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NPI 1649350844 · Fargo, ND · Ambulatory Surgical Clinic/Center
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Northern Plains Surgery Center LLC is a ambulatory surgical clinic/center provider located in Fargo, North Dakota. This profile covers 13 Medicare and 2 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 | Northern Plains Surgery Center LLC |
| Address | 2829 University Dr S Ste 103 |
| City | Fargo |
| State | ND |
| ZIP | 58103 |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| NPI Enumerated | October 16, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $1.6M |
| Medicaid | $21.9K |
NORTHERN PLAINS SURGERY CENTER LLC bills almost exclusively as an ambulatory surgical clinic/center with a procedure mix dominated by ophthalmic anterior-segment work: the presence of high-volume cataract removal and lens insertion codes (66984, 66982, 66991) plus corneal and glaucoma device codes (V2785, 65756, 66183) indicates the center’s clinical activity is centered on cataract and other anterior-segment eye surgeries. This operational focus is consistent across both Medicare and Medicaid billing.
Revenue for Medicare is highly concentrated: the precomputed top 3 Medicare codes by revenue account for 80.7% of this provider's total Medicare revenue, driven chiefly by 66984 (1.1K claims, $757 avg paid/claim, $832.7K revenue, 52.2%), J1097 (4.7K claims, $76 avg paid/claim, $360.2K revenue, 22.6%), and V2785 (25 claims, $3782 avg paid/claim, $94.6K revenue, 5.9%). That concentration shows cataract surgery and its related intraoperative supply (J1097) are the principal revenue drivers on the Medicare side.
Medicaid billing is extremely limited in scale compared with Medicare but similarly concentrated: total Medicaid revenue is $21.9K and the precomputed top 3 Medicaid codes account for 100.0% of Medicaid revenue, with 66984 (23 claims, $576 avg paid/claim, $13.2K revenue, 60.6%) and J1097 (41 claims, $210 avg paid/claim, $8.6K revenue, 39.4%) comprising the entire Medicaid portfolio. This pattern makes the provider effectively Medicare-dominant in payer mix while using the same core procedural codes for the small Medicaid volume it reports.
Competitive standing on Medicare for the center’s top codes is mixed: 66984 ranks #1878 of 15965 providers nationally (88th percentile) and J1097 ranks #49 of 443 providers nationally (89th percentile), which places both codes well above median national participation and indicates a typical but solid national presence for cataract procedures and the associated ophthalmic irrigation supply. Other Medicare codes such as V2785 (rank #96 of 231, 55th percentile) show only middling national participation, suggesting the center is not a major national hub for corneal tissue processing despite billing for it.
On the Medicaid side the state-level ranks are based on very small comparison pools and should be read cautiously: 66984 ranks #5 of 5 in-state (0th percentile) and J1097 ranks #2 of 2 in-state (0th percentile), which reflects the provider’s minimal Medicaid activity rather than clear dominance or absence of competition. The tiny in-state sample limits how much the Medicaid ranks reveal about competitive standing beyond confirming low Medicaid throughput.
One notable statistical signal is 15823 (159 claims, $440 avg paid/claim, $70K revenue), which is labeled "notably above typical national volume" at the 95th percentile; this suggests the center performs a higher-than-typical volume of upper-eyelid skin procedures (blepharoplasty/functional eyelid surgery) relative to peers, indicating a significant ancillary oculoplastic or functional-cosmetic eyelid service line in addition to cataract work. That service-line specialization may supplement surgical throughput and revenue outside of cataract-specific codes.
Operational throughput is evidenced by the high claim counts for procedure and supply codes: 66984 shows 1.1K Medicare claims while J1097 shows 4.7K Medicare claims, indicating frequent use of the ophthalmic irrigation/ketorolac preparation per operative session and steady surgical volume. The disparity in claim counts between Medicare and Medicaid for these same codes (Medicaid: 23 claims for 66984; 41 claims for J1097) reinforces that the center’s procedural activity is concentrated in the Medicare population.
The provider’s NPI was enumerated on 2006-10-16 (~20 years ago), indicating long tenure as an outpatient surgical provider. That longevity, combined with the concentrated Medicare revenue base of $1.6M versus $21.9K in Medicaid, points to an established, Medicare-focused ambulatory surgery center with specialized ophthalmic services rather than a broad multi-specialty outpatient clinic.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
13 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… | 1,100 | $760 | $832.7K |
| J1097 | phenylephrine 10.16 mg/ml and ketorolac 2.88 mg/ml ophthalmic irrigation solution, 1 ml | 4,740 | $80 | $360.2K |
| V2785 | Processing, preserving and transporting corneal tissue | 30 | $3,780 | $94.5K |
| 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… | 30 | $2,280 | $70.6K |
| 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… | 160 | $440 | $70K |
| 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… | 70 | $760 | $50.9K |
| 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. | 20 | $2,030 | $30.5K |
| 65756 | During this procedure, the provider performs a complete corneal transplant to replace a damaged corneal endothelium. | 20 | $1,380 | $28.9K |
| 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… | 50 | $480 | $26.1K |
| 67900 | The provider repairs a drooping eyebrow due to muscle weakness or paralysis, to improve cosmetic appearance or remove the obstruction to a patient’s vision. He makes an incision immediately above the… | 20 | $470 | $11.4K |
Showing 1–10 of 13
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 13 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
13 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| J1097 | 1 | 10 | 3,660 | $80 | $272.3K |
| V2785 | 2 | 10 | 30 | $3,860 | $100.4K |
| 66984 | 3 | 100 | 50 | $350 | $61.2K |
| 66991 | 8 | 10 | 30 | $1,320 | $50.1K |
| 65756 | 3 | 10 | 30 | $1,130 | $34K |
| 66982 | 4 | 20 | 40 | $590 | $29.4K |
| 15823 | 1 | 10 | 30 | $480 | $27.2K |
| 67900 | 3 | 10 | 60 | $420 | $25.9K |
| 66183 | 3 | 10 | 20 | $1,040 | $23.8K |
| 67904 | 1 | 10 | 20 | $570 | $17.8K |
Showing 1–10 of 13
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.
2 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… | 20 | $580 | $13.2K |
| J1097 | phenylephrine 10.16 mg/ml and ketorolac 2.88 mg/ml ophthalmic irrigation solution, 1 ml | 40 | $210 | $8.6K |
How this provider's Medicaid billing volume and revenue compare to other North Dakota providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. North Dakota median
2 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… | 5 | 10 | 120 | $480 | $55.1K |
| J1097 | phenylephrine 10.16 mg/ml and ketorolac 2.88 mg/ml ophthalmic irrigation solution, 1 ml | 2 | 10 | 60 | $140 | $7.6K |
Other providers in the same ZIP code as Northern Plains Surgery Center LLC, ranked by combined Medicare and Medicaid revenue.
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