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NPI 1720044522 · Mobile, AL · Ambulatory Surgical Clinic/Center
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Surgicare Of Mobile Ltd is a ambulatory surgical clinic/center provider located in Mobile, Alabama. This profile covers 26 Medicare and 7 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 | Surgicare Of Mobile Ltd |
| Address | 2890 Dauphin St |
| City | Mobile |
| State | AL |
| ZIP | 36606 |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| NPI Enumerated | April 21, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $1.5M |
| Medicaid | $101.9K |
SURGICARE OF MOBILE LTD is listed as an Ambulatory Surgical Clinic/Center and its Medicare billing mix shows a hybrid ophthalmology and gastrointestinal procedural footprint: the largest Medicare line is cataract extraction with intraocular lens insertion (66984), and high-volume endoscopy codes (45385 and 43239) together drive a substantial share of procedural revenue. This combination of ophthalmic and GI codes is consistent with an ASC that supports multiple specialty service lines rather than a single-focus clinic.
Medicare revenue is concentrated in just a few procedures: the top three Medicare codes (66984, 45385, 43239) account for 57.0% of this provider's total Medicare revenue, with 66984 alone comprising 36.6% of Medicare revenue. That concentration indicates the facility’s financial performance on Medicare is particularly sensitive to volume in cataract surgery and a small set of endoscopic procedures.
Medicaid billing is heavily concentrated in pediatric ENT procedures: the top three Medicaid codes (69436, 42820, 66984) account for 99.8% of the provider's total Medicaid revenue, with 69436 (tympanostomy with tube insertion) representing 78.9% and 42820 (tonsil/adenoid removal in children) representing 19.5%. This shows Medicaid activity is essentially driven by outpatient pediatric ear/nose/throat surgeries rather than the ophthalmology or GI mix that dominates Medicare.
On payer scale the practice is Medicare-dominant: lifetime Medicare revenue is $1.5M versus lifetime Medicaid revenue of $101.9K, so Medicare is the institution’s primary revenue source and Medicaid represents a much smaller share of billed public-payer volume. Analysts should treat Medicaid as a niche payer line for this provider rather than a co-equal revenue stream.
The provider is an extreme national outlier on several GI endoscopy metrics: 45385 (colon polypectomy) ranks #294 of 16310 providers nationally (98th percentile; extreme outlier) and 43239 (EGD with biopsy) ranks #194 of 17140 (99th percentile; extreme outlier). Those ranks indicate materially higher-than-typical national procedural volumes for these GI codes and suggest the ASC is a regional hub for endoscopic procedures relative to most peers.
By contrast, cataract surgery volumes are elevated but not extreme: 66984 ranks #2224 of 15965 providers nationally (86th percentile; typical, unremarkable volume for this code), and related ophthalmology codes (e.g., 66982) sit in similar mid-to-high national percentiles. This profile implies the center performs a steady, above-average caseload of ophthalmic surgery without being among the very highest-volume national cataract surgery centers.
Despite the Medicaid revenue concentration in tympanostomy, the facility does not appear to be a dominant statewide Medicaid provider for those pediatric ENT procedures: 69436 ranks #18 of 64 providers in-state (73th percentile) and 42820 ranks #19 of 43 in-state (57th percentile), both characterized as typical, unremarkable volumes. In other words, the facility relies on these Medicaid procedures for most Medicaid revenue but is not a top in-state volume leader for those codes.
The provider has long tenure in Medicare enrollment (NPI enumerated 2006-04-21 (~20 years ago)), which supports interpretation of these patterns as established operational specialization rather than a transient behavior. Longevity combined with concentrated code volumes suggests stable service lines (ophthalmology, GI endoscopy, and pediatric ENT under Medicaid) that analysts should consider when modeling referral networks or contracting opportunities.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
26 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… | 810 | $700 | $562.3K |
| 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… | 510 | $390 | $199.6K |
| 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. | 590 | $190 | $112.9K |
| 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… | 320 | $290 | $92.5K |
| 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… | 130 | $440 | $56.7K |
| 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 | $700 | $52.1K |
| G0105 | Colorectal cancer screening; colonoscopy on individual at high risk | 120 | $360 | $42.1K |
| 66174 | The provider expands the aqueous outflow (drainage) canal of the eye to help relieve pressure in the eye. The procedure does not include leaving a device or stent in place. | 30 | $1,340 | $41.5K |
| 43249 | The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum and dilates (widens) the esophagus with a balloon less than 30 mm in diameter. | 80 | $510 | $41.4K |
| 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. | 30 | $1,260 | $40.2K |
Showing 1–10 of 26
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 26 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.
7 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 69436 | This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia. | 880 | $90 | $80.3K |
| 42820 | The provider removes the tonsils and adenoids in a patient younger than 12 years old. | 60 | $360 | $19.8K |
| 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… | 130 | $10 | $1.5K |
| 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. | 10 | $20 | $250 |
| C1889 | Implantable/insertable device, not otherwise classified | 170 | $0 | $0 |
| 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… | 300 | $0 | $0 |
| L8699 | Prosthetic implant, not otherwise specified | 150 | $0 | $0 |
How this provider's Medicaid billing volume and revenue compare to other Alabama providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Alabama median
7 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 69436 | This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia. | 18 | 60 | 320 | $130 | $176.1K |
| 42820 | The provider removes the tonsils and adenoids in a patient younger than 12 years old. | 19 | 40 | 40 | $380 | $123.8K |
| 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. | 57 | 60 | 110 | $190 | $74.7K |
| 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 | 30 | 70 | $60 | $10.2K |
| C1889 | Implantable/insertable device, not otherwise classified | 1 | 10 | 100 | $0 | $0 |
| 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… | 9 | 30 | 220 | $0 | $0 |
| L8699 | Prosthetic implant, not otherwise specified | 3 | 10 | 210 | $0 | $0 |
Other providers in the same ZIP code as Surgicare Of Mobile Ltd, ranked by combined Medicare and Medicaid revenue.
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