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NPI 1588274963 · Wilmington, NC · Ambulatory Surgical Clinic/Center
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Wilmington Eye Surgery Center, LLC is a ambulatory surgical clinic/center provider located in Wilmington, North Carolina. This profile covers 29 Medicare and 1 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 | Wilmington Eye Surgery Center, LLC |
| Address | 1919 S 16th St |
| City | Wilmington |
| State | NC |
| ZIP | 28401 |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| NPI Enumerated | July 31, 2020 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $3.9M |
| Medicaid | $72K |
Service-line profile: Billing is concentrated in ophthalmic surgical procedures, with a clear mix of high-volume cataract work and specialized oculoplastic surgery. The Medicare code mix is led by 66984 (cataract extraction with IOL) and high-volume eyelid procedures such as 15823 (upper eyelid skin excision/blepharoplasty) and 67904 (levator tightening for ptosis), and the presence of codes like 66821 (YAG capsulotomy) and 66183/66180/66174 (glaucoma drainage/stent procedures) indicates the center performs both routine cataract operations and advanced anterior segment/glaucoma interventions.
Revenue concentration (Medicare): The provider’s top three Medicare codes account for 67.5% of its total Medicare revenue, with 66984 alone representing 50.9% of Medicare revenue. This concentration shows the business is heavily driven by a small set of high-revenue ophthalmic procedures.
Payer mix and scale: WILMINGTON EYE SURGERY CENTER reports $3.9M in total Medicare revenue versus $72K in total Medicaid revenue, indicating the practice is effectively Medicare-dominant and that Medicaid contributes only a small fraction of overall reimbursed activity. Medicaid billing is overwhelmingly concentrated in the same service line, reinforcing a single-specialty surgical profile.
Medicaid specifics: All reported Medicaid revenue (100.0%) is attributed to 66984 (440 claims, $164 avg paid/claim, $72.2K revenue), and this Medicaid volume ranks #26 of 74 in-state (66th percentile). This suggests Medicaid activity mirrors the center’s Medicare-driven cataract focus but at lower scale relative to in-state peers.
Competitive standing on key Medicare codes: The provider is a national high-volume participant for several codes — 15823 ranks #2 of 1718 (100th percentile; extreme outlier, far above typical national volume for this code) and 67904 ranks #2 of 991 (100th percentile; extreme outlier, far above typical national volume for this code). 66984 ranks #693 of 15965 (96th percentile; notably above typical national volume for this code), indicating strong national-scale cataract throughput compared with most providers.
Statistical outliers and notable volumes: Several codes are flagged as extreme outliers or notably above typical volume, including 15823 and 67904 (both extreme outliers) and 66821 (925 claims, $200 avg, $185K revenue; 99th percentile; extreme outlier). The center’s unusually high national ranks on multiple oculoplastic and cataract-related codes mark it as a specialized high-volume operator rather than a general ophthalmology practice.
Ancillary capabilities and supply utilization: The billing mix includes intraoperative drug supply J1097 (2.1K claims, $76 avg, $157.2K revenue) and items associated with corneal processing and transplant (V2785: 22 claims, $3841 avg, $84.5K revenue; C9250: 423 claims, $141 avg, $59.6K revenue). These lines suggest the facility supports OR-level consumables and handles corneal tissue processing/transplant-related cases in addition to routine cataract and oculoplastic procedures.
Tenure and operational maturity: The provider’s NPI was enumerated on 2020-07-31 (~6 years ago), indicating it has been billing under this identifier for multiple years and has rapidly accumulated concentrated surgical volume, particularly in cataract and oculoplastic services. The combination of recent enumeration with high procedural ranks implies the center scaled surgical throughput quickly after establishment.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
29 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… | 2,490 | $800 | $2M |
| 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… | 850 | $450 | $382.8K |
| 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… | 550 | $490 | $267.5K |
| 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… | 90 | $2,420 | $225.4K |
| 66821 | The provider removes the haziness from the capsule of the eye using a laser for a patient with a secondary membranous cataract. | 930 | $200 | $185K |
| J1097 | phenylephrine 10.16 mg/ml and ketorolac 2.88 mg/ml ophthalmic irrigation solution, 1 ml | 2,070 | $80 | $157.2K |
| 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. | 40 | $2,150 | $88.1K |
| V2785 | Processing, preserving and transporting corneal tissue | 20 | $3,840 | $84.5K |
| 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… | 100 | $770 | $76.6K |
| 67917 | During this procedure, the provider performs an extensive repair of an ectropion, which is an outward turning of the lower eyelid and eyelashes, which can lead to excessive tearing and irritation of… | 130 | $510 | $66K |
Showing 1–10 of 29
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 29 CPT/HCPCS codes.
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Full comparison — all codes billed, vs. state median
29 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| J1097 | 5 | 10 | 1,240 | $80 | $151.9K |
| V2785 | 4 | 10 | 30 | $3,760 | $101.5K |
| 66984 | 85 | 580 | 230 | $70 | $73.7K |
| C9250 | 1 | 10 | 420 | $140 | $59.5K |
| 66991 | 2 | 30 | 30 | $1,280 | $51.4K |
| 15823 | 1 | 50 | 50 | $520 | $40.3K |
| 66183 | 5 | 10 | 30 | $1,200 | $35.9K |
| 67904 | 1 | 40 | 30 | $570 | $31.7K |
| 65820 | 30 | 40 | 30 | $790 | $31.4K |
| 15260 | 18 | 50 | 20 | $720 | $24.4K |
Showing 1–10 of 29
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
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Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
1 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… | 440 | $160 | $72.2K |
How this provider's Medicaid billing volume and revenue compare to other North Carolina providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. North Carolina median
1 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… | 26 | 70 | 130 | $160 | $107.5K |
Other providers in the same ZIP code as Wilmington Eye Surgery Center, LLC, ranked by combined Medicare and Medicaid revenue.
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