January 29, 2007 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $1.7M |
| Medicaid | $491K |
NORTH IDAHO CATARACT & LASER CTR operates as an Ambulatory Surgical Clinic/Center with a procedure mix dominated by cataract and related anterior-segment eye procedures: its Medicare top codes include 66984 (extracapsular cataract extraction with intraocular lens insertion), 66991 (combined cataract extraction and aqueous drainage device), and 66821 (YAG laser capsulotomy), which together account for the clinical footprint described in the claims. This procedural mix (cataract extraction, intraocular lens insertion, YAG capsulotomy, plus occasional oculoplastic and glaucoma interventions) is consistent with a specialty ASC focused on high-volume cataract care rather than broad multispecialty surgical services.
Revenue concentration on Medicare is extremely focused: the precomputed top 3 Medicare codes by revenue account for 95.1% of this provider's total Medicare revenue. Within Medicare, 66984 alone represents $1.3M revenue (80.7% of Medicare revenue), 66991 contributes $153K (9.3%), and 66821 contributes $85.5K (5.2%), indicating that nearly all Medicare dollars flow from routine and secondary cataract procedures rather than a wide array of other services.
Medicaid billing is even more concentrated: the precomputed top 3 Medicaid codes by revenue account for 100.0% of this provider's total Medicaid revenue. Medicaid revenue is dominated by 66984 with $479.8K (97.6% of Medicaid revenue); the remaining Medicaid revenue comes almost entirely from administrative/quality codes G8907 and G8918, each at $5.9K (1.2% each), showing Medicaid activity is narrowly tied to the same core cataract service line.
Payer mix and scale show Medicare is the larger revenue source overall: Total Medicare revenue is $1.7M versus Total Medicaid revenue of $491K, so the practice clearly generates most of its programmatic revenue from Medicare while maintaining a meaningful Medicaid cataract volume. This pattern indicates Medicare-aged cataract patients are the primary payer population but the center also serves Medicaid beneficiaries at a nontrivial level for core cataract procedures.
On national Medicare competitiveness, the provider posts mixed standings by code: 66984 ranks #1348 of 15965 providers nationally (92th percentile; typical, unremarkable volume for this code), 66991 ranks #220 of 1445 (84th percentile; typical, unremarkable volume), while 66821 ranks #231 of 10087 (98th percentile; notably above typical national volume). The notably above-typical national volume for 66821 (YAG capsulotomy) suggests stronger-than-average follow-up or secondary-procedure throughput relative to peers.
On in-state Medicaid competitiveness the provider is a clear leader for the core procedure: Medicaid 66984 ranks #1 of 15 providers in-state (100th percentile; notably above typical state volume), indicating this center is the top Medicaid billing location in Idaho for extracapsular cataract extraction with lens insertion. That position implies a dominant role in the state Medicaid cataract pathway even though overall Medicaid revenue is smaller than Medicare.
Operational and quality/administrative signals are visible in Medicaid claim patterns: the provider submitted 849 claims each for G8907 and G8918 (each yielding $5.9K and representing 1.2% of Medicaid revenue), which are facility-level safety and preoperative-antibiotic documentation codes. These volumes suggest consistent documentation and reporting activity tied to surgical throughput rather than material revenue impact, reinforcing that the business is process-driven around high-volume cataract cases.
Tenure and stability are evident: the NPI was enumerated 2007-01-29 (~19 years ago), indicating the center has an established presence in the market. Combined with the concentration of high-volume cataract codes and leading in-state Medicaid ranking for 66984, the data support a profile of a long-standing, specialized cataract ASC with stable referral and operational patterns.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
8 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… | 1,620 | $820 | $1.3M |
| 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… | 60 | $2,470 | $153K |
| 66821 | The provider removes the haziness from the capsule of the eye using a laser for a patient with a secondary membranous cataract. | 490 | $180 | $85.5K |
| 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… | 30 | $810 | $25.8K |
| 67904 | The provider repairs a drooping eyelid by tightening the levator muscle that controls eyelid movement to improve cosmetic appearance or remove the obstruction to a patient’s vision. He accesses the… | 50 | $510 | $25.6K |
| 15823 | In this procedure, the provider surgically trims excessive skin that weighs down the upper eyelid, typically to improve the cosmetic appearance of the face and due to the interference of the tissue… | 40 | $510 | $22.6K |
| 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. | 50 | $100 | $5.1K |
| 67145 | The provider prevents the detachment of the retina in the presence of small tears or thinning of the edges (lattice degeneration) by applying an intense light (such as a laser) to create scar tissue… | 10 | $110 | $1.3K |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 8 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… | 1,590 | $300 | $479.8K |
| 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… | 850 | $10 | $5.9K |
| G8918 | Patient without preoperative order for iv antibiotic surgical site infection (ssi) prophylaxis | 850 | $10 | $5.9K |
How this provider's Medicaid billing volume and revenue compare to other Idaho providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Idaho 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… | 1 | 20 | 150 | $360 | $178.3K |
| G8918 | Patient without preoperative order for iv antibiotic surgical site infection (ssi) prophylaxis | 3 | 10 | 260 | $1 | $740 |
| 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… | 5 | 20 | 210 | $1 | $680 |
Other providers in the same ZIP code as North Idaho Cataract & Laser Ctr, ranked by combined Medicare and Medicaid revenue.
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