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NPI 1619935483 · Hilton Head Island, SC · Ambulatory Surgical Clinic/Center
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Outpatient Surgery Center Of Hilton Head is a ambulatory surgical clinic/center provider located in Hilton Head Island, South Carolina. This profile covers 39 Medicare and 10 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 | Outpatient Surgery Center Of Hilton Head |
| Address | 190 Pembroke Dr |
| City | Hilton Head Island |
| State | SC |
| ZIP | 29926 |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| NPI Enumerated | May 2, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $3.7M |
| Medicaid | $896K |
OUTPATIENT SURGERY CENTER OF HILTON HEAD is an ambulatory surgical clinic/center primarily delivering ophthalmic, orthopedic, and endoscopic procedures based on its top Medicare codes; 66984 (cataract extraction + IOL), 27447 (total knee replacement), and 45385 (polypectomy via colonoscopy) are the largest contributors, reflecting a mixed specialty ASC model that handles same-day eye surgery, joint arthroplasty cases, and high-volume GI endoscopy. The code mix suggests the center functions as a multi-specialty outpatient surgery facility rather than a single-procedure specialty clinic.
Revenue concentration on Medicare is high: the precomputed top 3 Medicare codes account for 57.1% of the provider’s total Medicare revenue, with 66984 alone representing $997.2K (27.7% of Medicare revenue). This concentration indicates the facility’s Medicare financial performance is heavily dependent on a handful of high-revenue procedures, particularly cataract surgery and knee arthroplasty.
Medicaid revenue is much smaller in scale compared with Medicare: total Medicare revenue is $3.7M versus total Medicaid revenue of $896K, so Medicare constitutes the dominant payer by revenue. On Medicaid the top 3 codes account for 76.8% of Medicaid revenue, indicating even greater concentration of services billed to Medicaid around a few dental procedure codes (D2930, D7140, D2391) rather than the surgical specialties driving Medicare.
Competitive standing versus national peers is mixed by service line: for Medicare 27447 ranks #521 of 12089 (96th percentile) and 45385 ranks #209 of 16310 (99th percentile), both described as notably above typical or extreme outlier volume, which signals regional or specialty prominence in knee arthroplasty and therapeutic colonoscopy relative to peers. By contrast, 66984 ranks #1685 of 15965 (89th percentile) and is characterized as typical/unremarkable volume, indicating the center’s cataract volumes are strong but not exceptional nationally.
For Medicaid the center’s dental-related billing is concentrated and typical within the state: D2930 (50.7% of Medicaid revenue) ranks #62 of 134 in-state (54th percentile) and D7140 and D2391 sit near mid-percentiles in-state. This pattern indicates the facility’s Medicaid activity is dominated by dental services at a level comparable to many peers in South Carolina, rather than being a top statewide outlier.
Tenure: the provider’s NPI was enumerated on 2006-05-02 (~20 years ago), indicating long-standing operational history in the market; this duration supports the observed high-volume patterns for several established procedures and suggests entrenched referral or patient flow relationships.
Several Medicare codes are statistical outliers in volume, reinforcing specialization: 45385 is labeled an extreme outlier (far above typical national volume) and G0105 ranks in the 99th percentile (extreme outlier) for high-risk colonoscopy, together showing outsized activity in colorectal procedures. Similarly, codes such as 23430, 45380, 43239, and 29827 are described as notably above typical national volume, pointing to meaningful secondary strengths in shoulder procedures, diagnostic endoscopy, and related services.
Operational risk and revenue sensitivity: given that a small set of codes drive the majority of revenue on both payers (57.1% Medicare top-3; 76.8% Medicaid top-3), the facility’s financial performance is sensitive to changes in reimbursement, referral patterns, or regulatory coverage for those specific codes. Diversifying case mix or payers could mitigate concentration risk if strategic changes are under consideration.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
39 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… | 1,300 | $770 | $997.1K |
| 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 | $6,500 | $799.4K |
| 45385 | The provider examines the colon and rectum using a colonoscope, a long, thin flexible tubular instrument with a light source and camera. He removes one or more tumors, polyps, or other lesions with a… | 630 | $410 | $256.4K |
| 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… | 30 | $6,750 | $202.4K |
| J1097 | phenylephrine 10.16 mg/ml and ketorolac 2.88 mg/ml ophthalmic irrigation solution, 1 ml | 2,080 | $80 | $157.8K |
| 23430 | In this procedure, the provider surgically cleans the long tendon of the biceps from its damaged fragment and fixes the tendon to the upper end of the humerus to improve the stability of the joint.… | 50 | $2,800 | $134.3K |
| 45380 | The provider examines the rectum and colon using a flexible colonoscope, a tubular instrument with a light source and camera, to look for the cause of a patient's symptoms, which may include… | 360 | $330 | $120.9K |
| G0105 | Colorectal cancer screening; colonoscopy on individual at high risk | 270 | $380 | $102.5K |
| 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… | 210 | $470 | $96.9K |
| 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. | 430 | $200 | $86.4K |
Showing 1–10 of 39
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 39 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
39 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| J1097 | 7 | 10 | 2,610 | $80 | $208.9K |
| 66984 | 50 | 270 | 210 | $170 | $141.3K |
| 27447 | 20 | 220 | 40 | $1,090 | $61.9K |
| 27130 | 84 | 150 | 40 | $1,060 | $44.7K |
| 67036 | 4 | 20 | 20 | $1,110 | $40.1K |
| 45385 | 8 | 270 | 90 | $270 | $36.9K |
| 15823 | 2 | 40 | 40 | $520 | $33.1K |
| 67042 | 2 | 30 | 20 | $1,150 | $32.3K |
| 67904 | 10 | 30 | 40 | $550 | $30.3K |
| 67108 | 3 | 20 | 20 | $1,150 | $24.1K |
Showing 1–10 of 39
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.
10 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| D2930 | N/A | 1,470 | $310 | $454.5K |
| D7140 | Extraction, erupted tooth or exposed root (elevation and/or forceps removal) | 440 | $310 | $138.1K |
| D2391 | Resin‑based composite – one surface, posterior | 400 | $240 | $95.7K |
| D3220 | N/A | 380 | $240 | $90K |
| D2392 | Post 2 surface resin‑based composite | 160 | $230 | $37.2K |
| D1120 | Prophylaxis–child | 330 | $110 | $35.5K |
| D1208 | Topical application of fluoride - excluding varnish | 270 | $80 | $20.9K |
| D0150 | Comprehensive oral evaluation – new or established patient | 90 | $180 | $15.7K |
| D2330 | Resin-based composite - one surface, anterior | 50 | $190 | $8.6K |
| 9 00 | N/A | 10 | $0 | $0 |
How this provider's Medicaid billing volume and revenue compare to other South Carolina providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. South Carolina median
10 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| D2930 | N/A | 62 | 130 | 1,060 | $150 | $371.1K |
| D2392 | Post 2 surface resin‑based composite | 236 | 350 | 520 | $100 | $175.3K |
| D1120 | Prophylaxis–child | 286 | 470 | 600 | $30 | $156.7K |
| D7140 | Extraction, erupted tooth or exposed root (elevation and/or forceps removal) | 140 | 290 | 380 | $90 | $125K |
| D2391 | Resin‑based composite – one surface, posterior | 128 | 300 | 270 | $80 | $110.5K |
| D3220 | N/A | 40 | 90 | 290 | $100 | $91.6K |
| D0150 | Comprehensive oral evaluation – new or established patient | 358 | 510 | 290 | $40 | $51.6K |
| D1208 | Topical application of fluoride - excluding varnish | 182 | 300 | 750 | $20 | $43.3K |
| D2330 | Resin-based composite - one surface, anterior | 45 | 70 | 100 | $100 | $27.6K |
| 9 00 | N/A | 1 | 10 | 10 | $0 | $0 |
Other providers in the same ZIP code as Outpatient Surgery Center Of Hilton Head, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Coastal Pediatric Dentistry, LLC | SC | Pediatric Dentistry | $0 | $13.8M |
| Ash Services | SC | Rehabilitation Clinic/Center | $0 | $4.9M |
| Hilton Head Health System, L.P. | SC | General Acute Care Hospital | $0 | $4.4M |
| Salerno Pediatric Care LLC | SC | Pediatrics Physician | $0 | $1.9M |
| Carl Baker | SC | Retina Specialist (Ophthalmology) Physician | $1.7M | $6.9K |
| Kidz Planet Pediatric Dentistry Hhi, PA | SC | Pediatric Dentistry | $0 | $1.7M |
| Stephen Luther | SC | Internal Medicine Physician | $1.2M | $0 |
| Peter Liggett | SC | Retina Specialist (Ophthalmology) Physician | $1M | $0 |
| Ravina Balchandani | SC | Cardiovascular Disease Physician | $952.8K | $0 |
| Albert Bundy | SC | Specialist | $897.1K | $0 |
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