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NPI 1720324296 · Ogden, UT · Ambulatory Surgical Clinic/Center
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Mt Ogden Utah Surgical Center LLC is a ambulatory surgical clinic/center provider located in Ogden, Utah. This profile covers 23 Medicare and 3 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 | Mt Ogden Utah Surgical Center LLC |
| Address | 4364 Washington Blvd |
| City | Ogden |
| State | UT |
| ZIP | 84403 |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| NPI Enumerated | January 2, 2013 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $1.3M |
| Medicare | $1.2M |
MT OGDEN UTAH SURGICAL CENTER LLC’s Medicare billing pattern is strongly ophthalmology‑weighted: the top Medicare codes include 66984, 66991, V2785 and 65756, indicating routine extracapsular cataract extraction with intraocular lens insertion, corneal tissue processing, and occasional corneal transplant procedures. The provider’s taxonomy as an Ambulatory Surgical Clinic/Center aligns with this mix of high‑throughput eye surgery and periodic specialized corneal services.
Medicare revenue is highly concentrated: the precomputed top‑3 Medicare codes account for 70.2% of the provider’s total Medicare revenue, and a single code, 66984, represents $686.8K or 57.1% of Medicare revenue (849 claims, $809 avg paid/claim). This concentration signals that cataract surgery is the dominant Medicare service line driving the $1.2M in lifetime Medicare receipts.
Medicaid revenue is effectively single‑code dependent: the precomputed top‑3 Medicaid codes account for 100.0% of Medicaid revenue, and 41899 alone represents $1.3M or 99.0% of the provider’s total Medicaid revenue (1.3K claims, $979 avg paid/claim). As a result, Medicaid receipts are almost entirely driven by a single unspecified dental procedure code, creating a high dependence on that coding stream.
Payer mix is roughly balanced in scale: lifetime totals show $1.2M in Medicare revenue versus $1.3M in Medicaid revenue, so the center draws meaningful business from both payers with Medicaid marginally larger. Because each payer’s revenue is driven by different codes (Medicare by cataract surgery codes; Medicaid by 41899), the facility’s financial exposure and operational focus differ by payer.
Competitive standing on Medicare is modest-to-routine rather than dominant: for its largest Medicare code 66984 the provider ranks #2159 of 15965 nationally (86th percentile) and is described as “typical, unremarkable volume,” while several specialty codes (for example V2785 at rank #147 of 231, 30th percentile, and 65756 at rank #412 of 567, 23rd percentile) place the center in lower or mid cohorts among smaller specialty provider groups. On Medicaid, 41899 ranks #9 of 23 in‑state (64th percentile; described as typical), indicating a mid‑pack position among state peers for that code.
Operational profile combines high‑throughput and episodic higher‑cost items: the center bills a large volume of relatively lower per‑claim cataract procedures (66984: 849 claims, $809 avg) alongside smaller volumes of higher per‑claim items such as V2785 (19 claims, $3517 avg) and 65756 (16 claims, $1468 avg). This mix suggests a business model built around steady cataract throughput supported by occasional tissue processing or transplant services.
There is a notable divergence in service lines between payers: Medicare activity centers on ophthalmic and endoscopy/urology codes (e.g., 66984, 45380, 43239), whereas Medicaid activity is concentrated in the dental/unspecified procedure code 41899 with 1.3K claims. This divergence could reflect payer coverage rules, contractual arrangements, or a separate Medicaid service stream operating under the same surgical center NPI; it warrants attention when comparing utilization drivers across payers.
The provider has an established tenure in the file (NPI enumerated 2013-01-02, ~13 years ago), so the observed concentration patterns (Medicare reliance on 66984 and Medicaid reliance on 41899) likely represent persistent service‑line choices rather than transitory startup effects. Given the high single‑code dependence on Medicaid and heavy reliance on cataract work for Medicare, the center may be sensitive to reimbursement or policy changes affecting those specific codes.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
23 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… | 850 | $810 | $686.8K |
| 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… | 40 | $2,440 | $90.4K |
| V2785 | Processing, preserving and transporting corneal tissue | 20 | $3,520 | $66.8K |
| 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… | 40 | $810 | $34.7K |
| 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… | 90 | $360 | $32.8K |
| 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. | 50 | $550 | $27.7K |
| 50590 | Extracorporeal shock wave lithotripsy (ESWL) is a procedure used to destroy calculus (kidney stones) in the kidneys and ureters. | 30 | $920 | $25.7K |
| 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. | 120 | $210 | $24.9K |
| 52332 | The provider performs cystourethroscopy, the inspection of the interior of the bladder, the urethra, prostatic urethra, and ureteric openings using a cystoscope passed through the urethra and into… | 30 | $880 | $24.6K |
| 65756 | During this procedure, the provider performs a complete corneal transplant to replace a damaged corneal endothelium. | 20 | $1,470 | $23.5K |
Showing 1–10 of 23
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 23 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
23 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| 66984 | 2 | 150 | 90 | $520 | $80.3K |
| V2785 | 1 | 10 | 20 | $3,360 | $63.9K |
| 66991 | 4 | 20 | 30 | $1,390 | $43.2K |
| 67904 | 10 | 10 | 40 | $530 | $32K |
| 45385 | 50 | 100 | 50 | $270 | $23.3K |
| 66982 | 14 | 50 | 30 | $620 | $22.2K |
| 15823 | 9 | 20 | 30 | $470 | $21.9K |
| 65756 | 5 | 10 | 20 | $1,140 | $20.5K |
| 29881 | 9 | 10 | 10 | $760 | $14.4K |
| 50590 | 5 | 20 | 20 | $590 | $14.1K |
Showing 1–10 of 23
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.
3 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 41899 | Use this code to report a procedure on the teeth and adjoining alveolar structures for which there is no specific code available. | 1,280 | $980 | $1.3M |
| 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… | 120 | $100 | $12.1K |
| 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. | 20 | $20 | $260 |
How this provider's Medicaid billing volume and revenue compare to other Utah providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Utah median
3 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 41899 | Use this code to report a procedure on the teeth and adjoining alveolar structures for which there is no specific code available. | 9 | 20 | 630 | $750 | $1.2M |
| 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. | 42 | 50 | 250 | $80 | $40.9K |
| 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 | $80 | $19.7K |
Other providers in the same ZIP code as Mt Ogden Utah Surgical Center LLC, ranked by combined Medicare and Medicaid revenue.
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