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NPI 1962402503 · Poulsbo, WA · Ambulatory Surgical Clinic/Center
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North Kitsap Ambulatory Surgery Center, LLC is a ambulatory surgical clinic/center provider located in Poulsbo, Washington. This profile covers 27 Medicare and 9 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 | North Kitsap Ambulatory Surgery Center, LLC |
| Address | 20669 Bond Rd Ne |
| City | Poulsbo |
| State | WA |
| ZIP | 98370 |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| NPI Enumerated | July 26, 2005 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $3.1M |
| Medicaid | $60.2K |
NORTH KITSAP AMBULATORY SURGERY CENTER, LLC is classified as an Ambulatory Surgical Clinic/Center and its Medicare billing mix indicates a dual clinical focus: high-revenue ophthalmology/cataract procedures (66984) and implantable neuromodulation/pain procedures (63685, 63650). This combination of cataract extraction with intraocular lens insertion and spinal neurostimulator implantation suggests the ASC supports both ophthalmic surgical case flow and device-based interventional pain programs out of the same facility footprint. Total Medicare revenue on file is $3.1M while total Medicaid revenue is $60.2K, underscoring that most of the facility’s procedural volume and revenue are Medicare-driven.
Revenue concentration on Medicare is heavily concentrated in a few codes: the precomputed top-three share is 71.4% of Medicare revenue, led by 66984 (32.5%, $992K), 63685 (25.6%, $782.7K), and 63650 (13.3%, $407.4K). Those three codes together drive the majority of the $3.1M Medicare intake, indicating that cataract surgery and spinal neuromodulation represent the facility’s primary revenue engines on Medicare. This concentration implies operational priorities and capital investment likely aligned with these high-yield procedures.
On the Medicaid side the precomputed top-three codes account for 94.4% of Medicaid revenue, dominated by 69436 (62.9%, $37.7K), followed by 87635 (22.8%, $13.6K) and 66984 (8.7%, $5.2K). That concentration shows Medicaid revenue is almost entirely driven by tympanostomy procedures and COVID testing encounters, with cataract surgery contributing a much smaller share of the $60.2K total. The Medicaid profile is therefore narrow and highly dependent on a single procedural category.
The payer mix is lopsided: Medicare ($3.1M) dwarfs Medicaid ($60.2K), so the center is effectively Medicare-dominant in scale. Medicaid represents only a small fraction of overall reported government payer revenue, meaning strategic decisions, staffing and equipment investments are likely justified primarily by Medicare case volumes rather than Medicaid demand. Analysts should treat Medicaid activity as marginal when modeling the center’s revenue sensitivity to payer shifts.
Competitive standing by code shows a modest but non-negligible national presence for the top Medicare procedures: 66984 ranks #1893 of 15965 (88th percentile, typical), 63685 ranks #127 of 1281 (89th percentile, typical), and 63650 ranks #164 of 1371 (88th percentile, typical). These percentiles indicate volumes above the median but still within a broadly typical range nationally — the center is not a dominant national leader for these codes but maintains higher-than-average activity compared with many peers. On Medicaid, 69436 ranks #12 of 32 in-state (65th percentile, typical), indicating the facility is a solid mid-tier state participant for tympanostomy billing rather than a market leader.
There are specific statistical outliers in the reported mix that point to operational specialties: Medicare code 64635 is described as “notably above typical national volume” and appears at the 96th percentile (rank #233 of 5957), and Medicare code 69436 is also labeled “notably above typical national volume” at the 96th percentile (rank #5 of 120). The elevated standing for 64635 (facet joint neurolysis) and 69436 (tympanostomy) suggests the center has particular clinical capacity or referral patterns for image-guided spinal interventions and ear procedures that exceed typical peer volumes.
Medicaid reporting includes several codes with recorded claim counts but $0 avg paid/claim (e.g., U0002, G8907, 99072, C1889, G8918), which collectively appear in the top Medicaid list despite generating no revenue in the dataset. This pattern is consistent with encounter-level, administrative, or non-reimbursed service codes appearing on Medicaid claim rosters and should be considered when interpreting billed claim volume versus reimbursed dollars. Analysts should not equate the presence of high claim counts for these codes with meaningful Medicaid revenue contribution.
The provider’s NPI was enumerated on 2005-07-26 (~21 years ago), indicating a multi-decade tenure in the market. That longevity supports the interpretation that the observed code mix and the facility’s referral relationships—particularly for cataract and implantable neurostimulator procedures—are established programs rather than newly developed service lines. Tenure also increases the likelihood of stable operational processes for the high-revenue procedures dominating Medicare payments.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
27 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… | 1,080 | $920 | $992K |
| 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… | 40 | $21,150 | $782.7K |
| 63650 | In this procedure, the provider places electrodes in the epidural space to relieve pain and reduce or eliminate spasms. | 100 | $4,200 | $407.4K |
| 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… | 60 | $2,800 | $173.5K |
| 64635 | Under fluoroscopic or CT guidance, the provider applies an agent to a lower back joint to destroy nerve tissue. | 180 | $540 | $95K |
| 55874 | Under imaging guidance, the provider inserts a needle through the perineum, the area between the anus and the scrotum, and injects one or more biodegradable materials, i.e., material that decomposes… | 30 | $2,940 | $79.3K |
| 45385 | The provider examines the colon and rectum using a colonoscope, a long, thin flexible tubular instrument with a light source and camera. He removes one or more tumors, polyps, or other lesions with a… | 150 | $500 | $73.4K |
| 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. | 40 | $1,300 | $53.1K |
| 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… | 140 | $370 | $50.6K |
| 31267 | In this procedure, the provider inserts an endoscope into the nasal cavity. She then gains access to the maxillary sinus through a cut in the uncinate process. The provider opens the maxillary sinus… | 30 | $1,510 | $48.4K |
Showing 1–10 of 27
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 27 CPT/HCPCS codes.
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Full comparison — all codes billed, vs. state median
27 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| 63685 | 1 | 30 | 20 | $8,250 | $148.4K |
| 63650 | 4 | 40 | 50 | $1,960 | $109.9K |
| 66984 | 12 | 460 | 50 | $560 | $97.5K |
| 66991 | 8 | 40 | 40 | $1,470 | $63.1K |
| 65820 | 6 | 20 | 20 | $1,120 | $37K |
| 45385 | 70 | 380 | 70 | $290 | $31K |
| 66982 | 28 | 120 | 30 | $720 | $27.3K |
| 64635 | 6 | 90 | 30 | $400 | $21.2K |
| 64483 | 36 | 160 | 50 | $200 | $19.7K |
| 55874 | 3 | 10 | 20 | $680 | $17.6K |
Showing 1–10 of 27
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.
9 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 69436 | This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia. | 210 | $180 | $37.7K |
| 87635 | Using an amplified nucleic acid probe technique, the lab analyst performs the necessary steps to identify the nucleic acids from the severe acute respiratory syndrome coronavirus 2 (SARS–COV–2) virus… | 680 | $20 | $13.6K |
| 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… | 50 | $120 | $5.2K |
| L8699 | Prosthetic implant, not otherwise specified | 50 | $60 | $3.3K |
| 99072 | The provider uses items, supplies materials, or requires clinical staff time in excess of what is normally used or provided for an office visit or other nonfacility encounter. These additional items… | 70 | $0 | $0 |
| C1889 | Implantable/insertable device, not otherwise classified | 10 | $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… | 120 | $0 | $0 |
| G8918 | Patient without preoperative order for iv antibiotic surgical site infection (ssi) prophylaxis | 10 | $0 | $0 |
| U0002 | 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc | 230 | $0 | $0 |
How this provider's Medicaid billing volume and revenue compare to other Washington providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Washington median
9 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 69436 | This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia. | 12 | 30 | 110 | $740 | $316.7K |
| 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… | 43 | 50 | 410 | $180 | $154K |
| L8699 | Prosthetic implant, not otherwise specified | 10 | 10 | 250 | $250 | $138.2K |
| 87635 | Using an amplified nucleic acid probe technique, the lab analyst performs the necessary steps to identify the nucleic acids from the severe acute respiratory syndrome coronavirus 2 (SARS–COV–2) virus… | 104 | 210 | 690 | $40 | $114.5K |
| U0002 | 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc | 21 | 60 | 140 | $20 | $20.4K |
| C1889 | Implantable/insertable device, not otherwise classified | 21 | 20 | 150 | $1 | $190 |
| 99072 | The provider uses items, supplies materials, or requires clinical staff time in excess of what is normally used or provided for an office visit or other nonfacility encounter. These additional items… | 218 | 330 | 160 | $1 | $50 |
| 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… | 23 | 50 | 90 | $1 | $1 |
| G8918 | Patient without preoperative order for iv antibiotic surgical site infection (ssi) prophylaxis | 27 | 30 | 120 | $0 | $0 |
Other providers in the same ZIP code as North Kitsap Ambulatory Surgery Center, LLC, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Kitsap County Fire District 18 | WA | Land Ambulance | $297.4K | $3M |
| Michael Jungkeit | WA | Specialist | $727.9K | $0 |
| James Lin | WA | Ophthalmology Physician | $583.3K | $0 |
| Dianne Levisohn | WA | Dermatology Physician | $324.7K | $0 |
| Paetra Ruddy | WA | Dermatology Physician | $311.1K | $0 |
| Andrea Smith | WA | Dermatology Physician | $291.1K | $0 |
| Matthew Voorsanger | WA | Cardiovascular Disease Physician | $287.2K | $0 |
| Manfred Henne | WA | Diagnostic Radiology Physician | $251.2K | $0 |
| Jonathan Mendelsohn | WA | Family Medicine Physician | $180.3K | $0 |
| Brian Bechtold | WA | Internal Medicine Physician | $169.1K | $0 |
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