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NPI 1962943118 · Phoenix, AZ · Ophthalmologic Surgery Clinic/Center
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Spectra Eye Institute, LLC is a ophthalmologic surgery clinic/center provider located in Phoenix, Arizona. This profile covers 25 Medicare and 4 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 | Spectra Eye Institute, LLC |
| Address | 15401 N 29th Ave |
| City | Phoenix |
| State | AZ |
| ZIP | 85053 |
| Taxonomy | Ophthalmologic Surgery Clinic/Center |
| NPI Enumerated | March 20, 2017 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $2.5M |
| Medicaid | $703.8K |
SPECTRA EYE INSTITUTE, LLC is operating as an ophthalmologic surgery clinic with a procedural mix heavily weighted toward cataract and vitreoretinal surgery. Its top Medicare revenue code is 66984 (cataract extraction with IOL), which alone represents 37.9% of Medicare revenue, and the practice also bills high volumes of vitrectomy and membrane-peel procedures (67036 and 67041), indicating an integrated cataract plus retina surgical practice rather than a purely outpatient or diagnostic eye clinic.
Medicare revenue is concentrated: the precomputed top 3 Medicare codes account for 49.5% of this provider's total Medicare revenue out of $2.5M total Medicare revenue. Those driving shares include 66984 (37.9%), 67036 (6.3%), and 67041 (5.3%), so nearly half of Medicare dollars derive from a small set of surgical procedures.
Medicaid billing is even more concentrated: the precomputed top 3 Medicaid codes account for 98.4% of this provider's total Medicaid revenue, with Medicaid totaling $703.8K. Code 66984 dominates Medicaid revenue at 83.8%, supplemented by 67113 (9.2%) and 67040 (5.4%), which suggests the provider’s Medicaid case mix is overwhelmingly cataract surgery with a smaller but material share of complex retinal work.
The provider’s payer mix shows Medicare substantially larger than Medicaid in scale: $2.5M in Medicare revenue versus $703.8K in Medicaid revenue. This means the practice is not single-payer dependent and realizes the majority of its public-payor income from Medicare rather than Medicaid.
On competitive standing for key Medicare services, SPECTRA’s retinal surgical volumes are nationally atypical: 67036 ranks #8 of 832 providers and 67041 ranks #4 of 461 providers (both labeled extreme outlier at the 99th percentile), signaling unusually high national market share for vitrectomy and membrane-peel procedures. By contrast, its cataract volume on Medicare (66984) ranks #1811 of 15965 providers at the 89th percentile and is described as typical or unremarkable for that code.
Other Medicare codes reinforce a specialty surgical profile: procedures such as 67108 rank at the 98th percentile (notably above typical national volume) and 66710 ranks at the 97th percentile (notably above typical), which together with glaucoma device codes (66174, 66183, 66180) indicate substantive retina and glaucoma procedural capacity beyond routine cataract care. Multiple codes with high percentile rankings point to concentrated competence in complex posterior-segment and glaucoma interventions.
State-level Medicaid positioning is mixed: for Medicaid 66984 the provider ranks #17 of 75 in-state (78th percentile; typical), while 67113 and 67040 rank #2 of 3 providers in-state (50th percentile), reflecting that complex retinal/pars-plana procedures are performed by very few Medicaid providers in Arizona and SPECTRA is among that small set. The small in-state peer counts for these retinal codes suggest the practice is one of only a handful of Medicaid providers offering higher-acuity retinal surgery.
The provider has an established but relatively recent NPI history: enumerated on 2017-03-20 (~9 years ago). This tenure is long enough to build a substantial public-payor surgical case volume reflected in the reported Medicare and Medicaid revenues, supporting the view of a mature surgical practice rather than a newly opened clinic.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
25 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… | 1,160 | $810 | $935K |
| 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. | 100 | $1,490 | $155.1K |
| 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… | 90 | $1,500 | $130.3K |
| V2785 | Processing, preserving and transporting corneal tissue | 30 | $3,780 | $120.9K |
| 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. | 90 | $1,380 | $119.7K |
| 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… | 50 | $2,530 | $113.9K |
| 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… | 70 | $1,500 | $109.4K |
| 67042 | In this procedure, the provider removes vitreous humor, the gelatinous material that gives shape to the eye, using a mechanical cutting tool. He removes the internal limiting membrane of the retina… | 70 | $1,510 | $98K |
| 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 | $830 | $85.4K |
| 67113 | The provider repairs a complicated detached retina. He removes vitreous humor, the gelatinous material that gives shape to the eye, and peels the retinal membrane. He reattaches the retina with… | 50 | $1,470 | $79.5K |
Showing 1–10 of 25
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 25 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
25 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| 66984 | 10 | 270 | 150 | $580 | $159.7K |
| V2785 | 4 | 10 | 30 | $3,500 | $146.8K |
| 66991 | 17 | 60 | 30 | $1,540 | $56.9K |
| 67041 | 2 | 20 | 30 | $1,220 | $51K |
| 15823 | 8 | 40 | 50 | $520 | $49.9K |
| 67042 | 4 | 40 | 30 | $1,160 | $46.5K |
| 66174 | 4 | 30 | 40 | $840 | $43.5K |
| 67113 | 2 | 20 | 20 | $1,190 | $40.3K |
| 67036 | 2 | 30 | 30 | $1,030 | $37.9K |
| 65756 | 6 | 10 | 20 | $1,250 | $37.6K |
Showing 1–10 of 25
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.
4 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… | 1,390 | $430 | $589.9K |
| 67113 | The provider repairs a complicated detached retina. He removes vitreous humor, the gelatinous material that gives shape to the eye, and peels the retinal membrane. He reattaches the retina with… | 50 | $1,260 | $64.5K |
| 67040 | The provider removes vitreous humor from the eye to access the posterior segment of the eye and introduce surgical instruments through incisions in the pars plana. This procedure also includes the… | 40 | $860 | $38K |
| 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… | 30 | $420 | $11.3K |
How this provider's Medicaid billing volume and revenue compare to other Arizona providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Arizona median
4 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… | 17 | 80 | 390 | $330 | $311.6K |
| 67113 | The provider repairs a complicated detached retina. He removes vitreous humor, the gelatinous material that gives shape to the eye, and peels the retinal membrane. He reattaches the retina with… | 2 | 10 | 50 | $1,270 | $165.1K |
| 67040 | The provider removes vitreous humor from the eye to access the posterior segment of the eye and introduce surgical instruments through incisions in the pars plana. This procedure also includes the… | 2 | 10 | 40 | $1,130 | $45.1K |
| 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… | 9 | 20 | 30 | $320 | $18.7K |
Other providers in the same ZIP code as Spectra Eye Institute, LLC, ranked by combined Medicare and Medicaid revenue.
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