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NPI 1811940141 · Charlotte, NC · Ambulatory Surgical Clinic/Center
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Southpark Surgery Center LLC is a ambulatory surgical clinic/center provider located in Charlotte, North Carolina. This profile covers 16 Medicare and 13 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 | Southpark Surgery Center LLC |
| Address | 6035 Fairview Rd |
| City | Charlotte |
| State | NC |
| ZIP | 28210 |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| NPI Enumerated | May 18, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $2.8M |
| Medicare | $2.1M |
Procedure mix shows a split service model: Medicare billing is dominated by ophthalmology—chiefly cataract surgery—while Medicaid billing is dominated by pediatric ENT procedures. The provider’s taxonomy as an Ambulatory Surgical Clinic/Center aligns with high-volume ambulatory cataract and ear/tonsil procedures rather than inpatient surgery services.
Revenue is highly concentrated in a few codes on both payers: the provider’s top three Medicare codes account for 78.6% of Medicare revenue, and the top three Medicaid codes account for 84.4% of Medicaid revenue. On Medicare the single code 66984 alone generates $1.5M (68.8% of Medicare revenue), while on Medicaid 69436 generates $1.1M (41.7%), 42820 generates $650K (23.6%), and 66984 generates $524.8K (19.1%).
This site has greater Medicaid exposure in scale: total Medicaid revenue is $2.8M versus total Medicare revenue of $2.1M, so Medicaid represents the larger payer base. That mix indicates material reliance on pediatric and Medicaid-covered volume in addition to its Medicare ophthalmology business.
On Medicaid the center is a statewide volume leader for tympanostomy and adenoid procedures: 69436 ranks #1 of 88 in-state (100th percentile; labeled an "extreme outlier, far above typical state volume for this code") and 42830 ranks #1 of 18 in-state (100th percentile; labeled "notably above typical state volume"). These rankings identify the facility as a dominant pediatric ENT provider within North Carolina.
Medicare competitive standing for ophthalmology is elevated but not extreme: 66984 ranks #1195 of 15965 nationally (92th percentile) and is described in the data as "typical, unremarkable volume for this code," while other ophthalmic codes such as 66982 and 65820 fall in upper national percentiles (93th and 86th respectively) but are likewise labeled typical. In short, the center reports strong ophthalmology volumes relative to peers but is not a national outlier on Medicare.
The mix of specific procedure codes indicates capability for both routine and more complex ambulatory eye surgery and pediatric ENT work. Medicare entries include complex anterior-segment procedures and corneal transplant codes (e.g., 66982, 65756, 66179), while Medicaid volume is concentrated in tympanostomy and tonsil/adenoid codes (69436, 42820, 42830), consistent with an ambulatory surgical center performing same-day pediatric and ophthalmic cases.
The provider has an established presence: NPI enumerated on 2006-05-18 (~20 years ago), indicating long-tenured operation in the market. That tenure is consistent with the high Medicaid pediatric volumes and likely reflects established referral patterns for both ophthalmology and pediatric ENT.
Several Medicaid line items appear on file with $0 avg paid/claim and $0 revenue (for example, J7120, J3010, J2405, J2704, G8907, G8918), and one intraocular lens HCPCS V2632 shows only $37 total. These entries do not drive revenue and may reflect bundled supplies/drugs or reporting conventions rather than standalone paid services.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
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… | 1,780 | $820 | $1.5M |
| V2785 | Processing, preserving and transporting corneal tissue | 30 | $3,840 | $118.9K |
| 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 | $1,510 | $90.3K |
| 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… | 110 | $800 | $88.8K |
| 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… | 30 | $2,500 | $75.1K |
| 65756 | During this procedure, the provider performs a complete corneal transplant to replace a damaged corneal endothelium. | 30 | $1,460 | $46.8K |
| 31267 | In this procedure, the provider inserts an endoscope into the nasal cavity. She then gains access to the maxillary sinus through a cut in the uncinate process. The provider opens the maxillary sinus… | 40 | $1,100 | $45.1K |
| 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… | 100 | $390 | $38.6K |
| 66179 | In this procedure, the provider places, by external approach, an aqueous shunt, an implantable device in the aqueous humor of the eye. The shunt facilitates drainage and thereby reduces the overall… | 10 | $1,950 | $27.3K |
| 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… | 50 | $540 | $27.1K |
Showing 1–10 of 16
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
16 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| V2785 | 2 | 10 | 30 | $3,760 | $101.5K |
| 66984 | 129 | 580 | 230 | $70 | $73.7K |
| 66991 | 14 | 30 | 30 | $1,280 | $51.4K |
| 15823 | 8 | 50 | 50 | $520 | $40.3K |
| 67904 | 10 | 40 | 30 | $570 | $31.7K |
| 65820 | 8 | 40 | 30 | $790 | $31.4K |
| 66179 | 1 | 10 | 10 | $1,950 | $27.3K |
| 66982 | 14 | 130 | 30 | $100 | $20.8K |
| 65756 | 3 | 20 | 20 | $970 | $20.3K |
| 31267 | 2 | 20 | 20 | $810 | $18.6K |
Showing 1–10 of 16
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
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Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
13 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. | 3,760 | $310 | $1.1M |
| 42820 | The provider removes the tonsils and adenoids in a patient younger than 12 years old. | 1,410 | $460 | $650K |
| 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… | 2,980 | $180 | $524.8K |
| 42830 | The provider performs an initial adenoidectomy in a patient who is less than 12 years old. | 780 | $480 | $370.6K |
| 30140 | This CPT code is for a submucous resection of the inferior turbinate (partial or complete by any method). | 250 | $240 | $57.8K |
| V2632 | Posterior chamber intraocular lens | 40 | $1 | $40 |
| 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 | 300 | $0 | $0 |
| J2405 | Injection, ondansetron hydrochloride, per 1 mg | 10 | $0 | $0 |
| J2704 | Injection, propofol, 10 mg | 10 | $0 | $0 |
Showing 1–10 of 13
How this provider's Medicaid billing volume and revenue compare to other North Carolina providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. North Carolina median
13 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. | 1 | 90 | 120 | $350 | $184.9K |
| J3490 | Unclassified drugs | 131 | 160 | 2,850 | $10 | $165.6K |
| 42820 | The provider removes the tonsils and adenoids in a patient younger than 12 years old. | 2 | 60 | 100 | $390 | $123.1K |
| 30140 | This CPT code is for a submucous resection of the inferior turbinate (partial or complete by any method). | 4 | 10 | 250 | $350 | $113.4K |
| 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… | 4 | 70 | 130 | $160 | $107.5K |
| 42830 | The provider performs an initial adenoidectomy in a patient who is less than 12 years old. | 1 | 20 | 90 | $410 | $79.3K |
| J7120 | Ringers lactate infusion, up to 1000 cc | 66 | 70 | 330 | $10 | $16.6K |
| J2405 | Injection, ondansetron hydrochloride, per 1 mg | 108 | 110 | 1,250 | $1 | $11K |
| J2704 | Injection, propofol, 10 mg | 83 | 80 | 350 | $10 | $9.3K |
| J3010 | Injection, fentanyl citrate, 0.1 mg | 80 | 80 | 290 | $10 | $6K |
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Other providers in the same ZIP code as Southpark Surgery Center LLC, ranked by combined Medicare and Medicaid revenue.
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