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NPI 1760437248 · Santurce, PR · Ophthalmologic Surgery Clinic/Center
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Eye Surgery Specialists Of Puerto Rico, LLC is a ophthalmologic surgery clinic/center provider located in Santurce, Puerto Rico. This profile covers 2 Medicare and 1 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 | Eye Surgery Specialists Of Puerto Rico, LLC |
| Address | 809 Hipodromo Street |
| City | Santurce |
| State | PR |
| ZIP | 00909 |
| Taxonomy | Ophthalmologic Surgery Clinic/Center |
| NPI Enumerated | May 23, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $216.2K |
| Medicaid | $8.2K |
The provider’s service mix is concentrated on cataract surgery and intraocular lens procedures, consistent with its Ophthalmologic Surgery Clinic/Center taxonomy. The two Medicare codes driving revenue — 66984 and 66982 — correspond to extracapsular cataract extraction with intraocular lens implantation and more complex intraocular lens techniques, indicating the practice operates primarily as a surgical cataract center rather than a broad multispecialty clinic.
Medicare revenue is highly concentrated: the precomputed top 3 Medicare codes account for 100.0% of Medicare revenue, and code 66984 alone represents 94.2% of Medicare payments to this provider ($203.6K from 345 claims at $590 avg paid/claim). The remaining Medicare revenue is almost entirely from 66982 (5.8%, $12.6K from 21 claims at $600 avg paid/claim), showing dependence on a narrow set of cataract surgery services.
Medicaid activity is minimal and fully concentrated: the precomputed top 3 Medicaid codes account for 100.0% of Medicaid revenue, with 66984 making up 100.0% of Medicaid revenue ($8.2K from 12 claims at $683 avg paid/claim). The Medicaid claim count is very small, so Medicaid payments reflect limited low-volume participation in state programs rather than a broad Medicaid service line.
Payer mix is effectively Medicare-dominant: total Medicare revenue ($216.2K) far exceeds total Medicaid revenue ($8.2K), indicating the practice’s commercial scale and case volume are concentrated in the Medicare population rather than Medicaid. Operational and reimbursement risk therefore will be driven predominantly by Medicare trends in cataract surgery.
Competitive standing for Medicare-coded cataract surgery is modest: 66984 ranks #3687 of 15965 providers nationally (77th percentile) and is described as "typical, unremarkable volume for this code," which places the provider above many peers but not among high-volume national leaders. For the more complex code 66982 the provider ranks #2940 of 4580 (32th percentile) and likewise shows typical, unremarkable volume, suggesting limited activity in complex lens procedures relative to specialized national centers.
Within the state Medicaid market the provider is a minor participant: 66984 ranks #56 of 59 providers in-state (0th percentile) with typical, unremarkable volume, indicating it is not a significant Medicaid cataract provider in Puerto Rico. This low in-state Medicaid rank combined with only 12 Medicaid claims suggests limited footprint or limited Medicaid contracting for surgical ophthalmology.
No codes are labeled as statistical outliers in the supplied descriptors; all top codes are noted as "typical, unremarkable volume for this code," so there is no flagged anomaly in coding intensity. Analysts should still interpret Medicaid averages cautiously given the small Medicaid claim counts (12 claims for 66984) compared with Medicare procedure volume (345 claims for 66984).
The NPI tenure indicates established practice continuity: the provider was enumerated on 2006-05-23 (~20 years ago), which supports interpretation of the billing profile as representing a sustained, narrowly focused surgical practice rather than a recent entrant or temporary clinic. This length of enumeration, coupled with concentrated cataract procedure billing, suggests a stable specialty operation.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
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… | 350 | $590 | $203.6K |
| 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… | 20 | $600 | $12.6K |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 2 CPT/HCPCS codes.
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.
1 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… | 10 | $680 | $8.2K |
How this provider's Medicaid billing volume and revenue compare to other Puerto Rico providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Puerto Rico median
1 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… | 56 | 60 | 160 | $380 | $270.5K |
Other providers in the same ZIP code as Eye Surgery Specialists Of Puerto Rico, LLC, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Best Option Healthcare Puerto Rico LLC | PR | Home Infusion Therapy Pharmacy | $0 | $41.5M |
| Vita Healthcare Inc | PR | Home Health Agency | $0 | $9.4M |
| Eladio Perez Cruz | PR | Gastroenterology Physician | $2.1K | $2.5M |
| Felix Lugo-adams | PR | Interventional Cardiology Physician | $3.7K | $1.9M |
| Farmacia San Rafael Santurce, Inc | PR | Community/Retail Pharmacy | $0 | $1.5M |
| Lauren Lynch | PR | Maternal & Fetal Medicine Physician | $0 | $1.4M |
| St Gianna Pediatrics | PR | Pediatrics Physician | $0 | $1.3M |
| Jaime Ruiz-rodriguez | PR | Cardiovascular Disease Physician | $17.7K | $1.2M |
| Empresas Alvaro Torres | PR | Speech-Language Pathologist | $0 | $1.1M |
| Best Option Healthcare Puerto Rico LLC | PR | Home Health Agency | $0 | $1.1M |
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