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NPI 1790772804 · Blue Ash, OH · Ophthalmologic Surgery Clinic/Center
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Cei Physicians Psc LLC is a ophthalmologic surgery clinic/center provider located in Blue Ash, Ohio. This profile covers 48 Medicare and 4 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 | Cei Physicians Psc LLC |
| Address | 1945 Cei Dr |
| City | Blue Ash |
| State | OH |
| ZIP | 45242 |
| Taxonomy | Ophthalmologic Surgery Clinic/Center |
| NPI Enumerated | October 4, 2005 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $4.1M |
| Medicaid | $1M |
CEI PHYSICIANS PSC LLC appears to operate primarily as an ophthalmologic surgical practice concentrated on cataract and retina procedures; the Medicare top codes are dominated by cataract extraction with IOL insertion (66984, 66982) and multiple vitreoretinal surgeries (67042, 67036, 67113). The code mix — high-volume cataract codes combined with substantial vitreoretinal and corneal procedure billing — indicates an integrated surgical center handling both routine cataract cases and more complex posterior-segment and corneal specialty care.
Revenue concentration in Medicare is highly skewed: the precomputed top 3 Medicare codes by revenue account for 59.6% of the provider’s total Medicare revenue, and a single Medicare code 66984 alone represents $1.9M or 49.3% of Medicare revenue. For Medicaid the concentration is even more pronounced: the top 3 Medicaid codes account for 100.0% of its Medicaid revenue and code 66984 constitutes $980.5K, or 96.0% of the provider’s Medicaid revenue, signaling heavy dependence on cataract surgery for both payers.
Payer mix shows Medicare is the larger contributor to lifetime revenue at $4.1M versus Medicaid at $1M, indicating the practice derives roughly four times more lifetime payments from Medicare than Medicaid. Both payers, however, are heavily dependent on the same primary service line (cataract extraction with IOL), suggesting clinical volume is focused on procedures commonly performed for older Medicare beneficiaries but also billed to Medicaid.
National and state competitive standing is strong for several codes: for Medicare the provider ranks in the top percentiles for major procedures — 66984 ranks in the 95th percentile nationally (rank #750 of 15965), 67042 and 67036 rank at the 98th percentile, and 15823 and 66821 are also high percentile outliers — indicating this entity is a major volume provider nationally for key ophthalmic surgeries. On Medicaid, 66984 ranks #3 of 89 providers in-state (98th percentile), showing the provider is a leading cataract surgery biller within Ohio Medicaid.
Several individual codes are flagged as statistical outliers or notably above typical volume, which underscores the provider’s specialty intensity: 67042 and 67036 are labeled "extreme outlier, far above typical national volume," 15823 and 66821 are "notably above typical national volume," and multiple glaucoma and retinal procedures also sit in high national percentiles. These labels support a picture of a high-volume specialty surgical practice rather than a general ophthalmology clinic.
The Medicaid coding detail shows near-exclusive reliance on a single procedure for state-program revenue: 66984 accounts for 96.0% of Medicaid revenue and the next Medicaid code, 66982, accounts for just 4.0%. This concentrated Medicaid profile means changes in reimbursement or referral patterns for cataract services in-state could materially affect the provider's Medicaid revenue.
Procedure-level reimbursement characteristics suggest case mix differences across payers: Medicare volumes for 66984 total 2.4K claims at $802 avg paid/claim generating $1.9M, while Medicaid shows 2.7K claims at $363 avg paid/claim generating $980.5K. These figures indicate higher per-claim reimbursement on Medicare for the same dominant service, contributing to Medicare’s larger lifetime revenue share for the provider.
The provider has long-standing presence in Medicare with an NPI enumerated on 2005-10-04 (~21 years ago), which supports a mature operational footprint and may help explain the accumulation of national-level volume and high percentile rankings on multiple specialty codes. This tenure aligns with the pattern of established specialty surgical volume across cataract, retinal, corneal, and oculoplastic procedures.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
48 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… | 2,380 | $800 | $1.9M |
| V2785 | Processing, preserving and transporting corneal tissue | 60 | $3,420 | $215.5K |
| 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… | 120 | $1,470 | $181.9K |
| 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… | 220 | $810 | $179.5K |
| 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… | 300 | $490 | $144.3K |
| 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… | 60 | $2,470 | $136K |
| C1839 | Iris prosthesis | 20 | $6,180 | $135.9K |
| 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. | 90 | $1,420 | $133.7K |
| 66821 | The provider removes the haziness from the capsule of the eye using a laser for a patient with a secondary membranous cataract. | 660 | $190 | $126.2K |
| 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. | 60 | $1,470 | $84K |
Showing 1–10 of 48
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 48 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
48 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| C1839 | 1 | 10 | 20 | $6,180 | $135.9K |
| V2785 | 1 | 10 | 20 | $3,400 | $108.8K |
| J1097 | 19 | 20 | 860 | $80 | $98.1K |
| 66984 | 53 | 530 | 210 | $110 | $92.8K |
| 66991 | 7 | 40 | 30 | $1,060 | $52.8K |
| 15823 | 1 | 50 | 50 | $500 | $35.8K |
| 67040 | 4 | 10 | 30 | $1,460 | $35K |
| 65820 | 3 | 40 | 40 | $850 | $33.3K |
| 66174 | 12 | 20 | 40 | $690 | $29.8K |
| 67042 | 2 | 50 | 20 | $960 | $29.7K |
Showing 1–10 of 48
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.
4 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… | 2,700 | $360 | $980.5K |
| 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… | 80 | $520 | $40.8K |
| 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… | 320 | $0 | $0 |
| G8918 | Patient without preoperative order for iv antibiotic surgical site infection (ssi) prophylaxis | 320 | $0 | $0 |
How this provider's Medicaid billing volume and revenue compare to other Ohio providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Ohio median
4 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… | 3 | 90 | 180 | $410 | $234.6K |
| 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… | 3 | 10 | 70 | $680 | $97.4K |
| G8918 | Patient without preoperative order for iv antibiotic surgical site infection (ssi) prophylaxis | 7 | 40 | 40 | $1 | $100 |
| 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… | 12 | 50 | 90 | $1 | $60 |
Other providers in the same ZIP code as Cei Physicians Psc LLC, ranked by combined Medicare and Medicaid revenue.
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