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NPI 1588681373 · Waterford, CT · Ambulatory Surgical Clinic/Center
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Constitution Surgery Center East LLC is a ambulatory surgical clinic/center provider located in Waterford, Connecticut. This profile covers 25 Medicare and 4 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 | Constitution Surgery Center East LLC |
| Address | 174 Cross Rd |
| City | Waterford |
| State | CT |
| ZIP | 06385 |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| NPI Enumerated | July 16, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $3M |
| Medicaid | $272.2K |
Scale and payer mix: CONSTITUTION SURGERY CENTER EAST LLC reports $3M in total Medicare revenue versus $272.2K in total Medicaid revenue, indicating Medicare is the dominant payer by a wide margin and Medicaid is a much smaller contributor to overall facility receipts. Both payers are present, but the center’s financial profile is effectively Medicare-driven given the order-of-magnitude difference in scale.
Medicare revenue concentration: The provider’s Medicare activity is highly concentrated — its top 3 Medicare codes account for 73.2% of total Medicare revenue, driven by 27447 (29.8% of Medicare revenue), 66984 (26.9% of Medicare revenue), and 27130 (16.5% of Medicare revenue). This concentration shows a small set of high-revenue procedures dominate facility billing on the Medicare side.
Service-line implications: The code mix indicates a dual clinical focus: high-revenue joint arthroplasty (27447 and 27130) alongside high-volume cataract surgery (66984). As an Ambulatory Surgical Clinic/Center, the facility appears to accommodate both orthopedic joint replacement procedures and ophthalmology cases, suggesting either multi-specialty staffing or co-located specialty practices performing outpatient surgical episodes.
Competitive standing for top Medicare procedures: The center has an outsized national position for some orthopaedic services — 27447 ranks #610 of 12089 (95th percentile) and is described as notably above typical national volume — while 27130 ranks #873 of 8062 (89th percentile) indicating a robust but less extreme presence. For cataract surgery 66984 the provider ranks #2098 of 15965 (87th percentile), reflecting a solid, broadly typical national volume rather than a dominant market share in ophthalmology.
Statistical outliers and specialty signals: Beyond the top-3 revenue drivers, several codes flag atypical volume patterns for this facility — 64624 ranks #1 of 521 (100th percentile; extreme outlier) with 177 claims and $703 avg paid/claim, and 64640 ranks #32 of 619 (95th percentile; notably above typical national volume). Additionally, C9290 shows 34.2K claims with $1 avg paid/claim and ranks #33 of 451 (93rd percentile; notably above typical national volume). These patterns suggest a notable volume of interventional pain/neurolytic procedures and frequent use of low-unit-cost injectables, which is not universal across ambulatory surgery centers.
Medicaid concentration and in-state standing: Medicaid billing is virtually all concentrated in a single service line — top Medicaid codes account for 100.0% of Medicaid revenue, with 66984 alone representing $271.9K (100.0% of Medicaid revenue) from 1.1K claims and an average $240 paid/claim. In-state competitive position for that Medicaid cataract work is middling: 66984 ranks #13 of 39 providers in-state (68th percentile), indicating typical to slightly above-typical state volume but not dominant statewide.
Payer rate and volume dynamics: The same procedure 66984 shows different payer economics and volumes: Medicare reporting for 66984 is 896 claims at $899 avg paid/claim generating $805.5K, while Medicaid shows 1.1K claims at $240 avg paid/claim for $271.9K. This divergence highlights materially lower Medicaid per-claim payments for cataract surgery at this center and implies that payer mix will materially affect per-case revenue and margin for the facility.
Tenure and operational stability: The provider’s NPI was enumerated on 2006-07-16 (~20 years ago), indicating an established operation with a long tenure in the market. Combined with concentrated Medicare revenue and repeated high-volume procedure codes, the center appears to be a mature ambulatory surgical operation with entrenched service lines in orthopedics and ophthalmology.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
25 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 27447 | In this procedure, the provider replaces the damaged weight bearing surfaces of both the medial and lateral compartments in the knee joint using implants of metal or other strong materials. The… | 120 | $7,640 | $893.3K |
| 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… | 900 | $900 | $805.5K |
| 27130 | In this procedure, the provider surgically replaces the hip joint by prosthesis, or artificial hip joint. He replaces both the femoral and acetabular components with or without using an autograft or… | 60 | $7,730 | $494.8K |
| 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 | $900 | $148.6K |
| 64624 | The provider uses a chemical, heat, or radiofrequency as a neurolytic agent to destroy branches of the genicular nerves that supply the knee joint; imaging guidance is included, if performed, so it… | 180 | $700 | $124.4K |
| 29827 | The provider examines the tissue inside the shoulder joint with an arthroscope. She inserts additional instruments to repair a torn rotator cuff, the grouping of muscles and tendons that surround and… | 40 | $2,020 | $88.7K |
| 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… | 20 | $2,610 | $52.3K |
| 64721 | Neuroplasty or transposition of the median nerve at the carpal tunnel is done to treat a condition called carpal tunnel syndrome (CTS). The carpal tunnel is a narrow tunnel in the wrist through which… | 50 | $690 | $35.9K |
| C9290 | Injection, bupivacaine liposome, 1 mg | 34,180 | $1 | $34.2K |
| 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. | 10 | $2,400 | $33.6K |
Showing 1–10 of 25
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 25 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
25 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| 66984 | 9 | 150 | 90 | $400 | $87.8K |
| 66991 | 10 | 10 | 30 | $1,920 | $73K |
| 27447 | 2 | 160 | 20 | $1,320 | $39.6K |
| 64624 | 1 | 10 | 50 | $510 | $37.3K |
| 27130 | 7 | 100 | 20 | $1,200 | $34.9K |
| 29827 | 2 | 30 | 20 | $1,350 | $29.7K |
| 66183 | 3 | 10 | 10 | $1,850 | $29.7K |
| 66982 | 2 | 40 | 30 | $740 | $27.5K |
| 29828 | 8 | 10 | 20 | $1,220 | $24.4K |
| 29881 | 4 | 10 | 20 | $1,100 | $22K |
Showing 1–10 of 25
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.
4 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… | 1,130 | $240 | $271.9K |
| 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… | 390 | $0 | $0 |
| G8916 | Patient with preoperative order for iv antibiotic surgical site infection (ssi) prophylaxis, antibiotic initiated on time | 10 | $0 | $0 |
| G8918 | Patient without preoperative order for iv antibiotic surgical site infection (ssi) prophylaxis | 290 | $0 | $0 |
How this provider's Medicaid billing volume and revenue compare to other Connecticut providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Connecticut median
4 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… | 13 | 40 | 380 | $310 | $334K |
| 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 | 30 | 110 | $0 | $0 |
| G8916 | Patient with preoperative order for iv antibiotic surgical site infection (ssi) prophylaxis, antibiotic initiated on time | 2 | 10 | 10 | $0 | $0 |
| G8918 | Patient without preoperative order for iv antibiotic surgical site infection (ssi) prophylaxis | 4 | 20 | 90 | $0 | $0 |
Other providers in the same ZIP code as Constitution Surgery Center East LLC, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Retina Group Of New England PC | CT | Retina Specialist (Ophthalmology) Physician | $0 | $8.6M |
| Nauman Chaudhry | CT | Retina Specialist (Ophthalmology) Physician | $5.1M | $0 |
| Visiting Nurse Association Of Southeastern Connecticut | CT | Home Health Agency | $0 | $4.1M |
| Juner Colina-biscotto | CT | Retina Specialist (Ophthalmology) Physician | $3.7M | $0 |
| Connections Counseling Center, LLC | CT | Psychiatry Physician | $0 | $1.7M |
| Waterford Ambulance Service, Inc | CT | Land Ambulance | $380.9K | $1.1M |
| Careco Medical, Inc. | CT | Home Health Agency | $0 | $1.4M |
| Waterford Public Schools | CT | Local Education Agency (LEA) | $0 | $1.2M |
| Mallory Devona | CT | Counselor | $0 | $1.2M |
| Brian Mann | CT | Optometrist | $8.6K | $1.1M |
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