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NPI 1851338677 · Dover, DE · Ambulatory Surgical Clinic/Center
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Delaware Surgery Center, LLC is a ambulatory surgical clinic/center provider located in Dover, Delaware. This profile covers 56 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 | Delaware Surgery Center, LLC |
| Address | 200 Banning St |
| City | Dover |
| State | DE |
| ZIP | 19904 |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| NPI Enumerated | June 1, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $4.5M |
| Medicaid | $408.4K |
DELAWARE SURGERY CENTER, LLC operates at a modest scale overall with Total Medicare revenue: $4.5M compared with Total Medicaid revenue: $408.4K, indicating Medicare is the dominant payer for this facility while Medicaid represents a much smaller portion of lifetime billing. The practice has an NPI enumerated 2006-06-01 (~20 years ago), signaling a sustained operating presence in Dover, DE.
Revenue concentration is high on both payers: the provider’s top 3 Medicare codes account for 48.0% of this provider's total Medicare revenue, and the top 3 Medicaid codes account for 100.0% of this provider's total Medicaid revenue. On Medicare the largest single contributors listed are 66984 ($995K, 24.2%), 27447 ($489.9K, 11.9%), and J1096 ($486.7K, 11.9%), while on Medicaid 66984 alone drives $397.6K (97.3%) of the $408.4K total.
The procedural mix points to a core ambulatory surgical focus with a strong ophthalmology footprint—multiple cataract and intraocular lens procedures (66984, 66982, 66991) and ophthalmic drug supplies (J1096, J1097) are prominent—alongside a smaller but material orthopedics component (27447) and a portfolio of spinal and joint injection procedures (G0260, 64483, 64493). This combination of codes is consistent with an ambulatory surgical clinic that provides high-volume eye surgery and complementary pain-management and orthopedic services.
Competitive standing on Medicare is mixed by code: the center is a national high-volume outlier on several specific services (J1096 ranks #8 of 282, 98th percentile, labeled notably above typical national volume; 66982 ranks in the 99th percentile; 15823 ranks #16 of 1718, 99th percentile and labeled an extreme outlier), yet the single largest Medicare revenue driver 66984 ($995K) ranks #1829 of 15965 (89th percentile) and is characterized as typical, unremarkable volume nationally. This indicates the facility is exceptionally specialized or concentrated for a subset of procedures while maintaining more typical volume for other high-revenue services.
On Medicaid the center is a clear in-state leader for cataract procedures: 66984 accounts for $397.6K (97.3% of Medicaid revenue) and ranks #1 of 11 providers in-state (100th percentile, notably above typical state volume). G0260 also appears as an in-state leader by rank but with only $11.1K (2.7% of Medicaid revenue) and no peer-volume comparison available for that code, underscoring that Medicaid activity is overwhelmingly driven by one service line.
Several codes are flagged as statistical outliers or notably above typical volume, which highlights concentrated specialty expertise: 15823 (extreme outlier), 50590 (extreme outlier), G0260 (extreme outlier on Medicare), and multiple codes in the 95–99th percentile range (e.g., 66982, 64483, 64493). These labels suggest focused clinical capacity or referral patterns for certain procedures rather than evenly distributed case mix.
From a risk and operational perspective, the provider’s heavy reliance on a handful of procedures—top 3 Medicare codes = 48.0% of Medicare revenue and top 3 Medicaid codes = 100.0% of Medicaid revenue—creates concentration exposure: changes in reimbursement, utilization, or referral pathways for those specific codes (notably 66984 and 27447/J1096) would materially affect revenue. Monitoring policy or payer edits affecting cataract surgery and associated ophthalmic drug supply codes should be a priority for payers and analysts.
The combination of long tenure (NPI enumerated 2006-06-01 (~20 years ago)), high national percentile ranks for particular ophthalmic and procedure codes, and a Medicaid footprint that is effectively centered on 66984 suggests the facility operates as a stable, specialty-oriented ambulatory surgical clinic with dominant ophthalmology services and adjunct pain/orthopedic procedures. Analysts evaluating network capacity or competitive supply in Delaware should treat this center as a key local cataract surgery site with notable national-level specialization on select codes.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
56 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… | 1,150 | $870 | $995K |
| 27447 | In this procedure, the provider replaces the damaged weight bearing surfaces of both the medial and lateral compartments in the knee joint using implants of metal or other strong materials. The… | 70 | $7,420 | $489.9K |
| J1096 | Dexamethasone, lacrimal ophthalmic insert, 0.1 mg | 4,920 | $100 | $486.7K |
| J1097 | phenylephrine 10.16 mg/ml and ketorolac 2.88 mg/ml ophthalmic irrigation solution, 1 ml | 4,920 | $80 | $373.6K |
| 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… | 90 | $2,590 | $225.1K |
| 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… | 10 | $19,690 | $216.5K |
| 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… | 230 | $860 | $198.5K |
| 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… | 310 | $520 | $164K |
| 64483 | This procedure is the injection of an anesthetic agent and/or steroid in the form of a transforaminal epidural injection into a single level (either lumbar or sacral). | 360 | $320 | $112.1K |
| 50590 | Extracorporeal shock wave lithotripsy (ESWL) is a procedure used to destroy calculus (kidney stones) in the kidneys and ureters. | 100 | $1,180 | $111.8K |
Showing 1–10 of 56
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 56 CPT/HCPCS codes.
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Full comparison — all codes billed, vs. state median
56 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| J1096 | 1 | 10 | 4,920 | $100 | $488.2K |
| J1097 | 1 | 10 | 2,720 | $80 | $207.4K |
| 66984 | 2 | 50 | 70 | $590 | $163.6K |
| 63685 | 2 | 10 | 20 | $4,820 | $110.8K |
| 66991 | 2 | 10 | 50 | $1,590 | $85.6K |
| J0585 | 4 | 20 | 5,800 | $1 | $76.2K |
| 64483 | 7 | 40 | 170 | $220 | $62.4K |
| 15823 | 1 | 10 | 60 | $550 | $60.3K |
| 66982 | 1 | 20 | 60 | $700 | $60K |
| 27447 | 16 | 50 | 50 | $810 | $52K |
Showing 1–10 of 56
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.
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… | 910 | $440 | $397.6K |
| G0260 | Injection procedure for sacroiliac joint; provision of anesthetic, steroid and/or other therapeutic agent, with or without arthrography | 70 | $160 | $11.1K |
| 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… | 1,020 | $0 | $0 |
| V2632 | Posterior chamber intraocular lens | 70 | $0 | $0 |
How this provider's Medicaid billing volume and revenue compare to other Delaware providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Delaware 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… | 1 | 10 | 380 | $300 | $112K |
| G0260 | Injection procedure for sacroiliac joint; provision of anesthetic, steroid and/or other therapeutic agent, with or without arthrography | 1 | 10 | 70 | $160 | $11.1K |
| 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… | 2 | 10 | 150 | $0 | $0 |
| V2632 | Posterior chamber intraocular lens | 1 | 10 | 40 | $0 | $0 |
Other providers in the same ZIP code as Delaware Surgery Center, LLC, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Bayada Home Health Care, Inc. | DE | Home Health Agency | $0 | $37.9M |
| At Home Infucare, LLC | DE | Home Health Agency | $0 | $28.5M |
| Amazing Home Care Agency | DE | Home Health Agency | $0 | $18.7M |
| Dedicated To Women Ob-gyn, P.A. | DE | Obstetrics & Gynecology Physician | $0 | $11.1M |
| Help At Home Of Delaware, LLC | DE | In Home Supportive Care Agency | $0 | $10.7M |
| A Center For Mental Wellness, Inc. | DE | Mental Health Counselor | $0 | $9.9M |
| State Of Delaware | DE | Case Management Agency | $0 | $9.2M |
| West Dover Dental, LLC | DE | Dentist | $0 | $9M |
| Americare Home Solutions | DE | In Home Supportive Care Agency | $0 | $8.4M |
| Vicdania Health Services LLC | DE | Home Health Agency | $0 | $7.4M |
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