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NPI 1871581876 · Sioux Falls, SD · Ambulatory Surgical Clinic/Center
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Ophthalmology Ltd Eye Surgery Center L L C is a ambulatory surgical clinic/center provider located in Sioux Falls, South Dakota. This profile covers 21 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 | Ophthalmology Ltd Eye Surgery Center L L C |
| Address | 6601 S. Minnesota Avenue |
| City | Sioux Falls |
| State | SD |
| ZIP | 57108 |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| NPI Enumerated | October 12, 2005 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $1.8M |
| Medicaid | $16.2K |
The provider operates as an ambulatory surgical clinic/center with a procedure mix dominated by cataract and advanced ophthalmic surgeries: Medicare revenue is $1.8M and the single largest Medicare line is 66984 ($846.2K, 46.1% of Medicare revenue), supported by substantial claims volume (1.1K claims). The top three Medicare codes (66984, 67108, 15823) together account for 58.6% of Medicare revenue, indicating the facility’s business is concentrated in a few high-yield surgical services rather than a broadly diversified outpatient case mix.
Medicare revenue concentration is high: the precomputed top-three share is 58.6%, with 66984 alone comprising $846.2K (46.1%). The other two codes in that top-three cluster are 67108 ($116.3K) and 15823 ($112.6K), which together with 66984 drive more than half of the provider’s Medicare receipts and therefore define its primary service lines.
On Medicaid the provider is effectively single-procedure concentrated: total Medicaid revenue is $16.2K and the precomputed top-three share is 100.0%, with 66984 representing $14.5K (89.3% of Medicaid revenue, 57 claims). The remaining Medicaid revenue is split between 00142 ($1.3K) and V2632 ($453), so Medicaid volumes and dollars are very small relative to Medicare and concentrated in cataract-related services.
The payer mix is heavily Medicare-weighted: Medicare revenue of $1.8M dwarfs Medicaid at $16.2K, so the facility functions as a Medicare-dominant surgical center. This scale difference implies strategic dependence on Medicare patients for surgical throughput and revenue sustainability rather than on Medicaid.
Competitive standing is mixed across codes: for Medicare cataract work 66984 ranks #1833 of 15965 (89th percentile; typical, unremarkable volume for this code), indicating solid but not exceptional national cataract volume. By contrast, the provider is a high outlier on specific specialty codes — 67108 ranks #14 of 706 (98th percentile; extreme outlier, far above typical national volume for this code) and 15823 ranks #31 of 1718 (98th percentile; extreme outlier, far above typical national volume for this code) — signaling unusually high activity in retinal detachment repair and eyelid skin procedures relative to peers.
Several additional Medicare codes show above-typical or notably above-typical volume for specialized procedures: 66821 ranks #223 of 10087 (98th percentile; notably above typical national volume for this code), and posterior-segment surgery codes such as 67041 and 67036 rank in high percentiles (98th and 86th respectively). These placements, together with the presence of V2785 (corneal tissue processing) revenue of $65.9K, suggest the center has capability and referral patterns for complex anterior and posterior segment ophthalmic surgery beyond routine cataract cases.
Medicaid competitive positioning differs materially from Medicare: Medicaid 66984 activity is small ($14.5K) and the provider ranks #8 of 8 in-state for that code (0th percentile; typical, unremarkable volume for this code), suggesting it captures relatively little Medicaid cataract volume compared with in-state peers. At the same time V2632 ranks #1 of 2 in-state (100th percentile) but contributes only $453, indicating some procedural billing presence for Medicaid that does not translate to significant revenue share.
Operational tenure and quality-reporting markers are notable: the NPI was enumerated 2005-10-12 (~21 years ago), indicating long-standing operation in Sioux Falls, SD. The Medicaid file also shows zero-paid administrative/quality codes (G8907 and G8918 recorded with $0 revenue), which are consistent with captured quality-event reporting or administrative claims lines rather than direct revenue drivers.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
21 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… | 1,140 | $740 | $846.2K |
| 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… | 80 | $1,390 | $116.3K |
| 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… | 250 | $450 | $112.6K |
| 67041 | In this procedure, the provider removes scar tissue from the retinal membrane that obscures vision. He removes vitreous humor, the gelatinous material that gives shape to the eye, using a mechanical… | 60 | $1,400 | $89.3K |
| 66821 | The provider removes the haziness from the capsule of the eye using a laser for a patient with a secondary membranous cataract. | 500 | $160 | $78.3K |
| 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. | 50 | $1,390 | $75.3K |
| 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… | 100 | $730 | $73.4K |
| 66174 | The provider expands the aqueous outflow (drainage) canal of the eye to help relieve pressure in the eye. The procedure does not include leaving a device or stent in place. | 50 | $1,400 | $72.6K |
| V2785 | Processing, preserving and transporting corneal tissue | 20 | $3,470 | $65.9K |
| 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. | 40 | $1,400 | $55.9K |
Showing 1–10 of 21
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 21 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
21 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| V2785 | 2 | 10 | 20 | $3,680 | $180.5K |
| 66984 | 4 | 130 | 40 | $410 | $67.7K |
| 15823 | 2 | 10 | 50 | $510 | $50.6K |
| 67042 | 4 | 10 | 30 | $1,140 | $38.6K |
| 65756 | 8 | 10 | 20 | $1,070 | $38.6K |
| 65820 | 1 | 10 | 40 | $1,010 | $37.2K |
| 66821 | 2 | 30 | 100 | $230 | $35.6K |
| 67041 | 1 | 10 | 30 | $1,190 | $35.6K |
| 67108 | 1 | 10 | 20 | $1,180 | $34.1K |
| 66183 | 3 | 10 | 30 | $1,520 | $33.4K |
Showing 1–10 of 21
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 |
|---|---|---|---|---|
| 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… | 60 | $250 | $14.5K |
| 00142 | The provider performs anesthesia services for a patient undergoing an eye lens procedure. | 30 | $40 | $1.3K |
| V2632 | Posterior chamber intraocular lens | 150 | $1 | $450 |
| 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… | 110 | $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 South Dakota providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. South Dakota median
5 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… | 8 | 10 | 100 | $250 | $60.9K |
| 00142 | The provider performs anesthesia services for a patient undergoing an eye lens procedure. | 3 | 10 | 60 | $40 | $11K |
| V2632 | Posterior chamber intraocular lens | 1 | 10 | 120 | $1 | $240 |
| 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 | 10 | 20 | $0 | $0 |
| G8918 | Patient without preoperative order for iv antibiotic surgical site infection (ssi) prophylaxis | 3 | 10 | 20 | $0 | $0 |
Other providers in the same ZIP code as Ophthalmology Ltd Eye Surgery Center L L C, ranked by combined Medicare and Medicaid revenue.
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