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NPI 1871698894 · Cincinnati, OH · Ophthalmologic Surgery Clinic/Center
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Tri-state Centers For Sight Inc is a ophthalmologic surgery clinic/center provider located in Cincinnati, Ohio. This profile covers 20 Medicare and 2 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 | Tri-state Centers For Sight Inc |
| Address | 8044 Montgomery Rd |
| City | Cincinnati |
| State | OH |
| ZIP | 45236 |
| Taxonomy | Ophthalmologic Surgery Clinic/Center |
| NPI Enumerated | September 14, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $1.9M |
| Medicaid | $559.6K |
TRI-STATE CENTERS FOR SIGHT operates primarily as an ophthalmologic surgery clinic centered on cataract care: the code mix is dominated by cataract extraction and intraocular lens procedures (66984, 66991, 66982) alongside procedural ophthalmic drug administration codes (J1096, J1097), which is consistent with an ambulatory surgical practice that performs high volumes of cataract surgery and uses adjunct intraoperative medications. The Medicaid and Medicare data both show strong emphasis on anterior segment surgical services rather than primary care or broad multispecialty work.
Revenue concentration is high at both payers: the provider’s top 3 Medicare codes account for 65.0% of its Medicare revenue, and the top 3 Medicaid codes account for 100.0% of its Medicaid revenue, indicating a tight dependence on a small set of procedure lines to drive receipts. This concentration suggests financial sensitivity to volume or reimbursement changes for those specific codes.
Medicare revenue ($1.9M) materially exceeds Medicaid revenue ($559.6K), so the practice’s payer mix is Medicare-weighted by scale even though cataract surgery is important to both payers. The provider is not single-payer — it bills both — but Medicare represents the larger revenue pool and therefore likely drives broader financial performance and capacity decisions.
The single largest Medicare revenue driver is 66984: 1K claims, $803 avg paid/claim, $815.8K revenue (43.1% of Medicare revenue), and it ranks #1957 of 15965 providers nationally (88th percentile) where it is described as typical, unremarkable volume. This means while 66984 is a dominant line for this provider’s Medicare receipts, its national volume positioning is common among peers rather than uniquely dominant.
On Medicaid the provider is effectively a cataract specialist: 66984 appears as 1.2K claims, $458 avg paid/claim, $560.1K revenue (100.0% of this provider's total Medicaid revenue) and ranks #18 of 89 providers in-state (81th percentile). That code’s statewide standing is described as typical for in-state peers, but it nevertheless represents virtually all Medicaid revenue reported for the entity, indicating very concentrated Medicaid case mix.
Several other procedure codes place the practice above typical peer volumes in specific niches: 66821 ranks #342 of 10087 providers (97th percentile) and 67950 ranks #5 of 197 providers (97th percentile), while 67917 ranks #37 of 596 providers (94th percentile) and is labeled notably above typical national volume for that code. These high-percentile findings reflect stronger relative activity in posterior capsule management (66821) and oculoplastic procedures (67950, 67917) compared with many peers, suggesting subspecialty capacity beyond routine cataract extraction.
The provider’s portfolio also includes retina and vitreoretinal services (67108, 67041, 67036, 67042) and glaucoma interventions (66174, 0449T, 65855), each contributing smaller Medicare revenue slices but indicating clinical breadth across anterior and posterior segment surgical care. The presence of medium-value retina and glaucoma codes alongside high-volume cataract work suggests a mixed ambulatory surgical practice that handles both routine cataract cases and more complex ocular surgeries.
The practice has a long-enumerated NPI (2006-09-14, ~20 years ago), which supports interpretation of the observed patterns as the output of an established clinic rather than a new entrant. Tenure combined with concentrated cataract volumes and selective above-typical activity in oculoplastics and YAG capsulotomy points to a stable surgical center with focused service lines and some subspecialty strengths.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
20 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… | 1,020 | $800 | $815.8K |
| J1096 | Dexamethasone, lacrimal ophthalmic insert, 0.1 mg | 2,170 | $100 | $214.6K |
| J1097 | phenylephrine 10.16 mg/ml and ketorolac 2.88 mg/ml ophthalmic irrigation solution, 1 ml | 2,640 | $80 | $200.3K |
| 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… | 40 | $2,470 | $93.9K |
| 66821 | The provider removes the haziness from the capsule of the eye using a laser for a patient with a secondary membranous cataract. | 360 | $190 | $69.1K |
| 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… | 70 | $810 | $53.5K |
| 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. | 40 | $1,140 | $48.9K |
| 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 | $440 | $45.9K |
| 67950 | Canthoplasty (median or lateral) is often referred to as a corner eye lift or eye tendon surgery. The ophthalmologist uses this technique to strengthen the lateral canthal tendon or orbicularis… | 90 | $490 | $41.9K |
| 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… | 30 | $1,490 | $40.1K |
Showing 1–10 of 20
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 20 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
20 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| J1097 | 4 | 20 | 860 | $80 | $98.1K |
| 66984 | 157 | 530 | 210 | $110 | $92.8K |
| J1096 | 1 | 10 | 660 | $100 | $77.7K |
| 66991 | 14 | 40 | 30 | $1,060 | $52.8K |
| 15823 | 11 | 50 | 50 | $500 | $35.8K |
| 65820 | 31 | 40 | 40 | $850 | $33.3K |
| 66174 | 11 | 20 | 40 | $690 | $29.8K |
| 67042 | 42 | 50 | 20 | $960 | $29.7K |
| 0449T | 3 | 10 | 20 | $1,780 | $28.5K |
| 67904 | 6 | 40 | 40 | $540 | $28.2K |
Showing 1–10 of 20
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.
2 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… | 1,220 | $460 | $560.1K |
| 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… | 20 | $0 | $0 |
How this provider's Medicaid billing volume and revenue compare to other Ohio providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Ohio median
2 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… | 18 | 90 | 180 | $410 | $234.6K |
| 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… | 44 | 50 | 90 | $1 | $60 |
Other providers in the same ZIP code as Tri-state Centers For Sight Inc, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Assisted Care By Black Stone Of Cincinnati, LLC | OH | Home Health Agency | $0 | $17.7M |
| Jewish Hospital LLC | OH | General Acute Care Hospital | $0 | $15.4M |
| Interim Healthcare Of Cincinnati, Inc | OH | Home Health Agency | $0 | $13.7M |
| Kruti Patel | OH | Hematology & Oncology Physician | $1.1M | $0 |
| Nelson Watts | OH | Endocrinology, Diabetes & Metabolism Physician | $878.7K | $0 |
| Ergeba Sheferaw | OH | Internal Medicine Physician | $838.6K | $0 |
| Kenneth Smith | OH | General Practice Physician | $572.3K | $0 |
| Arshdeep Tindni | OH | Nephrology Physician | $504.1K | $0 |
| James Essell | OH | Hematology & Oncology Physician | $475.8K | $0 |
| Emily Fisher | OH | Dermatology Physician | $437K | $0 |
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