Loading...
NPI 1023005139 · Salem, VA · Ambulatory Surgical Clinic/Center
Customize your policy alerts
Get alerted when relevant policies change without checking for updates manually.
Monitor payer policy activity
Roanoke Valley Center For Sight LLC is a ambulatory surgical clinic/center provider located in Salem, Virginia. This profile covers 31 Medicare and 8 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 | Roanoke Valley Center For Sight LLC |
| Address | 438 W Main St |
| City | Salem |
| State | VA |
| ZIP | 24153 |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| NPI Enumerated | October 4, 2005 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $8.4M |
| Medicaid | $1.7M |
ROANOKE VALLEY CENTER FOR SIGHT LLC operates as an ambulatory surgical clinic/center with a clear procedural focus on cataract surgery and associated intraoperative/postoperative ophthalmic products; its Medicare billing is led by 66984 ($3.8M) and supported by high-volume medication/product codes J1097 ($1.6M) and J1096 ($868.5K), consistent with a surgical practice that pairs lens extraction with routine use of irrigation and implantable ophthalmic therapies. The provider’s taxonomy and the code mix together indicate a surgical cataract hub rather than a primarily diagnostic or multi-specialty outpatient clinic.
Revenue concentration is very high on Medicare: the precomputed top-three Medicare codes account for 75.5% of total Medicare revenue, driven primarily by 66984, J1097, and J1096. This concentration implies that changes in cataract procedure volumes or reimbursement for these specific codes would disproportionately affect the provider’s Medicare revenue stream.
Medicaid billing is even more concentrated: the precomputed top-three Medicaid codes account for 99.6% of total Medicaid revenue, with 66984 alone representing $1.6M or 94.7% of the provider’s Medicaid revenue. The Medicaid mix is effectively single-service dominated (cataract extraction with lens insertion), indicating limited diversification of state-covered services.
In payer-scale terms, Medicare is the dominant payer by scale for this facility: total Medicare revenue is $8.4M compared with total Medicaid revenue of $1.7M, indicating the practice’s financial footprint is substantially larger on Medicare. Analysts should treat Medicaid activity as significant for state-level market share but limited in absolute revenue compared with Medicare.
The provider is a competitive outlier on several codes nationally and statewide. On Medicare, J1097 ranks #1 of 443 providers nationally (100th percentile, labeled an "extreme outlier") and 66984 ranks #139 of 15965 providers nationally (99th percentile), signaling unusually large national volumes for those items; on Medicaid, 66984 ranks #1 of 50 providers in-state (100th percentile), indicating dominant in-state cataract procedure volume. These rank/percentile positions suggest the provider is a major regional surgical player and a nationally notable outlier for certain intraoperative ophthalmic products.
Beyond cataract extraction, the provider bills for glaucoma and retinal procedures at lower volumes, which points to a broader surgical capability: examples include 66991 ($454.7K, Medicare), 66183 ($150.6K, Medicare), and 67041 ($132.2K, Medicare). These codes contribute meaningful niche revenue but do not approach the revenue share of the top cataract- and medication-related codes, suggesting secondary service lines rather than primary revenue drivers.
Service-line details show high utilization of intraoperative and implantable ophthalmic products: Medicare claims for J1097 number 21.3K with $1.6M in revenue and J1096 number 8.8K claims with $868.5K in revenue, both characterized as extreme outliers or near-extreme outliers in national rank. This pattern is consistent with routine, high-volume use of specific ophthalmic irrigation and lacrimal insert products in conjunction with cataract surgeries at this site.
The provider has an established operational tenure that supports its observed volume profile: NPI enumerated (registered) on 2005-10-04 (~21 years ago), which aligns with the scale and specialization shown in the billing data and suggests a longstanding ambulatory surgical presence in the Salem, VA market.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
31 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… | 5,030 | $760 | $3.8M |
| J1097 | phenylephrine 10.16 mg/ml and ketorolac 2.88 mg/ml ophthalmic irrigation solution, 1 ml | 21,280 | $80 | $1.6M |
| J1096 | Dexamethasone, lacrimal ophthalmic insert, 0.1 mg | 8,770 | $100 | $868.5K |
| 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… | 190 | $2,360 | $454.7K |
| 66821 | The provider removes the haziness from the capsule of the eye using a laser for a patient with a secondary membranous cataract. | 1,450 | $160 | $236.3K |
| 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… | 240 | $760 | $183.2K |
| 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. | 140 | $1,120 | $159.6K |
| 66183 | The provider inserts a small device into the anterior chamber of the eye that helps to reduce the intraocular pressure of the eye in patients with glaucoma. | 70 | $2,090 | $150.6K |
| 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… | 100 | $1,390 | $132.2K |
| V2785 | Processing, preserving and transporting corneal tissue | 40 | $3,570 | $125K |
Showing 1–10 of 31
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 31 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
31 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| J1096 | 1 | 10 | 1,630 | $100 | $256.8K |
| J1097 | 1 | 10 | 1,400 | $80 | $248K |
| V2785 | 4 | 10 | 40 | $3,750 | $146.1K |
| 66984 | 16 | 380 | 250 | $130 | $139K |
| 66183 | 3 | 10 | 70 | $1,410 | $89K |
| 65820 | 3 | 40 | 30 | $1,110 | $63.1K |
| 66991 | 1 | 30 | 30 | $1,460 | $61.3K |
| 66988 | 1 | 10 | 40 | $870 | $34.7K |
| 15823 | 2 | 30 | 50 | $530 | $34.5K |
| 67042 | 3 | 20 | 20 | $1,130 | $33.8K |
Showing 1–10 of 31
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.
8 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… | 6,110 | $270 | $1.6M |
| 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… | 150 | $330 | $49.1K |
| 66821 | The provider removes the haziness from the capsule of the eye using a laser for a patient with a secondary membranous cataract. | 320 | $110 | $35.3K |
| J1097 | phenylephrine 10.16 mg/ml and ketorolac 2.88 mg/ml ophthalmic irrigation solution, 1 ml | 940 | $10 | $5.6K |
| J1096 | Dexamethasone, lacrimal ophthalmic insert, 0.1 mg | 20 | $40 | $720 |
| 00142 | The provider performs anesthesia services for a patient undergoing an eye lens procedure. | 90 | $1 | $360 |
| 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… | 1,300 | $0 | $0 |
| G8918 | Patient without preoperative order for iv antibiotic surgical site infection (ssi) prophylaxis | 70 | $0 | $0 |
How this provider's Medicaid billing volume and revenue compare to other Virginia providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Virginia median
8 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… | 1 | 50 | 200 | $350 | $282.9K |
| 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… | 2 | 10 | 100 | $420 | $56.4K |
| 00142 | The provider performs anesthesia services for a patient undergoing an eye lens procedure. | 13 | 20 | 300 | $30 | $21.1K |
| 66821 | The provider removes the haziness from the capsule of the eye using a laser for a patient with a secondary membranous cataract. | 1 | 10 | 110 | $100 | $12.8K |
| J1097 | phenylephrine 10.16 mg/ml and ketorolac 2.88 mg/ml ophthalmic irrigation solution, 1 ml | 1 | 10 | 490 | $10 | $3.2K |
| J1096 | Dexamethasone, lacrimal ophthalmic insert, 0.1 mg | 1 | 10 | 20 | $40 | $720 |
| G8918 | Patient without preoperative order for iv antibiotic surgical site infection (ssi) prophylaxis | 9 | 20 | 70 | $1 | $20 |
| 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… | 3 | 30 | 150 | $1 | $10 |
Other providers in the same ZIP code as Roanoke Valley Center For Sight LLC, ranked by combined Medicare and Medicaid revenue.
Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.