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NPI 1558327213 · Jackson, MS · Ambulatory Surgical Clinic/Center
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Surgicare Of Jackson Ltd is a ambulatory surgical clinic/center provider located in Jackson, Mississippi. This profile covers 22 Medicare and 8 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 | Surgicare Of Jackson Ltd |
| Address | 760 Lakeland Dr |
| City | Jackson |
| State | MS |
| ZIP | 39216 |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| NPI Enumerated | April 21, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $1.2M |
| Medicaid | $424.3K |
Payer mix and scale: SURGICARE OF JACKSON LTD reports total Medicare revenue of $1.2M and total Medicaid revenue of $424.3K, making Medicare the larger single-payer revenue source on file. The provider is not effectively single-payer but Medicare represents the majority of reported lifetime public-payer revenue.
Medicare revenue concentration: the provider’s top three Medicare codes account for 66.5% of this provider's total Medicare revenue, driven largely by 64590 ($448.6K, 37.3%), 69930 ($261.1K, 21.7%), and 36561 ($90.2K, 7.5%). This concentration indicates a small set of high-revenue procedures dominate Medicare receipts rather than a broad, even case mix.
Medicaid revenue concentration: the top three Medicaid codes account for 95.6% of this provider's total Medicaid revenue, overwhelmingly concentrated in 69436 ($276.7K, 65.2%) and 42820 ($100.1K, 23.6%), with 62323 contributing $28.6K (6.7%). Medicaid dollars are therefore heavily dependent on pediatric ENT/tympanostomy and related procedures.
Service-line implications and alignment with taxonomy: listed procedure codes show a mix of implantable device surgery (64590 neurostimulator, 69930 cochlear implant), central venous access and port management (36561, 36590), ophthalmic/eyelid repairs (multiple 67xxx codes), cataract surgery (66984), and high-volume pediatric ENT work under Medicaid (69436, 42820). This code mix is consistent with the provider’s Ambulatory Surgical Clinic/Center taxonomy and suggests the center performs both device-heavy implant cases and routine ambulatory ENT/ophthalmic surgeries.
Medicare competitive standing — national specialization: SURGICARE of JACKSON is a national outlier on several access/device codes — 36561 ranks #21 of 3475 (99th percentile; extreme outlier, far above typical national volume) and 36590 ranks #13 of 651 (98th percentile; extreme outlier, far above typical national volume). At the same time, 64590 (rank #58 of 561, 88th percentile) shows solid but not dominant national volume and 69930 (rank #136 of 176, 10th percentile) is comparatively modest, indicating the practice is a major national player for specific vascular access and port procedures rather than broadly dominant across all implantable-device codes.
Medicaid competitive standing — in-state position: for Medicaid in Mississippi the provider’s tympanostomy volume (69436: 626 claims, $276.7K, rank #15 of 46, 69th percentile) and tonsil/adenoid work (42820: 68 claims, $100.1K, rank #16 of 30, 48th percentile) place it as a meaningful but not dominant in-state participant for pediatric ENT. The provider does, however, appear unusually high-volume for L8699 in-state (rank #1 of 5, 100th percentile) despite that line contributing only $3.5K in revenue, suggesting concentrated procedural coding patterns for small-reimbursement implant items.
Notable statistical outliers and monitoring considerations: several codes are flagged as extreme outliers or notably above typical volume — explicitly 36561 (extreme outlier), 36590 (extreme outlier), and 68720 (rank #1 of 62, 100th percentile; extreme outlier) — which indicates volumes for central venous access and certain lacrimal procedures are far above peer medians. For payers and analysts this pattern warrants focused utilization and appropriateness review of high-volume device/access procedures while recognizing these are legitimate surgical services in an ambulatory setting.
Tenure and operational stability: the provider’s NPI was enumerated on 2006-04-21 (~20 years ago), indicating two decades of operation under the current identifier. This tenure, combined with concentrated high-volume procedural lines, suggests an established ambulatory surgical operation with entrenched service lines rather than a newly formed 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 |
|---|---|---|---|---|
| 64590 | The provider inserts or replaces a peripheral, sacral, or gastric neurostimulator pulse generator or receiver. The system is one that requires surgical creation of a pocket for placement and that… | 30 | $13,590 | $448.6K |
| 69930 | The external parts include microphone, speech processor, and a transmitter. The implant is surgically placed under the skin behind the ear. The internal parts are a receiver and stimulator which are… | 10 | $21,760 | $261.1K |
| 36561 | A central venous access catheter is a device that the physician inserts beneath the skin to draw blood or administer medication/nutrients to the patient. The catheter's tip must terminate in the… | 90 | $1,010 | $90.2K |
| 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… | 100 | $750 | $73.1K |
| 47562 | The provider removes the gallbladder through a laparoscope, a tubular instrument with a light source and camera inserted through the abdominal wall, to treat gallbladder disease. | 30 | $1,790 | $55.6K |
| 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… | 100 | $470 | $48.7K |
| 31200 | In this procedure, the provider makes an intranasal incision to gain access into the anterior ethmoid sinus. The provider then removes all diseased contents from the anterior ethmoid sinus. | 20 | $1,840 | $35K |
| 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… | 60 | $410 | $25.1K |
| 68815 | The provider probes the nasolacrimal duct to identify a possible obstruction or stricture; he may or may not irrigate the duct. He inserts a tube or stent to keep the nasolacrimal duct open. | 50 | $400 | $20.6K |
| 68720 | The provider performs a dacryocystorhinostomy, or DCR, to correct dysfunction of the nasolacrimal duct and restore the flow of tears from the tear duct into the nose. | 30 | $670 | $19.3K |
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 |
|---|---|---|---|---|---|
| 64590 | 8 | 20 | 30 | $6,100 | $201.4K |
| 69930 | 2 | 10 | 10 | $9,800 | $137.2K |
| 66984 | 94 | 240 | 70 | $470 | $90.5K |
| 67904 | 5 | 20 | 80 | $520 | $39K |
| 67966 | 6 | 10 | 30 | $500 | $25.4K |
| 15823 | 11 | 40 | 40 | $460 | $25.2K |
| C9290 | 3 | 10 | 14,360 | $1 | $23.5K |
| 31200 | 1 | 10 | 20 | $1,080 | $19.4K |
| 67900 | 5 | 10 | 40 | $380 | $18.8K |
| 66821 | 60 | 160 | 50 | $200 | $17.6K |
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.
8 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 69436 | This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia. | 630 | $440 | $276.7K |
| 42820 | The provider removes the tonsils and adenoids in a patient younger than 12 years old. | 70 | $1,470 | $100.1K |
| 62323 | The provider injects a diagnostic or a therapeutic substance, such as pain medication or a steroid, into the space around the spinal nerves of the lumbar (lower back) or sacral (caudal, or tailbone)… | 290 | $100 | $28.6K |
| 43239 | The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis. | 50 | $310 | $14.1K |
| L8699 | Prosthetic implant, not otherwise specified | 880 | $1 | $3.5K |
| 62321 | The provider injects a diagnostic or a therapeutic substance, such as pain medication or a steroid, into the space around the spinal nerves of the cervical (neck) or thoracic (upper and middle back)… | 10 | $100 | $1.1K |
| 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… | 300 | $0 | $0 |
| G8918 | Patient without preoperative order for iv antibiotic surgical site infection (ssi) prophylaxis | 250 | $0 | $0 |
How this provider's Medicaid billing volume and revenue compare to other Mississippi providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Mississippi median
8 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 42820 | The provider removes the tonsils and adenoids in a patient younger than 12 years old. | 16 | 30 | 70 | $1,790 | $891.2K |
| 69436 | This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia. | 15 | 50 | 300 | $510 | $483.3K |
| 43239 | The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis. | 61 | 70 | 200 | $180 | $200.4K |
| 62323 | The provider injects a diagnostic or a therapeutic substance, such as pain medication or a steroid, into the space around the spinal nerves of the lumbar (lower back) or sacral (caudal, or tailbone)… | 22 | 40 | 280 | $110 | $46.9K |
| 62321 | The provider injects a diagnostic or a therapeutic substance, such as pain medication or a steroid, into the space around the spinal nerves of the cervical (neck) or thoracic (upper and middle back)… | 14 | 20 | 40 | $90 | $7.2K |
| L8699 | Prosthetic implant, not otherwise specified | 1 | 10 | 100 | $1 | $760 |
| G8918 | Patient without preoperative order for iv antibiotic surgical site infection (ssi) prophylaxis | 13 | 40 | 140 | $1 | $590 |
| 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… | 34 | 60 | 520 | $1 | $200 |
Other providers in the same ZIP code as Surgicare Of Jackson Ltd, ranked by combined Medicare and Medicaid revenue.
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