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NPI 1851552483 · Pocatello, ID · Ambulatory Surgical Clinic/Center
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Skyline Surgery Center, LLC is a ambulatory surgical clinic/center provider located in Pocatello, Idaho. This profile covers 18 Medicare and 10 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 | Skyline Surgery Center, LLC |
| Address | 285 Vista Dr |
| City | Pocatello |
| State | ID |
| ZIP | 83201 |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| NPI Enumerated | June 17, 2008 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $1.1M |
| Medicare | $413.1K |
This entity’s payer mix is Medicaid‑heavy: Total Medicare revenue is $413.1K while Total Medicaid revenue is $1.1M, so Medicaid represents the larger share of recorded lifetime revenue for this provider. The provider therefore appears to derive greater scale from state Medicaid business than from Medicare fee‑for‑service.
The Medicare CPT mix is dominated by ophthalmology and spine/interventional pain procedures, consistent with an ambulatory surgical center profile. The top Medicare code is 66984 (cataract extraction with IOL) with $158.2K revenue (38.3% of Medicare revenue) and the next two largest contributions are 64635 ($58.8K, 14.2%) and G0260 ($36.1K, 8.7%), together accounting for the precomputed 61.3% share of Medicare revenue.
Medicare revenue concentration is significant: the precomputed top‑3 codes account for 61.3% of Medicare revenue, indicating reliance on a small set of high‑value procedures. The single largest Medicare line is 66984 (38.3% of Medicare revenue), which suggests cataract surgery is a primary revenue driver within the Medicare population at this site.
On the Medicaid side the revenue mix is extremely concentrated in a small number of codes: the precomputed top‑3 Medicaid codes account for 97.0% of Medicaid revenue. Code 41899 alone contributes $661K (61.0% of Medicaid revenue) and T1015 contributes $342.9K (31.7%), which together explain the vast majority of the facility’s Medicaid receipts and point to a dominant dental/clinic service line in state‑payer activity.
Competitive standing varies by code: for Medicare the cataract code 66984 ranks #5578 of 15965 providers nationally (65th percentile; typical, unremarkable volume for this code), while the spinal/neurolytic code 64635 ranks #497 of 5957 providers nationally (91th percentile; typical, unremarkable volume for this code) and G0260 ranks #124 of 967 providers nationally (87th percentile; typical, unremarkable volume for this code). This pattern indicates the center is a modest national participant overall but has relatively stronger national positioning in specific interventional pain procedures.
Within Idaho Medicaid the provider is a leading biller for the unspecified dental procedure code 41899 — it ranks #4 of 18 providers in‑state (82th percentile; typical, unremarkable volume for this code) — while its clinic visit code T1015 ranks #108 of 143 providers in‑state (25th percentile; typical, unremarkable volume for this code). In short, the facility is a major in‑state player for the high‑revenue unspecified dental code but only a modest contributor for general clinic visit volume.
The NPI tenure (enumerated 2008-06-17 (~18 years ago)) indicates this ambulatory surgical clinic/center has an established presence, which may help explain the development of both surgical (Medicare) and dental/clinic (Medicaid) service lines over time. Longitudinal presence reduces the likelihood that observed concentration is a brand‑new pattern and suggests operational continuity.
From an operational and payer‑risk standpoint, both payers show concentration risk: Medicare revenue is concentrated (top‑3 = 61.3%) around cataract and pain interventions, and Medicaid is heavily concentrated (top‑3 = 97.0%) in one unspecified dental code plus clinic visits. This degree of concentration makes the provider sensitive to coding, coverage, or reimbursement changes affecting those handful of high‑revenue 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.
18 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… | 190 | $820 | $158.2K |
| 64635 | Under fluoroscopic or CT guidance, the provider applies an agent to a lower back joint to destroy nerve tissue. | 120 | $480 | $58.8K |
| G0260 | Injection procedure for sacroiliac joint; provision of anesthetic, steroid and/or other therapeutic agent, with or without arthrography | 180 | $200 | $36.1K |
| 64721 | Neuroplasty or transposition of the median nerve at the carpal tunnel is done to treat a condition called carpal tunnel syndrome (CTS). The carpal tunnel is a narrow tunnel in the wrist through which… | 40 | $630 | $26K |
| 26055 | Trigger finger, or stenosing tenosynovitis, is when a finger remains in a bent position. It is painful to open or close the finger. A swollen tendon or formation of knots or nodules in the tendon may… | 50 | $480 | $21.6K |
| 66821 | The provider removes the haziness from the capsule of the eye using a laser for a patient with a secondary membranous cataract. | 70 | $200 | $13K |
| 64633 | In this procedure, the provider destroys the facet joint nerve of a cervical or thoracic spinal segment using neurolytic agents like heat, electric current, or a chemical compound. He makes use of… | 20 | $520 | $12.6K |
| 43239 | The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis. | 50 | $200 | $10.5K |
| 45380 | The provider examines the rectum and colon using a flexible colonoscope, a tubular instrument with a light source and camera, to look for the cause of a patient's symptoms, which may include… | 30 | $400 | $10.4K |
| 62323 | The provider injects a diagnostic or a therapeutic substance, such as pain medication or a steroid, into the space around the spinal nerves of the lumbar (lower back) or sacral (caudal, or tailbone)… | 40 | $240 | $10K |
Showing 1–10 of 18
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 18 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
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.
10 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 41899 | Use this code to report a procedure on the teeth and adjoining alveolar structures for which there is no specific code available. | 1,130 | $590 | $661K |
| T1015 | Clinic visit/encounter, all-inclusive | 560 | $610 | $342.9K |
| D2930 | N/A | 270 | $170 | $46.3K |
| D9420 | N/A | 210 | $90 | $17.9K |
| 43239 | The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis. | 40 | $180 | $6.8K |
| 42820 | The provider removes the tonsils and adenoids in a patient younger than 12 years old. | 10 | $380 | $5.3K |
| D7140 | Extraction, erupted tooth or exposed root (elevation and/or forceps removal) | 10 | $150 | $1.8K |
| D2391 | Resin‑based composite – one surface, posterior | 10 | $100 | $1.2K |
| D2390 | N/A | 30 | $0 | $0 |
| 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… | 200 | $0 | $0 |
How this provider's Medicaid billing volume and revenue compare to other Idaho providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Idaho median
10 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| T1015 | Clinic visit/encounter, all-inclusive | 108 | 140 | 5,470 | $180 | $2.6M |
| 41899 | Use this code to report a procedure on the teeth and adjoining alveolar structures for which there is no specific code available. | 4 | 20 | 500 | $820 | $662.5K |
| 42820 | The provider removes the tonsils and adenoids in a patient younger than 12 years old. | 19 | 20 | 110 | $840 | $224.4K |
| D2930 | N/A | 40 | 50 | 750 | $70 | $171.2K |
| D9420 | N/A | 21 | 40 | 180 | $150 | $80.8K |
| 43239 | The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis. | 25 | 40 | 180 | $170 | $75K |
| D7140 | Extraction, erupted tooth or exposed root (elevation and/or forceps removal) | 106 | 110 | 300 | $30 | $32.4K |
| D2391 | Resin‑based composite – one surface, posterior | 143 | 140 | 270 | $40 | $27.9K |
| 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… | 11 | 20 | 210 | $1 | $680 |
| D2390 | N/A | 1 | 10 | 30 | $0 | $0 |
Other providers in the same ZIP code as Skyline Surgery Center, LLC, ranked by combined Medicare and Medicaid revenue.
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