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NPI 1780117440 · Lone Tree, CO · Ambulatory Surgical Clinic/Center
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Insight Surgery Center, LLC is a ambulatory surgical clinic/center provider located in Lone Tree, Colorado. This profile covers 13 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 | Insight Surgery Center, LLC |
| Address | 9777 S Yosemite St |
| City | Lone Tree |
| State | CO |
| ZIP | 80124 |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| NPI Enumerated | April 9, 2017 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $1.4M |
| Medicaid | $79.2K |
INSIGHT SURGERY CENTER, LLC presents as an ophthalmic-focused ambulatory surgical clinic: its top Medicare revenue drivers are cataract extraction with intraocular lens insertion (66984, $698.1K, 50.9% of Medicare revenue), intraoperative ophthalmic irrigation drug billing (J1097, $237.7K, 17.3%), and vitrectomy (67036, $124K, 9.0%). The code mix — heavy on 66984 and supported by high-volume use of J1097 and targeted vitreoretinal procedures — is consistent with an ASC that primarily performs cataract and selective posterior-segment eye surgery rather than broad multispecialty surgery.
Revenue concentration is high on both payers: the provider’s top three Medicare codes account for 77.3% of its Medicare revenue, and the precomputed top-three share for Medicaid is 100.0%. On Medicaid the entire $79.2K of reported revenue is captured by 66984 (170 claims), indicating near-total Medicaid exposure to cataract surgery.
The payer mix is Medicare-dominant: total Medicare revenue is $1.4M versus total Medicaid revenue of $79.2K, showing the practice’s commercial scale is built almost entirely on Medicare patients. This makes the facility effectively Medicare-focused with only modest Medicaid activity concentrated in a single procedure.
Competitive standing varies by service line. For vitreoretinal surgery 67036 the provider ranks #23 of 832 nationally (97th percentile) and is described as notably above typical national volume, signaling a meaningful specialty footprint in posterior-segment surgery; by contrast, cataract surgery 66984 ranks #2183 of 15965 (86th percentile) and is characterized as typical, unremarkable volume — high absolute revenue but not an extreme outlier versus peers.
The high utilization of J1097 (3.1K claims, $237.7K; rank #93 of 443, 79th percentile) indicates frequent intraoperative medication use tied to cataract cases and supports the interpretation of substantial cataract throughput. This pairing of a high-claim supply code with a high-revenue surgical code is typical for high-volume cataract-focused ASCs.
Secondary ophthalmic procedures provide incremental revenue but are not dominant: 66821 (YAG capsulotomy) contributes $67.2K (4.9% of Medicare revenue) and is ranked in the 96th percentile but labeled typical, unremarkable volume, while retinal adjuncts such as 67042 ($52.2K, 3.8%) and 67041 ($36.8K, 2.7%) sit at typical peer percentiles. These entries suggest routine follow-up and retinal repair activity that complements the center’s core cataract and vitreoretinal work rather than representing separate high-volume service lines.
Corneal tissue processing (V2785) appears as a modest revenue line ($35.5K, 2.6%) and is ranked #200 of 231 (6th percentile) in the national listing; the dataset describes this as typical, unremarkable volume, indicating limited corneal tissue activity relative to many peers and that corneal services are not a major strategic focus here.
The provider’s NPI was enumerated on 2017-04-09 (~9 years ago), giving it nearly a decade of operating history. Combined with the concentrated Medicare revenue base and the mix of cataract and specialized retinal codes, this tenure and code profile point to an established, specialty ophthalmic ASC with steady Medicare-driven volume and minimal Medicaid diversification.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
13 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… | 830 | $840 | $698.1K |
| J1097 | phenylephrine 10.16 mg/ml and ketorolac 2.88 mg/ml ophthalmic irrigation solution, 1 ml | 3,130 | $80 | $237.7K |
| 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. | 80 | $1,510 | $124K |
| 66821 | The provider removes the haziness from the capsule of the eye using a laser for a patient with a secondary membranous cataract. | 330 | $210 | $67.2K |
| 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… | 30 | $1,540 | $52.2K |
| 67041 | In this procedure, the provider removes scar tissue from the retinal membrane that obscures vision. He removes vitreous humor, the gelatinous material that gives shape to the eye, using a mechanical… | 20 | $1,540 | $36.8K |
| V2785 | Processing, preserving and transporting corneal tissue | 10 | $2,730 | $35.5K |
| 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… | 60 | $520 | $30.6K |
| 66180 | The provider implants a shunt in the anterior chamber of the eye to facilitate drainage of aqueous humor, or fluid, in order to reduce intraocular pressure. He uses a graft to reinforce the tissue… | 10 | $2,040 | $26.5K |
| 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 | $530 | $22.7K |
Showing 1–10 of 13
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 13 CPT/HCPCS codes.
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Full comparison — all codes billed, vs. state median
13 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| J1097 | 3 | 10 | 3,130 | $80 | $197.2K |
| 66984 | 11 | 280 | 70 | $570 | $97.1K |
| V2785 | 4 | 10 | 20 | $3,080 | $64.6K |
| 67036 | 2 | 30 | 20 | $1,100 | $37.3K |
| 67042 | 7 | 30 | 20 | $1,140 | $29.6K |
| 67904 | 3 | 10 | 40 | $590 | $28.8K |
| 67108 | 16 | 20 | 20 | $1,260 | $26.5K |
| 66982 | 56 | 60 | 30 | $690 | $24.2K |
| 67041 | 2 | 10 | 10 | $1,260 | $21.4K |
| 66180 | 3 | 10 | 10 | $1,280 | $19.2K |
Showing 1–10 of 13
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… | 170 | $470 | $79.2K |
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
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… | 23 | 50 | 170 | $310 | $171.3K |
Other providers in the same ZIP code as Insight Surgery Center, LLC, ranked by combined Medicare and Medicaid revenue.
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