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NPI 1669474748 · Louisville, KY · Ambulatory Surgical Clinic/Center
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Arc Kentucky LLC is a ambulatory surgical clinic/center provider located in Louisville, Kentucky. This profile covers 17 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 | Arc Kentucky LLC |
| Address | 4004 Dupont Cir |
| City | Louisville |
| State | KY |
| ZIP | 40207 |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| NPI Enumerated | June 2, 2005 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $2.1M |
| Medicaid | $872.5K |
ARC KENTUCKY LLC operates as an Ambulatory Surgical Clinic/Center with a clear ophthalmology procedural mix: the Medicare and Medicaid top codes are dominated by cataract extraction with intraocular lens placement (66984) and multiple posterior-segment vitreoretinal procedures (67036, 67041, 67042). The presence of high-volume ophthalmic drug codes J1097 and J1096 further signals routine intraoperative irrigation and anti-inflammatory/insert use consistent with surgical cataract and retina workflows. This code mix is consistent with a focused ambulatory surgical practice serving surgical ophthalmology cases rather than broad multispecialty services.
Revenue concentration on Medicare is high: the precomputed top 3 Medicare codes by revenue account for 71.3% of this provider's total Medicare revenue, driven by 66984 ($1.2M, 58.2% of Medicare revenue), J1097 ($168K, 8.0%), and 67036 ($105.7K, 5.1%). This concentration indicates the provider’s Medicare business is heavily dependent on a small set of ophthalmic procedures, with cataract surgery as the primary revenue engine.
Medicaid revenue is effectively single-procedure dependent: 66984 accounts for $872.3K and represents 100.0% of this provider's total Medicaid revenue, with G8907 recorded as 318 claims but $0 paid. Medicaid activity for this provider is therefore overwhelmingly tied to cataract surgeries billed under 66984, suggesting limited Medicaid utilization outside routine cataract services.
Payer mix and scale show Medicare is the larger revenue source: Total Medicare revenue is $2.1M versus Total Medicaid revenue of $872.5K, so the provider maintains meaningful activity across both payers but Medicare contributes the majority of revenue. The practice is not single-payer on file, but Medicare appears to be the principal commercial source of surgical revenue.
Competitive standing varies by service line: for cataract surgery (66984) the provider ranks #1415 of 15965 nationally and is at the 91th percentile with a characterization of "typical, unremarkable volume for this code," while the same code ranks #12 of 71 in-state for Medicaid at the 84th percentile. In contrast, select vitreoretinal procedures are relative outliers nationally — 67036 ranks #30 of 832 (96th percentile) and 67041 ranks #13 of 461 (97th percentile) and are labeled "notably above typical national volume for this code," indicating above-typical specialization or higher-than-average volume for posterior-segment surgery compared with peers.
Tenure is long-standing: the NPI was enumerated (registered) on 2005-06-02 (~21 years ago), indicating the facility has an established operating history which may support existing referral relationships and operational maturity in its surgical ophthalmology niche.
Clinical supply and device utilization is visible in billing patterns: J1097 shows 2.2K claims and $168K revenue on Medicare, and J1096 shows 456 claims and $45.6K revenue, reflecting routine use of intraoperative irrigation/medication and dexamethasone lacrimal inserts associated with cataract and anterior-segment procedures. The large claim counts for these drug codes align with the high volume of 66984 and suggest standard perioperative pharmaceutical utilization patterns for an ophthalmic ASC.
There are service-level contrasts across low- and high-percentile codes: certain procedures such as 66180 (12 claims, $22.8K; ranks #305 of 375, 7th percentile) appear at the lower end of national volume and are noted as "typical, unremarkable" but comparatively scarce, while other codes like 66821 (23 claims, $4.3K; 21th percentile) are also lower-volume. The Medicaid-only code G8907 appears as 318 claims with $0 paid, reflecting a quality/reporting measure rather than a revenue driver for the facility.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
17 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… | 1,560 | $780 | $1.2M |
| J1097 | phenylephrine 10.16 mg/ml and ketorolac 2.88 mg/ml ophthalmic irrigation solution, 1 ml | 2,210 | $80 | $168K |
| 67036 | The provider removes vitreous fluid from the eye to access the posterior segment of the eye and introduce surgical instruments through incisions in the pars plana. | 70 | $1,430 | $105.7K |
| 67041 | In this procedure, the provider removes scar tissue from the retinal membrane that obscures vision. He removes vitreous humor, the gelatinous material that gives shape to the eye, using a mechanical… | 60 | $1,400 | $86.8K |
| 65820 | The provider incises the limbus to improve drainage of aqueous humor in the eye. This procedure is typically performed on children, usually to treat congenital glaucoma. | 50 | $1,410 | $76.3K |
| V2785 | Processing, preserving and transporting corneal tissue | 20 | $3,130 | $75.2K |
| 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… | 50 | $1,410 | $69K |
| J1096 | Dexamethasone, lacrimal ophthalmic insert, 0.1 mg | 460 | $100 | $45.6K |
| 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… | 60 | $750 | $44.8K |
| 67108 | The provider repairs a detached retina using heat produced by a laser beam or by freezing the tissues. He may attach a scleral buckle to simplify the passage of fluid through and behind the retina or… | 30 | $1,430 | $44.3K |
Showing 1–10 of 17
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 17 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
17 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| V2785 | 2 | 10 | 20 | $3,210 | $86.8K |
| 66984 | 155 | 310 | 1,560 | $40 | $67.1K |
| J1097 | 1 | 10 | 480 | $80 | $65K |
| J1096 | 2 | 10 | 330 | $100 | $32.5K |
| 67036 | 1 | 20 | 20 | $910 | $28.1K |
| 65820 | 1 | 10 | 30 | $890 | $24.8K |
| 67040 | 2 | 10 | 20 | $1,030 | $24.7K |
| 67041 | 1 | 10 | 20 | $1,020 | $24.5K |
| 67042 | 1 | 10 | 20 | $1,170 | $23.4K |
| 67108 | 3 | 10 | 20 | $1,010 | $23.2K |
Showing 1–10 of 17
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… | 1,910 | $460 | $872.3K |
| 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… | 320 | $0 | $0 |
How this provider's Medicaid billing volume and revenue compare to other Kentucky providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Kentucky 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… | 12 | 70 | 210 | $310 | $290K |
| 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… | 8 | 20 | 260 | $1 | $1 |
Other providers in the same ZIP code as Arc Kentucky LLC, ranked by combined Medicare and Medicaid revenue.
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