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NPI 1912174996 · Great Falls, MT · Ambulatory Surgical Clinic/Center
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Pacific Cataract And Laser Institute Inc PC is a ambulatory surgical clinic/center provider located in Great Falls, Montana. This profile covers 3 Medicare and 0 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 | Pacific Cataract And Laser Institute Inc PC |
| Address | 1621 Market Place Dr |
| City | Great Falls |
| State | MT |
| ZIP | 59404 |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| NPI Enumerated | May 9, 2008 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $379.3K |
| Medicaid | $0 |
The provider’s declared taxonomy is Ambulatory Surgical Clinic/Center and its Medicare billing mix is concentrated in cataract-related surgical and laser procedures, indicating an operation focused on outpatient ophthalmic surgery rather than general ambulatory care. The top-revenue CPTs reported (66984, 66991, 66821) all map to cataract extraction/IOL placement, combined IOL plus aqueous drainage device placement, and YAG capsulotomy, respectively, which together define a cataract-and-anterior-segment surgical service line.
Revenue concentration is extreme within Medicare: the precomputed top-3 codes account for 100.0% of the provider’s total Medicare revenue, with code 66984 alone representing 73.1% of Medicare revenue. This concentration means the financial profile is highly dependent on a very small set of procedure types rather than a broad mix of services.
Detailed Medicare activity shows 66984 at 358 claims with $775 avg paid/claim yielding $277.5K revenue (73.1% of Medicare revenue); 66991 at 34 claims with $2334 avg paid/claim yielding $79.4K revenue (20.9%); and 66821 at 150 claims with $151 avg paid/claim yielding $22.7K revenue (6.0%). These exact counts, average payments, and revenue figures illustrate that volume (claims) and per-claim payment both contribute to the revenue mix, with high volume/medium payment for 66984, low volume/high payment for 66991, and moderate volume/low payment for 66821.
The provider appears effectively single-payer in scope: reported lifetime Medicare revenue is $379.3K while there is no Medicaid billing on file. From a payer-mix perspective, the absence of Medicaid activity means Medicaid is not a contributor to the practice’s reported public-payer revenue and any analysis of public reimbursement should treat Medicare as the dominant public payer.
Competitive standing by code is generally modest-to-typical rather than dominant. For 66984 the provider ranks #3598 of 15965 providers (77th percentile) and is described as having "typical, unremarkable volume for this code;" for 66991 it ranks #596 of 1445 providers (57th percentile) with the same "typical, unremarkable volume for this code" label; and for 66821 it ranks #1368 of 10087 providers (86th percentile) and is again characterized as "typical, unremarkable volume for this code." These rank/percentile positions suggest respectable activity in cataract services nationally but not market-leading dominance.
The NPI was enumerated on 2008-05-09 (~18 years ago), indicating a long-tenured billing relationship with Medicare. That tenure supports stable historical participation in Medicare fee-for-service billing, which can be relevant when assessing referral relationships and consistency of surgical throughput over time.
Because 100.0% of Medicare revenue is concentrated in three cataract-related codes, the provider’s revenue is operationally sensitive to changes in cataract surgical volumes, reimbursement rates, and referral patterns. Any shifts in Medicare policy for these specific CPTs, changes in local referral networks, or material variation in cataract case flow could materially affect the practice’s reported public-payer revenue given the narrow service-line footprint.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
3 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… | 360 | $780 | $277.4K |
| 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… | 30 | $2,330 | $79.4K |
| 66821 | The provider removes the haziness from the capsule of the eye using a laser for a patient with a secondary membranous cataract. | 150 | $150 | $22.6K |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 3 CPT/HCPCS codes.
Other providers in the same ZIP code as Pacific Cataract And Laser Institute Inc PC, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Quality Life Concepts Inc. | MT | Community/Behavioral Health Agency | $0 | $26M |
| Central Montana Eyecare PC | MT | Optometrist | $0 | $1.8M |
| Martha Morgan | MT | Clinical Social Worker | $15.9K | $546.9K |
| Tanya Richem | MT | Professional Counselor | $0 | $546.5K |
| Lisa Anderson Mangan | MT | Professional Counselor | $0 | $500.6K |
| Rays Of Light, LLC | MT | Community/Behavioral Health Agency | $0 | $367.2K |
| Sharon Altschwager | MT | Counselor | $0 | $327K |
| Elisabeth Purdy | MT | Professional Counselor | $0 | $246.4K |
| Carey Welsh | MT | Family Medicine Physician | $116.1K | $0 |
| Anthony Turk | MT | Optometrist | $40.6K | $60.2K |
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