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NPI 1053952937 · St Thomas, VI · Ambulatory Surgical Clinic/Center
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Paragon Surgical Center, LLC is a ambulatory surgical clinic/center provider located in St Thomas, U.S. Virgin Islands. This profile covers 8 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 | Paragon Surgical Center, LLC |
| Address | 9149 Estate Thomas Ste 303 |
| City | St Thomas |
| State | VI |
| ZIP | 00802 |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| NPI Enumerated | October 2, 2019 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $224.3K |
| Medicaid | $41K |
PARAGON SURGICAL CENTER, LLC bills predominantly for ophthalmologic surgeries and procedures alongside a smaller mix of endoscopy and pain-management injections; the largest single CPT contributor is 66984 (cataract extraction with intraocular lens) which generated $132.9K on 212 Medicare claims and also represents the entire Medicaid program revenue ($41K on 75 Medicaid claims). This code-level mix is consistent with an ambulatory surgical center that focuses operationally on eye surgery while offering ancillary services such as colonoscopy screening and spinal injections.
Revenue concentration on Medicare is high: the precomputed top 3 Medicare codes account for 79.4% of the provider's total Medicare revenue, driven mainly by 66984 (59.3% of Medicare revenue), with 65820 and 66174 making up the balance of that top-three share. For Medicaid the top-3 share is 100.0%, indicating Medicaid billing is effectively concentrated entirely in the small set of codes led by 66984.
Payer mix is Medicare-dominant in scale: lifetime Medicare revenue on file is $224.3K versus $41K in Medicaid revenue, so Medicare represents the bulk of public-payer billing for this facility. Medicaid is present but materially smaller and appears to be almost entirely represented by a single procedure (66984) in the state-level dataset.
Competitive standing on key ophthalmology code 66984 is modest-to-typical: for Medicare 66984 ranks #5193 of 15965 providers nationally (67th percentile) and for Medicaid it ranks #2 of 4 providers in-state (67th percentile), both labeled as typical, unremarkable volume versus peers. In contrast, some codes show very limited national presence—66174 ranks #690 of 741 providers nationally (4th percentile) and 65420 ranks #6 of 6 providers nationally (0th percentile)—indicating minimal participation on those specific procedures relative to national peers.
The provider reports non-eye services as well: colon polypectomy 45385 contributed $17.8K on Medicare (45 claims) and colorectal screening G0121 added $11.5K (32 claims), each described as typical, unremarkable volumes versus national peers. This suggests the ASC is capable of gastroenterology procedures in addition to its primary ophthalmic case mix, supporting a multi-specialty ambulatory model rather than a single-procedure stand-alone clinic.
Several lower-volume codes tied to pain-management injections (64483 and 64493) are present on the Medicare ledger but represent a small share of revenue ($6.6K and $5.2K respectively) and sit at or below the mid-percentile range among national peers (25th and 15th percentiles, respectively). These entries imply occasional use of interventional pain services but not a strategic revenue driver for the facility.
The provider’s Medicare top codes include both high-frequency lower-paid services and lower-frequency higher-paid services (for example, 66984 averages $627 paid/claim while 66174 averages $1304 paid/claim), reflecting a mixture of throughput-driven cataract work and less frequent glaucoma or canal procedures. Operationally this pattern aligns with an ASC that relies on volume of routine ophthalmic cases to generate the majority of revenue while offering higher-value specialty procedures on a smaller scale.
PARAGON’s NPI was enumerated on 2019-10-02 (~7 years ago), indicating several years of claims history but still relatively short tenure compared with long-established centers; this timeframe is consistent with an ASC that has ramped to a stable Medicare revenue profile dominated by cataract surgery. Continued monitoring of national rank movement for 66984 and the low-percentile codes (66174, 65420) will show whether the facility expands specialty volume or remains focused on high-throughput ophthalmic services.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
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… | 210 | $630 | $132.9K |
| 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. | 20 | $1,230 | $25.7K |
| 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. | 20 | $1,300 | $19.6K |
| 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… | 50 | $400 | $17.8K |
| G0121 | Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk | 30 | $360 | $11.5K |
| 64483 | This procedure is the injection of an anesthetic agent and/or steroid in the form of a transforaminal epidural injection into a single level (either lumbar or sacral). | 30 | $230 | $6.6K |
| 64493 | The provider injects a diagnostic or therapeutic substance into a single lumbar or sacral paravertebral facet (zygapophyseal) joint, or into the nerves that supply that joint, using imaging guidance… | 20 | $220 | $5.2K |
| 65420 | During this procedure, the provider excises or transposes the pterygium to improve patient comfort and vision but does not perform a graft. | 10 | $420 | $5K |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 8 CPT/HCPCS codes.
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.
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… | 80 | $550 | $41K |
| 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… | 10 | $0 | $0 |
How this provider's Medicaid billing volume and revenue compare to other U.S. Virgin Islands providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. U.S. Virgin Islands 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… | 2 | 10 | 70 | $430 | $30.3K |
| 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… | 2 | 10 | 80 | $0 | $0 |
Other providers in the same ZIP code as Paragon Surgical Center, LLC, ranked by combined Medicare and Medicaid revenue.
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