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NPI 1740629245 · Colorado Springs, CO · Ambulatory Surgical Clinic/Center
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Surgery Affiliates, LLC is a ambulatory surgical clinic/center provider located in Colorado Springs, Colorado. 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 | Surgery Affiliates, LLC |
| Address | 2770 N. Union Blvd. |
| City | Colorado Springs |
| State | CO |
| ZIP | 80909 |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| NPI Enumerated | June 18, 2013 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $2.8M |
| Medicaid | $493.6K |
Taxonomy and code mix indicate this is an ophthalmic-focused ambulatory surgical center: the top Medicare codes are dominated by cataract and posterior-segment eye procedures (66984, 67036, 67042) and the list includes multiple retina repair and oculoplastic codes such as 67108 and 15823, consistent with the provider taxonomy Ambulatory Surgical Clinic/Center and a surgical practice centered on eye surgery. This pattern suggests the facility operates as a specialty ASC handling both common cataract cases and high-complexity retinal procedures.
Revenue concentration is high across both payers: the precomputed top 3 Medicare codes account for 67.9% of this provider's total Medicare revenue and the precomputed top 3 Medicaid codes account for 98.4% of this provider's total Medicaid revenue. Such concentration means a small set of procedures—particularly cataract and specific retinal surgeries—drive the majority of billed revenue for each payer.
The provider is predominantly Medicare-funded in scale: total Medicare revenue is $2.8M compared with total Medicaid revenue of $493.6K, so Medicare constitutes the larger revenue base for this facility. While both payers are active, Medicaid represents a substantially smaller portion of lifetime revenue.
Cataract surgery (66984) is the single biggest revenue driver across payers: Medicare shows 1.8K claims and $1.5M revenue for 66984 (52.7% of Medicare revenue) while Medicaid shows 1.3K claims and $427.4K revenue for 66984 (86.6% of Medicaid revenue). Those figures indicate cataract work accounts for the majority of the provider’s Medicaid activity and a large share of Medicare activity, confirming reliance on high-volume cataract throughput.
This provider is a national outlier for several complex retinal procedures, indicating a regional or specialty referral role: Medicare volumes for 67036 (152 claims, $228.2K; rank #2 of 832, 100th percentile; labeled an extreme outlier) and 67042 (131 claims, $196.2K; rank #17 of 1087, 99th percentile; labeled an extreme outlier) are far above typical national volumes. On Medicaid, 67108 (65 claims, $54.1K) is reported as #1 of 1 in-state with no state peer volume comparison available, reinforcing that this facility handles more complex retinal surgery than most local peers.
Competitive standing is mixed by procedure: for cataract 66984 the provider ranks #1226 of 15965 nationally (92th percentile) for Medicare and #10 of 46 in-state (80th percentile) for Medicaid, which is characterized in the source as typical or unremarkable volume nationally but strong within the state. In contrast, retinal procedure ranks (67036 and 67042) are at the extreme outlier end nationally, showing the center is a major national-volume contributor for selected posterior-segment surgeries even if its overall cataract volume is not exceptional on a national scale.
Several procedural and quality-reporting codes appear frequently in Medicaid with no associated paid revenue—G8918 and G8907 each have 376 claims and $0 paid/claim but rank highly in-state (95th and 94th percentiles respectively). This pattern points to consistent capture of required preoperative and event-reporting documentation in Medicaid billing, rather than revenue-driving activity, and suggests established administrative workflows for perioperative quality measures.
The NPI was enumerated on 2013-06-18 (~13 years ago), indicating the provider has been operating for an extended period. Combined with the high-volume, high-rank retina procedures and substantial cataract throughput, the tenure supports a profile of an established ambulatory surgical center with mature referral relationships and specialized surgical capacity.
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… | 1,750 | $840 | $1.5M |
| 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. | 150 | $1,500 | $228.2K |
| 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… | 130 | $1,500 | $196.2K |
| 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… | 90 | $1,520 | $132.2K |
| 66821 | The provider removes the haziness from the capsule of the eye using a laser for a patient with a secondary membranous cataract. | 640 | $200 | $124.4K |
| 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… | 190 | $510 | $97.5K |
| 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 | $2,520 | $85.8K |
| 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… | 60 | $830 | $50.6K |
| 67113 | The provider repairs a complicated detached retina. He removes vitreous humor, the gelatinous material that gives shape to the eye, and peels the retinal membrane. He reattaches the retina with… | 30 | $1,520 | $47.1K |
| 67039 | The provider removes vitreous humor from the eye to access the posterior segment of the eye and introduce surgical instruments through incisions in the pars plana. This procedure also includes the… | 30 | $1,520 | $47K |
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
26 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| 66984 | 2 | 280 | 70 | $570 | $97.1K |
| 66991 | 11 | 30 | 30 | $1,620 | $53.5K |
| 67036 | 1 | 30 | 20 | $1,100 | $37.3K |
| 67040 | 1 | 10 | 20 | $1,520 | $36.5K |
| 65820 | 8 | 10 | 30 | $940 | $30.1K |
| 67042 | 1 | 30 | 20 | $1,140 | $29.6K |
| 67904 | 5 | 10 | 40 | $590 | $28.8K |
| 67903 | 5 | 10 | 40 | $500 | $27.3K |
| 15823 | 1 | 40 | 40 | $520 | $27.2K |
| 67039 | 1 | 10 | 20 | $1,230 | $27.2K |
Showing 1–10 of 26
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 |
|---|---|---|---|---|
| 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… | 1,300 | $330 | $427.4K |
| 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… | 70 | $830 | $54.1K |
| 66821 | The provider removes the haziness from the capsule of the eye using a laser for a patient with a secondary membranous cataract. | 50 | $80 | $4.2K |
| 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. | 20 | $240 | $4.2K |
| 67311 | The provider realigns an imbalance in the eye muscles by either recession, which weakens the eye muscle or resection, which strengthens the muscles so as to restore normal vision. This procedure is… | 20 | $160 | $3.7K |
| 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… | 380 | $0 | $0 |
| G8918 | Patient without preoperative order for iv antibiotic surgical site infection (ssi) prophylaxis | 380 | $0 | $0 |
How this provider's Medicaid billing volume and revenue compare to other Colorado providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Colorado median
7 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… | 10 | 50 | 170 | $310 | $171.3K |
| 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… | 1 | 10 | 70 | $830 | $54.1K |
| 66821 | The provider removes the haziness from the capsule of the eye using a laser for a patient with a secondary membranous cataract. | 2 | 10 | 20 | $150 | $6.4K |
| 67311 | The provider realigns an imbalance in the eye muscles by either recession, which weakens the eye muscle or resection, which strengthens the muscles so as to restore normal vision. This procedure is… | 2 | 10 | 20 | $100 | $4.7K |
| 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. | 1 | 10 | 20 | $240 | $4.2K |
| 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… | 3 | 30 | 70 | $0 | $0 |
| G8918 | Patient without preoperative order for iv antibiotic surgical site infection (ssi) prophylaxis | 2 | 20 | 60 | $0 | $0 |
Other providers in the same ZIP code as Surgery Affiliates, LLC, ranked by combined Medicare and Medicaid revenue.
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