Why are Medicare and Medicaid shown separately instead of combined?

They come from two different CMS data sources with no shared claim identifier, so they can't be reconciled into one number without double-counting or guessing. Every table and chart on this page keeps them fully separate.

Why is there no private/commercial revenue figure?

Private and commercial payer data comes from Transparency in Coverage files, which only publish negotiated rates — not claims or utilization volume. Without a volume figure, no revenue number can be computed for any provider from that data.

What does "Rank" mean in the Competitive Analysis & Benchmarks tables?

For a given CPT/HCPCS code, it's this provider's position by claims volume among all providers billing that same code at that geography level (State, National, or Wisconsin for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Wisconsin only?

Medicaid is administered per-state with no single national fee schedule, so a state or national comparison the way Medicare has one isn't available. Wisconsin (this provider's own state) is the only grouping that's conceptually meaningful.

Why are the numbers rounded to the nearest 10?

To avoid implying more precision than the underlying data supports at a single-provider level. Ratios are kept precise since they're a relative comparison, not a volume or dollar figure.

How current is this data?

The Medicare and Medicaid tables are both single current snapshots, not refreshed on a recurring schedule yet.

Novamed Surgery Center Of Madison, Limited Partnership (NPI 1679570774)

Field	Value
Entity Type	Organization
Organization	Novamed Surgery Center Of Madison, Limited Partnership
Address	1200 John Q Hammons Dr
City	Madison
State	WI
ZIP	53717
Taxonomy	Ambulatory Surgical Clinic/Center
NPI Enumerated	July 5, 2005

Payer Source	Total Paid
Medicare	$931.1K
Medicaid	$0

Key Findings

NOVAMED SURGERY CENTER OF MADISON operates as an ambulatory surgical clinic/center with a clear ophthalmology/cataract service-line focus: the top Medicare codes are concentrated in cataract extraction and intraocular lens procedures (66984: 420 claims, $884 avg paid/claim, $371.3K revenue) and ophthalmic drug/irrigation items (J1096: 2.1K claims, $100 avg paid/claim, $211.4K revenue; J1097: 2.1K claims, $77 avg paid/claim, $163.1K revenue). These volumes and code mix indicate the center primarily delivers high-throughput cataract surgeries along with routine intraoperative or postoperative ophthalmic pharmaceutical administration.

Revenue is highly concentrated: the precomputed top-3 Medicare codes account for 79.9% of this provider’s total Medicare revenue, with 66984 alone representing 39.8% of Medicare revenue. That concentration means changes to reimbursement or utilization for these specific cataract and ophthalmic drug codes would disproportionately impact the provider’s topline.

The provider’s Medicare scale is modest but meaningful: lifetime Medicare revenue is $931.1K while there is no Medicaid billing on file, so the organization is effectively single-payer (Medicare) in the available claims data. Absence of Medicaid billing suggests limited exposure to, or participation in, state Medicaid populations and creates reliance on Medicare volume and reimbursement trends.

Competitive standing by code is mixed but generally within typical national activity levels: 66984 ranks #3257 of 15965 providers nationally (80th percentile) and is described as having "typical, unremarkable volume," while J1096 ranks #50 of 282 providers nationally (83th percentile) and J1097 ranks #135 of 443 (70th percentile), both also labeled "typical, unremarkable volume." These rankings imply the center is a routine participant on high-volume cataract and ophthalmic drug codes, with some relatively stronger placement among the smaller national cohort billing J1096.

The provider also bills for more complex ophthalmic procedures beyond routine cataract extraction: 66982 (101 claims, $869 avg paid/claim, $87.8K revenue, 9.4% of Medicare revenue) and 66991 (32 claims, $2636 avg paid/claim, $84.4K revenue, 9.0% of Medicare revenue) together account for a meaningful minority of revenue. Presence of these codes indicates capability to perform complex intraocular lens and combined procedures, contributing higher per-claim reimbursement (notably $2636 avg for 66991) despite lower claim counts.

Statistical characterizations provided in the dataset uniformly label most top codes as "typical, unremarkable volume," including 66984, J1096, J1097, 66982, 66991 and 65820 (65820: 19 claims, $794 avg paid/claim, $15.1K revenue, 1.6% of Medicare revenue; ranks #1005 of 1249, 16th percentile). Using the supplied plain-English labels, the provider’s activity profile should be interpreted as consistent with routine ophthalmic ambulatory surgery centers rather than as an outlier.

Operational tenure is long enough to suggest an established practice footprint: the NPI was enumerated on 2005-07-05 (~21 years ago), indicating sustained enrollment and likely stability in facility operations and payer relationships. That longevity, combined with concentrated Medicare revenue, suggests the center has an established referral and service pattern centered on Medicare-aged ophthalmology patients.

The payer and revenue profile points to concentration risk and potential strategic levers: with $931.1K of Medicare revenue and no Medicaid revenue on file, the center depends on Medicare volume and payments for sustainability, and the top three codes (79.9% of Medicare revenue) are strategic priorities for revenue management, quality monitoring, and contract negotiation discussions with payers or networks. Analysts should monitor utilization trends and reimbursement changes for 66984, J1096, and J1097 first, given their outsized contribution to revenue.

Medicare: Complete Services Breakdown

The CPT/HCPCS codes generating the most Medicare revenue for this provider.

6 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…	420	$880	$371.3K
J1096	Dexamethasone, lacrimal ophthalmic insert, 0.1 mg	2,110	$100	$211.4K
J1097	phenylephrine 10.16 mg/ml and ketorolac 2.88 mg/ml ophthalmic irrigation solution, 1 ml	2,120	$80	$163.1K
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…	100	$870	$87.8K
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	$2,640	$84.4K
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.	20	$790	$15.1K

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 6 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Wisconsin Distribution

Novamed Surgery Center Of Madison, Limited Partnership — 2 of 6 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Wisconsin

Full comparison — all codes billed, vs. state median

6 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J1097	1	10	1,030	$80	$88.9K
J1096	1	10	410	$100	$80.8K
66984	152	310	350	$50	$66.4K
66991	13	30	30	$1,270	$53.3K
65820	11	20	20	$870	$25.2K
66982	8	80	20	$490	$21.7K

Related Providers

Other providers that share a Tax Identification Number (TIN) with Novamed Surgery Center Of Madison, Limited Partnership, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Jay Met	WI	Ophthalmology Physician	$92K	$20K

Nearby Providers

Other providers in the same ZIP code as Novamed Surgery Center Of Madison, Limited Partnership, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Lumicera Health Services, LLC	WI	Specialty Pharmacy	$0	$9.4M
Janice Scholz	WI	Behavior Analyst	$0	$5.7M
Bright Dental Madison LLC	WI	Dental Clinic/Center	$0	$5.6M
Brittany Schumacher	WI	Behavior Analyst	$0	$2.8M
Erin Junemann	WI	Behavior Analyst	$0	$2.4M
Joseph Perron	WI	Clinical Psychologist	$0	$1.9M
Jodie Deruyter	WI	Behavior Analyst	$0	$1.9M
Crystal Held	WI	Behavior Analyst	$0	$1.7M
Michelle Sherman	WI	Social Worker	$0	$1.6M
Kimberly Knippel	WI	Behavior Analyst	$0	$1.4M

Novamed Surgery Center Of Madison, Limited Partnership — Billing Profile & Reimbursement Data

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Novamed Surgery Center Of Madison, Limited Partnership — Billing Profile & Reimbursement Data

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Key Findings

Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References