Why are Medicare and Medicaid shown separately instead of combined?

They come from two different CMS data sources with no shared claim identifier, so they can't be reconciled into one number without double-counting or guessing. Every table and chart on this page keeps them fully separate.

Why is there no private/commercial revenue figure?

Private and commercial payer data comes from Transparency in Coverage files, which only publish negotiated rates — not claims or utilization volume. Without a volume figure, no revenue number can be computed for any provider from that data.

What does "Rank" mean in the Competitive Analysis & Benchmarks tables?

For a given CPT/HCPCS code, it's this provider's position by claims volume among all providers billing that same code at that geography level (State, National, or Georgia for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Georgia only?

Medicaid is administered per-state with no single national fee schedule, so a state or national comparison the way Medicare has one isn't available. Georgia (this provider's own state) is the only grouping that's conceptually meaningful.

Why are the numbers rounded to the nearest 10?

To avoid implying more precision than the underlying data supports at a single-provider level. Ratios are kept precise since they're a relative comparison, not a volume or dollar figure.

How current is this data?

The Medicare and Medicaid tables are both single current snapshots, not refreshed on a recurring schedule yet.

Thomas Eye Surgery Center LLC (NPI 1588663512)

Key Findings

Field	Value
Entity Type	Organization
Organization	Thomas Eye Surgery Center LLC
Address	5995 Barfield Rd
City	Sandy Springs
State	GA
ZIP	30328
Taxonomy	Ambulatory Surgical Clinic/Center
NPI Enumerated	July 20, 2005

Payer Source	Total Paid
Medicare	$1.8M
Medicaid	$0

THOMAS EYE SURGERY CENTER LLC is an ambulatory surgical clinic/center with its NPI enumerated 2005-07-20 (~21 years ago). Its Medicare reporting shows a concentrated ophthalmology surgical practice where high-volume cataract and intraocular procedures dominate the billing mix, and no Medicaid billing is on file.

Revenue is highly concentrated: the top 3 Medicare codes by revenue (66984, 66991, 66982) account for 77.9% of this provider's total Medicare revenue. The single largest contributor is 66984, which generated $1.1M (58.8% of Medicare revenue) across 1.3K claims, indicating cataract extraction with lens insertion is the practice’s primary revenue driver.

Clinical mix indicates a core cataract surgery business supplemented by higher-complexity intraocular work: 66991 produced $202.4K (81 claims) and 66982 produced $144.1K (174 claims), together reflecting regular performance of combined or complex lens/implant procedures. The presence of these codes alongside 66984 suggests the center handles both routine and more complex cataract cases rather than purely minor ophthalmic procedures.

The provider is an outlier in vitreoretinal surgery relative to national peers: 67040 appears on the profile with 57 claims and $85.7K revenue and ranks #4 of 144 providers nationally (98th percentile; extreme outlier, far above typical national volume). 67042 also appears with 39 claims and $56.1K revenue (84th percentile), so the center appears to offer substantive vitreoretinal capabilities beyond a typical cataract-only ASC.

Competitive standing for cataract-related codes is above typical in national rankings: 66982 ranks #119 of 4580 providers (97th percentile) and 66991 ranks #120 of 1445 providers (92nd percentile), while 66984 ranks #1696 of 15965 providers (89th percentile). Together these ranks indicate the center is a notable regional/national participant for complex cataract and combined procedures, even if 66984’s volume is described as typical rather than dominant.

Oculoplastic and lacrimal procedure lines are also present but represent modest revenue diversification: examples include 15823 ($40.7K, 85 claims), 67904 ($39.7K, 77 claims), and 68720 ($20.4K, 20 claims). These procedures suggest the center offers eyelid and tear-duct surgeries in addition to intraocular operations, broadening referral appeal to ophthalmologists managing periocular conditions.

Payer mix is effectively single-payer Medicare for the dataset shown: total Medicare revenue is $1.8M and there is no Medicaid billing on file. This concentration on Medicare patients amplifies reimbursement and volume exposure to Medicare policy and contract changes rather than Medicaid dynamics.

Operational and contracting implications: the extreme outlier status on 67040 and high average payment for 66991 ($2499 avg paid/claim) point to higher-acuity services that could support negotiation leverage for retina and complex cataract case management. At the same time, the heavy reliance on three codes for 77.9% of Medicare revenue indicates revenue vulnerability if referral patterns or reimbursement for those specific procedures change.

Medicare: Complete Services Breakdown

The CPT/HCPCS codes generating the most Medicare revenue for this provider.

18 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…	1,280	$830	$1.1M
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	$2,500	$202.4K
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…	170	$830	$144.1K
67040	The provider removes vitreous humor from the eye to access the posterior segment of the eye and introduce surgical instruments through incisions in the pars plana. This procedure also includes the…	60	$1,500	$85.7K
67042	In this procedure, the provider removes vitreous humor, the gelatinous material that gives shape to the eye, using a mechanical cutting tool. He removes the internal limiting membrane of the retina…	40	$1,440	$56.1K
66821	The provider removes the haziness from the capsule of the eye using a laser for a patient with a secondary membranous cataract.	200	$210	$42.2K
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…	90	$480	$40.7K
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…	80	$520	$39.7K
67950	Canthoplasty (median or lateral) is often referred to as a corner eye lift or eye tendon surgery. The ophthalmologist uses this technique to strengthen the lateral canthal tendon or orbicularis…	50	$540	$27.6K
67311	The provider realigns an imbalance in the eye muscles by either recession, which weakens the eye muscle or resection, which strengthens the muscles so as to restore normal vision. This procedure is…	40	$550	$21.4K

Showing 1–10 of 18

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Finan Dermatopathology Laboratory, P.C.	GA	Clinical Medical Laboratory	$1.8M	$0
Paul Kaufman	GA	Ophthalmology Physician	$1.7M	$0
Jessica Mccluskey	GA	Ophthalmology Physician	$1.3M	$0
Woolfson Ambulatory Surgery Center, LLC	GA	Ophthalmologic Surgery Clinic/Center	$861.9K	$0
Merinda Herron	GA	Pediatrics Physician	$0	$770.9K
Mid Physician Network (oh), LLC	GA	General Practice Physician	$0	$756.5K
Kirk Paulk	GA	Internal Medicine Physician	$711.8K	$0
Nandini Setia	GA	Rheumatology Physician	$629.3K	$0
Mark Berman	GA	Ophthalmology Physician	$395.1K	$0
Marco Rodriguez	GA	Emergency Medicine Physician	$22.1K	$370.8K

Thomas Eye Surgery Center LLC — Billing Profile & Reimbursement Data

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Thomas Eye Surgery Center LLC — Billing Profile & Reimbursement Data

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Key Findings

Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
66984	69	410	190	$160	$103.1K
66991	3	40	30	$1,620	$60.1K
67040	1	10	30	$1,230	$40.5K
67904	9	30	30	$560	$33.7K
67042	3	20	20	$1,200	$31.1K
15823	7	60	40	$520	$23.5K
66982	2	110	20	$490	$21.9K
66821	24	270	60	$210	$20.9K
67311	3	10	40	$470	$20.5K
14060	49	70	20	$550	$17K