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NPI 1811001548 · Opelousas, LA · Ambulatory Surgical Clinic/Center
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Ambulatory Surgery Center Of Opelousas is a ambulatory surgical clinic/center provider located in Opelousas, Louisiana. This profile covers 15 Medicare and 5 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 | Ambulatory Surgery Center Of Opelousas |
| Address | 187 Ventre Blvd |
| City | Opelousas |
| State | LA |
| ZIP | 70570 |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| NPI Enumerated | August 19, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $1.4M |
| Medicaid | $416.3K |
This facility’s Medicare billing is concentrated in high-value spinal implant and cataract procedures: 63685 ($531.7K, 36.9% of Medicare revenue), 63655 ($282.3K, 19.6%), and 66984 ($159.5K, 11.1%) together account for 67.6% of its total Medicare revenue. The mix (spinal neurostimulator insertion and paddle electrode placement alongside routine cataract extraction with IOL) indicates an ASC model that combines specialized spine implant work with ophthalmic surgery.
The two highest-paid Medicare codes show large per-claim payments and suggest procedural complexity drives revenue: 63685 averages $16617 paid/claim and 63655 averages $11761 paid/claim. National rankings for these codes are mid-to-upper percentile but described as "typical, unremarkable volume" (63685 ranks #195 of 1281, 84th percentile; 63655 ranks #45 of 245, 82th percentile), implying the center is a recognized regional participant in spinal implant procedures but not a national outlier.
Medicaid activity is overwhelmingly pediatric ENT—69436 (tympanostomy with tube) generates $265.7K (63.8% of Medicaid revenue) and 42820 (tonsil/adenoid removal <12y) generates $141.4K (33.9%), with 42830 adding $9.5K (2.3%). The precomputed top-3 Medicaid codes account for 100.0% of the provider’s Medicaid revenue, indicating Medicaid caseload is almost entirely driven by these ENT procedures.
State-level competitive standing differs by payer and service line: for Medicaid ENT volume the center ranks relatively high in-state (69436 ranks #20 of 82, 77th percentile; 42820 ranks #6 of 48, 89th percentile), signaling a strong regional position in pediatric ENT. By contrast, its Medicare specialty codes are solid but not dominant nationally (e.g., 66984 ranks #5212 of 15965, 67th percentile), which supports characterization as a notable regional ASC rather than a national leader.
In scale, Medicare ($1.4M) represents the larger single source of reported revenue compared with Medicaid ($416.3K), so the business has meaningful exposure to both payers but is not effectively single-payer. Given the concentration of Medicare dollars in a few high-cost implant codes and Medicaid dollars in a few pediatric ENT codes, payer mix volatility or changes in utilization for those specific services could materially affect overall revenue.
The provider has an established operating history with an NPI enumerated on 2006-08-19 (~20 years ago), consistent with a mature ASC that has developed discrete specialty lines (spine implants, cataract, and pediatric ENT) over time. Tenure supports the observed mix of implant-intensive Medicare work alongside high-volume Medicaid pediatric procedures.
Several ancillary and administrative codes appear in the datasets and are low- or zero-revenue items: Medicaid G8918 and G8907 show 0 revenue despite multiple claims, and some Medicare supply/drug codes (for example J1097) sit in lower percentiles (J1097 ranks 13th percentile). These entries suggest routine reporting of quality/administrative measures and ancillary supplies that are not primary revenue drivers for this facility.
Revenue concentration on a small set of codes is a salient operational risk: the top 3 Medicare codes account for 67.6% of Medicare revenue and the top 3 Medicaid codes account for 100.0% of Medicaid revenue. That concentration—high-value spinal implants and pediatric ENT—indicates limited diversification of payor-dependent service lines and underscores the importance of monitoring utilization and regional competition for those specific 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.
15 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 63685 | The provider inserts or replaces a spinal neurostimulator pulse generator or receiver. The system is one that requires surgical creation of a pocket for placement and that requires a connection… | 30 | $16,620 | $531.7K |
| 63655 | In this procedure, the provider removes a portion of the vertebra called the lamina and places a permanent plate/paddle electrode in the epidural space, or area between the dura membrane and the wall… | 20 | $11,760 | $282.3K |
| 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… | 210 | $760 | $159.5K |
| 22869 | Through a minimally invasive approach, the provider inserts an interlaminar stabilization or interspinous distraction, or decompression, device (IPD) and attaches it to the bony projections (spinous… | 20 | $7,620 | $144.8K |
| 0627T | The provider injects a cellular or tissue–based product under fluoroscopic guidance to treat a lumbar intervertebral disc. This code applies to the first level injected. The injection may occur on… | 20 | $6,480 | $136.1K |
| J1096 | Dexamethasone, lacrimal ophthalmic insert, 0.1 mg | 650 | $100 | $62.5K |
| 45385 | The provider examines the colon and rectum using a colonoscope, a long, thin flexible tubular instrument with a light source and camera. He removes one or more tumors, polyps, or other lesions with a… | 120 | $390 | $45K |
| G0121 | Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk | 50 | $370 | $19.6K |
| G0105 | Colorectal cancer screening; colonoscopy on individual at high risk | 50 | $370 | $19.3K |
| J1097 | phenylephrine 10.16 mg/ml and ketorolac 2.88 mg/ml ophthalmic irrigation solution, 1 ml | 160 | $70 | $11.7K |
Showing 1–10 of 15
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 15 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
15 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| 63685 | 1 | 20 | 20 | $7,420 | $141K |
| 66984 | 55 | 210 | 80 | $500 | $91.3K |
| 63655 | 1 | 10 | 10 | $3,990 | $67.8K |
| 22869 | 1 | 10 | 20 | $3,960 | $67.3K |
| J1097 | 7 | 10 | 410 | $80 | $66.3K |
| 0627T | 10 | 10 | 20 | $2,290 | $57.3K |
| J1096 | 1 | 10 | 230 | $100 | $31.1K |
| 45385 | 52 | 230 | 60 | $270 | $27.5K |
| 64721 | 27 | 40 | 20 | $380 | $12.9K |
| 43239 | 197 | 250 | 60 | $120 | $12.4K |
Showing 1–10 of 15
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.
5 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 69436 | This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia. | 1,240 | $220 | $265.7K |
| 42820 | The provider removes the tonsils and adenoids in a patient younger than 12 years old. | 620 | $230 | $141.4K |
| 42830 | The provider performs an initial adenoidectomy in a patient who is less than 12 years old. | 60 | $150 | $9.4K |
| 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… | 90 | $0 | $0 |
| G8918 | Patient without preoperative order for iv antibiotic surgical site infection (ssi) prophylaxis | 50 | $0 | $0 |
How this provider's Medicaid billing volume and revenue compare to other Louisiana providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Louisiana median
5 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 69436 | This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia. | 20 | 80 | 220 | $140 | $122.4K |
| 42820 | The provider removes the tonsils and adenoids in a patient younger than 12 years old. | 6 | 50 | 180 | $240 | $75.4K |
| 42830 | The provider performs an initial adenoidectomy in a patient who is less than 12 years old. | 23 | 40 | 110 | $240 | $73.8K |
| 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… | 41 | 50 | 320 | $0 | $0 |
| G8918 | Patient without preoperative order for iv antibiotic surgical site infection (ssi) prophylaxis | 29 | 40 | 190 | $0 | $0 |
Other providers in the same ZIP code as Ambulatory Surgery Center Of Opelousas, ranked by combined Medicare and Medicaid revenue.
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