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NPI 1831165331 · Spokane, WA · Ambulatory Surgical Clinic/Center
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Spokane Eye Clinic Ps is a ambulatory surgical clinic/center provider located in Spokane, Washington. This profile covers 27 Medicare and 7 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 | Spokane Eye Clinic Ps |
| Address | 427 S Bernard St |
| City | Spokane |
| State | WA |
| ZIP | 99204 |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| NPI Enumerated | February 24, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $3M |
| Medicaid | $716.1K |
SPOKANE EYE CLINIC PS is a surgery-focused ambulatory ophthalmology center: its Medicare top codes are dominated by cataract extraction and intraocular lens insertion (66984, 66982, 66991) and a range of retina and glaucoma procedures (67042, 67108, 67036, 66180), indicating a practice that performs both routine cataract surgery and higher-acuity posterior segment and glaucoma interventions. The mix of codes suggests an operation organized around procedural, same-day surgical care rather than primarily office-based vision services.
Medicare revenue is concentrated in a very small set of procedures: the top 3 Medicare codes account for 62.3% of the provider's total Medicare revenue, driven largely by 66984 which alone represents $1.5M (49.8% of Medicare revenue). This concentration implies financial dependence on a few high-volume/high-revenue surgical codes and potential sensitivity to reimbursement or referral changes for those procedures.
On Medicaid the revenue mix is even more concentrated: the top 3 Medicaid codes account for 97.6% of total Medicaid revenue, with 66984 contributing $513.6K (71.5% of Medicaid revenue) and V2632 adding $139.6K (19.4%). This indicates Medicaid business is overwhelmingly cataract-related and that non-cataract services generate negligible Medicaid revenue for this provider.
In payer scale terms, the practice reports $3M in total Medicare revenue versus $716.1K in total Medicaid revenue, showing Medicare is the dominant source of public-payer revenue by scale. The presence of meaningful Medicaid cataract volume, however, indicates some payer-mix diversity in surgical cataract throughput even though the overall Medicaid contribution is much smaller than Medicare.
Competitive standing varies by procedure: for Medicare retina procedures such as 67042 and 67108 the provider ranks at the very top nationally (67042 ranks #12 of 1087, 99th percentile; 67108 ranks #11 of 706, 98th percentile), which the source labels as "extreme outlier" and indicates unusually high national volume for complex retinal surgery. By contrast, cataract code 66984 ranks #1249 of 15965 (92nd percentile) and is described as "typical, unremarkable volume," showing the provider is a strong regional player for cataract surgery but not an exceptional national outlier for that specific code.
Several codes are flagged as notably above typical national volume, signaling subspecialty procedure strength beyond cataracts: 67036 (96th percentile), 66821 (98th percentile), 66250 (95th percentile), and 67228 (94th percentile) all appear at high percentiles for Medicare, supporting the conclusion that the clinic provides a wide set of advanced retinal, posterior-segment, and YAG laser services at volumes above typical peers.
State-level Medicaid ranks show dominant in-state cataract activity: Medicaid 66984 ranks #4 of 51 providers in Washington (94th percentile) and V2632 ranks #3 of 15 (86th percentile), consistent with a leading regional position for Medicaid-funded cataract procedures. Other Medicaid codes are small contributors or zero-paid quality codes (G8907, G8918) and do not materially alter the conclusion that Medicaid activity is concentrated in cataract-related services.
The NPI tenure (enumerated ~2006-02-24, ~20 years ago) indicates the provider has established operating history, which is consistent with the sustained high volumes observed across both Medicare and Medicaid for cataract and complex retinal procedures. This longevity supports expectations of stable referral networks and operational maturation in ambulatory ophthalmic surgery.
While the provider shows high volumes for certain complex retina and glaucoma interventions (several codes marked "extreme outlier" or "notably above typical" nationally), nearly half of Medicare revenue is tied to a single code 66984; combined with Medicaid concentration (97.6% top-three share) this creates revenue concentration risk if surgical volumes or reimbursements for those few codes shift. Analysts should view the clinic as a high-volume surgical center with subspecialty retinal and glaucoma strength but with disproportionate revenue exposure to cataract surgery coding across both payers.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
27 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… | 1,720 | $870 | $1.5M |
| 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… | 150 | $1,590 | $235.6K |
| 67108 | The provider repairs a detached retina using heat produced by a laser beam or by freezing the tissues. He may attach a scleral buckle to simplify the passage of fluid through and behind the retina or… | 90 | $1,590 | $138.4K |
| 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… | 160 | $870 | $135.5K |
| 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… | 50 | $2,660 | $135.4K |
| V2785 | Processing, preserving and transporting corneal tissue | 40 | $3,600 | $129.7K |
| 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. | 70 | $1,590 | $116.4K |
| 66821 | The provider removes the haziness from the capsule of the eye using a laser for a patient with a secondary membranous cataract. | 530 | $210 | $111.5K |
| 67113 | The provider repairs a complicated detached retina. He removes vitreous humor, the gelatinous material that gives shape to the eye, and peels the retinal membrane. He reattaches the retina with… | 50 | $1,580 | $81.9K |
| 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… | 30 | $2,090 | $60.6K |
Showing 1–10 of 27
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 27 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
27 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| 66984 | 3 | 460 | 50 | $560 | $97.5K |
| V2785 | 3 | 10 | 30 | $3,540 | $91.9K |
| 66991 | 10 | 40 | 40 | $1,470 | $63.1K |
| 67042 | 2 | 40 | 30 | $1,190 | $39.2K |
| 66183 | 10 | 10 | 20 | $1,530 | $33.6K |
| 67113 | 1 | 10 | 20 | $1,240 | $32.2K |
| 66180 | 1 | 10 | 20 | $1,750 | $31.5K |
| 67108 | 1 | 20 | 20 | $1,180 | $29.6K |
| 67036 | 2 | 20 | 20 | $1,140 | $28.6K |
| 65756 | 2 | 20 | 20 | $1,270 | $27.9K |
Showing 1–10 of 27
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.
7 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… | 3,540 | $150 | $513.6K |
| V2632 | Posterior chamber intraocular lens | 670 | $210 | $139.6K |
| 66821 | The provider removes the haziness from the capsule of the eye using a laser for a patient with a secondary membranous cataract. | 390 | $120 | $48.1K |
| 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… | 140 | $110 | $14.9K |
| 67228 | In retinopathy, tiny new vessels grow profusely and fibrous tissue proliferates in between the layers of the retina, which may extend into the optic nerve and vitreous, clear gel that fills the space… | 10 | $170 | $2K |
| 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… | 360 | $0 | $0 |
| G8918 | Patient without preoperative order for iv antibiotic surgical site infection (ssi) prophylaxis | 20 | $0 | $0 |
How this provider's Medicaid billing volume and revenue compare to other Washington providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Washington median
7 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… | 4 | 50 | 410 | $180 | $154K |
| 66821 | The provider removes the haziness from the capsule of the eye using a laser for a patient with a secondary membranous cataract. | 3 | 10 | 250 | $110 | $33.3K |
| 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… | 3 | 10 | 90 | $150 | $16.1K |
| V2632 | Posterior chamber intraocular lens | 3 | 20 | 100 | $40 | $15.9K |
| 67228 | In retinopathy, tiny new vessels grow profusely and fibrous tissue proliferates in between the layers of the retina, which may extend into the optic nerve and vitreous, clear gel that fills the space… | 6 | 10 | 10 | $130 | $4.8K |
| 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… | 13 | 50 | 90 | $1 | $1 |
| G8918 | Patient without preoperative order for iv antibiotic surgical site infection (ssi) prophylaxis | 19 | 30 | 120 | $0 | $0 |
Other providers in the same ZIP code as Spokane Eye Clinic Ps, ranked by combined Medicare and Medicaid revenue.
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