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NPI 1770603706 · Troy, MI · Ambulatory Surgical Clinic/Center
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Birmingham Ambulatory Surgical Center, PLLC is a ambulatory surgical clinic/center provider located in Troy, Michigan. This profile covers 16 Medicare and 0 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 | Birmingham Ambulatory Surgical Center, PLLC |
| Address | 230 W Maple Road |
| City | Troy |
| State | MI |
| ZIP | 48084 |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| NPI Enumerated | March 31, 2007 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $2.8M |
| Medicaid | $0 |
BIRMINGHAM AMBULATORY SURGICAL CENTER, PLLC operates as an ophthalmic-focused ambulatory surgical center: its top Medicare revenue drivers and code descriptions center on cataract extraction and intraocular lens insertion (66984, 66982), intraoperative ophthalmic irrigation (J1097), and posterior capsulotomy (66821). The code mix indicates a procedural practice model concentrated on anterior-segment eye surgery and related eyelid procedures rather than broad multispecialty services.
Revenue concentration is high and narrowly focused: the precomputed top-3 Medicare codes account for 81.5% of the provider's total Medicare revenue, with 66984 generating $1.5M (53.2% of Medicare revenue), J1097 generating $605.9K (21.7%), and 66982 generating $183.7K (6.6%). This concentration means most Medicare receipts are tied to a very small set of cataract-related services and associated supplies.
The provider is effectively single-payer from the available claims: lifetime Medicare revenue is $2.8M and there is no Medicaid billing on file. The absence of Medicaid activity suggests a patient mix skewed to Medicare beneficiaries and exposure concentrated to Medicare payment policies and eligibility patterns.
Competitive standing on specific codes is mixed: J1097 ranks #7 of 443 providers nationally (99th percentile; notably above typical national volume), indicating unusually high national volume for that intraoperative irrigation supply, while 66821 ranks #143 of 10087 (99th percentile; notably above typical national volume) and 67904 ranks #20 of 991 (98th percentile; notably above typical national volume), all signaling above-typical national activity on certain cataract and eyelid interventions. By contrast, 66984 ($1.5M revenue) and 66982 ($183.7K) are described as “typical, unremarkable volume” despite high percentile placements in the dataset, which suggests solid but not exceptional procedural volumes versus the full national provider set.
Operational breadth includes ancillary eyelid and glaucoma procedures in addition to cataract work: notable Medicare revenue items include 65820 (80 claims, $1440 avg paid/claim, $115.2K revenue, 4.1% of Medicare revenue) and 67904 (203 claims, $515 avg paid/claim, $104.5K revenue, 3.7%), showing the ASC also performs pediatric/congenital glaucoma and reconstructive/ptosis surgeries at nontrivial volumes. This mix implies the center treats both routine cataract cases and a subset of more specialized anterior-segment and eyelid conditions.
There are clear statistical outliers in supply and follow-up procedure usage that warrant attention: J1097 is a standout high-volume item (99th percentile; notably above typical national volume), which likely reflects consistent per-case use of that specific ophthalmic irrigation/ketorolac supply in the center’s surgical workflow. Conversely, a few codes with small revenue footprints such as 68326 ($11.8K, rank #55 of 59, 3th percentile) sit at the low end of national activity, indicating limited or niche use of certain conjunctival graft procedures.
The provider has an established operational history: NPI enumerated (registered) 2007-03-31 (~19 years ago), which indicates long-tenure market presence and suggests existing referral relationships and procedural throughput that produced the $2.8M Medicare lifetime revenue figure. Longevity combined with the concentrated code mix suggests a stable, narrowly specialized ASC business model.
Concentration-driven business risk is material: because a small number of cataract and related supply codes drive the bulk of Medicare revenue (top 3 = 81.5%), the provider’s financial performance is sensitive to changes in Medicare reimbursement for those specific CPT/HCPCS codes or to shifts in per-case supply usage patterns. Analysts should monitor payment policy changes for 66984, J1097, and 66982 and any utilization shifts in high-volume follow-up procedures such as 66821.
Medicare revenue breakdown by CPT/HCPCS procedure code.
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The CPT/HCPCS codes generating the most Medicare revenue for this provider.
16 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… | 1,880 | $790 | $1.5M |
| J1097 | phenylephrine 10.16 mg/ml and ketorolac 2.88 mg/ml ophthalmic irrigation solution, 1 ml | 7,970 | $80 | $605.9K |
| 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… | 230 | $790 | $183.7K |
| 66821 | The provider removes the haziness from the capsule of the eye using a laser for a patient with a secondary membranous cataract. | 720 | $200 | $141.5K |
| 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. | 80 | $1,440 | $115.2K |
| 67904 | The provider repairs a drooping eyelid by tightening the levator muscle that controls eyelid movement to improve cosmetic appearance or remove the obstruction to a patient’s vision. He accesses the… | 200 | $520 | $104.5K |
| 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… | 110 | $470 | $49.8K |
| J1096 | Dexamethasone, lacrimal ophthalmic insert, 0.1 mg | 450 | $100 | $44.4K |
| 67917 | During this procedure, the provider performs an extensive repair of an ectropion, which is an outward turning of the lower eyelid and eyelashes, which can lead to excessive tearing and irritation of… | 40 | $490 | $19.6K |
| 68326 | The provider performs a surgical repair of the conjunctiva at the location where the tissue covering the eyeball and the eyelid meet, using the patient’s own conjunctival tissue as a graft or by… | 10 | $990 | $11.8K |
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How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 16 CPT/HCPCS codes.
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Full comparison — all codes billed, vs. state median
Other providers in the same ZIP code as Birmingham Ambulatory Surgical Center, PLLC, ranked by combined Medicare and Medicaid revenue.
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