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NPI 1154323988 · Fredericksburg, VA · Ambulatory Surgical Clinic/Center
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Central Virginia Surgi-center LP is a ambulatory surgical clinic/center provider located in Fredericksburg, Virginia. This profile covers 29 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 | Central Virginia Surgi-center LP |
| Address | 1500 Dixon St |
| City | Fredericksburg |
| State | VA |
| ZIP | 22401 |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| NPI Enumerated | August 11, 2005 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $3.2M |
| Medicaid | $318.9K |
CENTRAL VIRGINIA SURGI-CENTER LP is principally an ambulatory surgical center focused on ophthalmology and endoscopy-driven procedures: its largest Medicare revenue contributor is 66984 (cataract extraction with lens insertion), which generates $1.8M and represents 58.1% of the provider's Medicare revenue, and the Medicaid top code is also 66984 accounting for $278.4K (87.3% of Medicaid revenue). Together these figures indicate a service-line emphasis on outpatient cataract surgery supplemented by gastrointestinal endoscopy services.
Revenue is highly concentrated across both payers. Precomputed metrics show the top 3 Medicare codes account for 69.9% of total Medicare revenue, and the top 3 Medicaid codes account for 100.0% of total Medicaid revenue, signaling dependence on a very small set of high-revenue procedures—principally cataract extraction and select endoscopic and ocular procedures.
Medicare dominates this facility's payer mix by scale: lifetime Medicare revenue is $3.2M versus $318.9K from Medicaid, indicating Medicare receipts are an order of magnitude larger and that the center operates effectively with Medicare as its primary revenue source. Medicaid activity is present but much smaller and concentrated almost entirely in the same cataract code.
The provider shows above-typical national volume on multiple Medicare codes, suggesting regional or specialty prominence for certain procedures. For example, 66984 ranks #860 of 15965 providers nationally (95th percentile) and 45385 ranks #355 of 16310 (98th percentile), both labeled notably above typical national volume, while 45378 is an extreme outlier (99th percentile) for colonoscopy brushings. These ranks indicate the center is a major local source for both cataract and colorectal endoscopy procedures compared to national peers.
Not all high-revenue codes show the same competitive strength: selected high-reimbursement but low-volume Medicare codes are typical or unremarkable. For instance, 64590 (neurostimulator pulse generator insertion) produces $169.9K but ranks at the 0th percentile among a small national cohort, and C9740 ranks in the 11th percentile; these positions imply occasional use of specialized implants but without broad volume leadership.
The Medicaid data mirror the Medicare service mix but at lower reimbursement levels: Medicaid billing for 66984 includes 907 claims at $307 avg paid/claim yielding $278.4K (87.3% of Medicaid revenue), and 43239 contributes the remaining Medicaid revenue. This suggests the center provides the same core outpatient cataract and upper endoscopy services across both payers but is paid substantially less per claim under Medicaid, concentrating Medicaid receipts on high-volume, lower-paid cataract work.
Tenure is long-standing: the NPI was enumerated on 2005-08-11 (~21 years ago), indicating the center has been operating for multiple Medicare/Medicaid reporting cycles, which supports the development of the concentrated case mix and the high procedural volumes observed in cataract and endoscopy codes.
From a payer contracting and network strategy perspective, the combination of high Medicare volume (notably above typical national volume for several codes) and concentrated revenue risk suggests the center is strategically important for network access to cataract and endoscopy capacity in the Fredericksburg market. Payers seeking to manage utilization or negotiate rates for those service lines should prioritize engagement on 66984 and the top endoscopy codes, given they drive the bulk of revenue for both Medicare and Medicaid at this facility.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
29 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… | 2,190 | $850 | $1.8M |
| 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… | 460 | $440 | $203.8K |
| 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. | 110 | $1,560 | $174.3K |
| 64590 | The provider inserts or replaces a peripheral, sacral, or gastric neurostimulator pulse generator or receiver. The system is one that requires surgical creation of a pocket for placement and that… | 10 | $15,450 | $169.9K |
| 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… | 390 | $340 | $135.5K |
| 43239 | The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis. | 450 | $240 | $105.8K |
| 29827 | The provider examines the tissue inside the shoulder joint with an arthroscope. She inserts additional instruments to repair a torn rotator cuff, the grouping of muscles and tendons that surround and… | 40 | $2,340 | $100.7K |
| C9740 | Cystourethroscopy, with insertion of transprostatic implant; 4 or more implants | 10 | $5,770 | $75K |
| 45378 | The provider examines the colon and rectum using a colonoscope, a flexible tube with a camera at its inserted end. If he sees any areas of abnormal mucosa or tissue, he takes samples using a brush… | 200 | $340 | $66.1K |
| 64721 | Neuroplasty or transposition of the median nerve at the carpal tunnel is done to treat a condition called carpal tunnel syndrome (CTS). The carpal tunnel is a narrow tunnel in the wrist through which… | 60 | $620 | $38.1K |
Showing 1–10 of 29
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 29 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
29 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| C9740 | 5 | 10 | 30 | $5,580 | $189.6K |
| 66984 | 64 | 380 | 250 | $130 | $139K |
| 64590 | 11 | 10 | 20 | $4,000 | $76.1K |
| 65820 | 5 | 40 | 30 | $1,110 | $63.1K |
| 29827 | 14 | 120 | 20 | $1,010 | $29.2K |
| 66982 | 67 | 120 | 30 | $610 | $28.7K |
| 45385 | 4 | 400 | 70 | $260 | $24.7K |
| 26123 | 14 | 20 | 20 | $830 | $16.5K |
| 25447 | 16 | 40 | 20 | $580 | $15.6K |
| 64721 | 15 | 90 | 30 | $420 | $15.4K |
Showing 1–10 of 29
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… | 910 | $310 | $278.4K |
| 43239 | The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis. | 260 | $150 | $40.3K |
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
2 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 43239 | The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis. | 78 | 150 | 300 | $420 | $381.2K |
| 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… | 15 | 50 | 200 | $350 | $282.9K |
Other providers in the same ZIP code as Central Virginia Surgi-center LP, ranked by combined Medicare and Medicaid revenue.
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