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NPI 1619144607 · Kennewick, WA · Ambulatory Surgical Clinic/Center
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Pacific Cataract And Laser Institute, Inc., P.C. is a ambulatory surgical clinic/center provider located in Kennewick, Washington. This profile covers 9 Medicare and 5 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 | Pacific Cataract And Laser Institute, Inc., P.C. |
| Address | 6695 W Rio Grande Ave |
| City | Kennewick |
| State | WA |
| ZIP | 99336 |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| NPI Enumerated | May 9, 2008 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $2.4M |
| Medicaid | $520.5K |
PACIFIC CATARACT AND LASER INSTITUTE, INC., P.C. in KENNEWICK, WA is listed as an Ambulatory Surgical Clinic/Center and has an NPI enumerated on 2008-05-09 (~18 years ago). Its reported lifetime revenues show Total Medicare revenue of $2.4M and Total Medicaid revenue of $520.5K, consistent with an established specialty surgical practice focused on eye procedures.
Medicare represents the dominant revenue source for this entity: Total Medicare revenue is $2.4M versus Total Medicaid revenue of $520.5K, placing Medicare at a materially larger scale in the provider's payer mix. Medicaid activity exists but generates considerably less lifetime revenue than Medicare for this provider.
Revenue is highly concentrated within a small set of cataract-related services on the Medicare side: the top 3 Medicare codes account for 96.4% of Medicare revenue, led by 66984 ($1.9M, 78.2%), then 66991 ($289.3K, 11.9%), and 66821 ($152.2K, 6.3%). This concentration signals a core business model centered on extracapsular cataract extraction with intraocular lens procedures and associated laser follow-up.
Medicaid billing is even more concentrated: the top 3 Medicaid codes account for 100.0% of Medicaid revenue, with 66984 contributing $506.1K (97.3%), followed by 00142 ($9.3K, 1.8%) and 66821 ($4.4K, 0.9%). The Medicaid pattern indicates the provider bills almost exclusively for cataract/lens procedures to Medicaid enrollees, with limited ancillary Medicaid revenue lines.
At the code-level the provider ranks as a high-volume national performer for key cataract codes: Medicare 66984 ranks #805 of 15965 (95th percentile) and is described as notably above typical national volume, 66991 ranks #42 of 1445 (97th percentile) and is also notably above typical national volume, while 66821 ranks #118 of 10087 (99th percentile) and is labeled an extreme outlier, reflecting very high laser capsulotomy volumes relative to peers. These rank and percentile positions indicate strong national competitive standing on core cataract procedures.
In the state Medicaid market the provider is a major participant for the flagship cataract procedure: Medicaid 66984 ranks #6 of 51 in-state (90th percentile) and is described as notably above typical state volume, while other Medicaid codes such as 00142 and 66821 show modest in-state presence and account for small shares of Medicaid revenue. This suggests local market prominence for cataract surgery deliveries.
The service-line mix — high volumes of same-session lens insertion codes (66984 and 66991) combined with frequent 66821 laser capsulotomy claims — is typical of an ambulatory surgical center that performs primary cataract surgeries plus postoperative laser care. Operationally this pattern implies the center captures both the surgical episode and significant follow-up procedures in-house.
Payer-rate and volume interactions are evident at the claim level: for 66984 the provider reported 2.3K Medicare claims with an average paid per claim of $834 yielding $1.9M, versus 3.1K Medicaid claims with an average paid per claim of $164 yielding $506.1K. Despite similar or higher Medicaid claim counts for this code, Medicare payment levels drive the majority of revenue for the same clinical activity.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
9 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… | 2,280 | $830 | $1.9M |
| 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… | 120 | $2,470 | $289.3K |
| 66821 | The provider removes the haziness from the capsule of the eye using a laser for a patient with a secondary membranous cataract. | 860 | $180 | $152.2K |
| 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… | 40 | $830 | $33.1K |
| 65756 | During this procedure, the provider performs a complete corneal transplant to replace a damaged corneal endothelium. | 10 | $1,510 | $21.1K |
| 66986 | The provider removes a previously placed intraocular lens and places a new one. | 20 | $800 | $19.1K |
| 65426 | During this procedure, the provider excises or transposes the pterygium to improve patient comfort and vision and also performs a graft. | 10 | $700 | $7.7K |
| 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. | 60 | $90 | $5.8K |
| 66761 | The provider uses a laser beam to create a small hole in the iris that equalizes the intraocular pressure between anterior and posterior chamber of the eyes. Report this code for single session of… | 10 | $140 | $1.7K |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 9 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
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.
5 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… | 3,090 | $160 | $506.1K |
| 00142 | The provider performs anesthesia services for a patient undergoing an eye lens procedure. | 340 | $30 | $9.3K |
| 66821 | The provider removes the haziness from the capsule of the eye using a laser for a patient with a secondary membranous cataract. | 60 | $80 | $4.4K |
| 92136 | The provider uses a noninvasive method to measure the patient’s eye or eyes to get information that the provider then uses to calculate the appropriate power for an intraocular lens (IOL). Selecting… | 20 | $1 | $70 |
| 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… | 330 | $0 | $0 |
How this provider's Medicaid billing volume and revenue compare to other Washington providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Washington median
5 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… | 6 | 50 | 410 | $180 | $154K |
| 00142 | The provider performs anesthesia services for a patient undergoing an eye lens procedure. | 11 | 20 | 370 | $50 | $43.5K |
| 66821 | The provider removes the haziness from the capsule of the eye using a laser for a patient with a secondary membranous cataract. | 5 | 10 | 250 | $110 | $33.3K |
| 92136 | The provider uses a noninvasive method to measure the patient’s eye or eyes to get information that the provider then uses to calculate the appropriate power for an intraocular lens (IOL). Selecting… | 19 | 30 | 70 | $10 | $7.1K |
| 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… | 14 | 50 | 90 | $1 | $1 |
Other providers in the same ZIP code as Pacific Cataract And Laser Institute, Inc., P.C., ranked by combined Medicare and Medicaid revenue.
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