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NPI 1659335438 · Reston, VA · Ambulatory Surgical Clinic/Center
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Reston Surgery Center, LP is a ambulatory surgical clinic/center provider located in Reston, Virginia. This profile covers 28 Medicare and 6 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 | Reston Surgery Center, LP |
| Address | 1860 Town Center Dr |
| City | Reston |
| State | VA |
| ZIP | 20190 |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| NPI Enumerated | April 17, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $2.8M |
| Medicaid | $869.2K |
RESTON SURGERY CENTER, LP appears to operate as an outpatient ambulatory surgical clinic concentrated on ophthalmology and gastrointestinal endoscopy: its top Medicare revenue drivers are 66984 (cataract extraction with lens insertion), 45385 (colonoscopic polypectomy), and 45380 (colonoscopy with biopsy), and Medicaid revenue is overwhelmingly driven by 66984. The code mix — large shares for cataract and endoscopy procedures — is consistent with an ASC model that performs high-volume, same-day surgical eye care and endoscopic diagnostic/therapeutic procedures.
Revenue is highly concentrated in a small number of procedures for both payers: the top 3 Medicare codes account for 68.3% of the provider's total Medicare revenue, while the top 3 Medicaid codes account for 100.0% of the provider's total Medicaid revenue. This concentration indicates financial sensitivity to volume changes in a few key procedures, especially cataract surgery and colonoscopy services.
By scale, Medicare is the dominant payer: reported lifetime Medicare revenue is $2.8M compared with $869.2K in lifetime Medicaid revenue, so Medicare represents the primary revenue stream for this facility. Medicaid activity is meaningful but much smaller and is heavily concentrated in a single service line (66984), making the provider effectively Medicare-led in overall business scale.
The facility is a high-volume endoscopy provider relative to national Medicare peers: 45385 ranks #296 of 16310 providers nationally (98th percentile; extreme outlier) and 45380 ranks #165 of 16427 providers nationally (99th percentile; extreme outlier). Those rankings signal that RESTON SURGERY CENTER is an unusually active center for colonoscopy and polypectomy procedures compared with most U.S. providers, suggesting a regional or specialty referral role for GI care.
Cataract surgery drives the majority of Medicaid revenue and is also the single largest Medicare line item: 66984 accounts for $1.4M and 52.4% of this provider's Medicare revenue and 66984 accounts for $856.3K and 98.4% of the provider's Medicaid revenue. Nationally, 66984 ranks #1279 of 15965 providers (92nd percentile; typical, unremarkable volume), while in-state Medicaid ranking (#6 of 50; 90th percentile) positions the center among the higher-volume Medicaid cataract providers in Virginia without being an extreme national outlier.
Screening and diagnostic endoscopy is a notable part of the mix: G0121 (colorectal cancer screening colonoscopy on average-risk individuals) ranks #65 of 7750 providers nationally (99th percentile; extreme outlier) and other EGD/biopsy codes such as 43239 show elevated volume (43239 ranks #539 of 17140 providers nationally; 97th percentile; notably above typical national volume). The combination of screening and therapeutic endoscopy codes indicates both preventive screening throughput and follow-on therapeutic procedures are major operational activities.
The provider shows longevity in the market: its NPI was enumerated on 2006-04-17 (~20 years ago), which supports an interpretation of established operations and likely sustained referral relationships in the local market. That tenure, combined with concentrated volume in cataract and endoscopy services, suggests an experienced ASC managing consistent outpatient surgical caseloads.
Procedure mix includes additional specialty activity beyond eye and GI care — for example, 43239 (EGD biopsy) and 66982 (complex cataract/IOL insertion) appear on Medicare top codes and smaller-volume orthopedic and ENT procedures are present — indicating some service diversification. While these other codes are smaller contributors to revenue, their presence points to multi-specialty utilization of the ASC rather than a single-procedure shop.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
28 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… | 1,700 | $850 | $1.4M |
| 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… | 510 | $460 | $236.6K |
| 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… | 580 | $350 | $200K |
| 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. | 100 | $1,560 | $160.7K |
| 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. | 360 | $290 | $104.3K |
| 27447 | In this procedure, the provider replaces the damaged weight bearing surfaces of both the medial and lateral compartments in the knee joint using implants of metal or other strong materials. The… | 10 | $7,460 | $96.9K |
| G0121 | Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk | 190 | $430 | $80.2K |
| 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… | 70 | $660 | $47.4K |
| 50590 | Extracorporeal shock wave lithotripsy (ESWL) is a procedure used to destroy calculus (kidney stones) in the kidneys and ureters. | 40 | $1,140 | $45.4K |
| 43251 | An esophagogastroduodenoscopy is a procedure to view the esophagus, stomach, and duodenum by means of flexible endoscope through the mouth. The physician removes one or more lesions using a snare… | 70 | $600 | $39.7K |
Showing 1–10 of 28
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 28 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
28 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| 66984 | 85 | 380 | 250 | $130 | $139K |
| 27447 | 290 | 310 | 40 | $1,150 | $64.4K |
| 65820 | 7 | 40 | 30 | $1,110 | $63.1K |
| 15823 | 21 | 30 | 50 | $530 | $34.5K |
| 67042 | 15 | 20 | 20 | $1,130 | $33.8K |
| 29827 | 71 | 120 | 20 | $1,010 | $29.2K |
| 66982 | 36 | 120 | 30 | $610 | $28.7K |
| 45385 | 3 | 400 | 70 | $260 | $24.7K |
| 67036 | 17 | 20 | 20 | $940 | $19.8K |
| 31239 | 1 | 10 | 20 | $1,060 | $17K |
Showing 1–10 of 28
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.
6 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… | 2,360 | $360 | $856.3K |
| 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. | 30 | $360 | $9.6K |
| 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… | 10 | $310 | $3.7K |
| V2632 | Posterior chamber intraocular lens | 40 | $10 | $300 |
| 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… | 230 | $0 | $0 |
| G8918 | Patient without preoperative order for iv antibiotic surgical site infection (ssi) prophylaxis | 130 | $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
6 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. | 121 | 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… | 6 | 50 | 200 | $350 | $282.9K |
| 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… | 87 | 90 | 150 | $520 | $281.8K |
| V2632 | Posterior chamber intraocular lens | 14 | 20 | 110 | $1 | $170 |
| G8918 | Patient without preoperative order for iv antibiotic surgical site infection (ssi) prophylaxis | 4 | 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… | 10 | 30 | 150 | $1 | $10 |
Other providers in the same ZIP code as Reston Surgery Center, LP, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Reston Hospital Center LLC | VA | General Acute Care Hospital | $0 | $14.9M |
| Phong Nguyen | VA | Rheumatology Physician | $4.2M | $0 |
| Claude Abujrab-saba | VA | Rheumatology Physician | $2.9M | $0 |
| Alexia Gospodinoff | VA | Rheumatology Physician | $812.5K | $0 |
| Dhruv Pateder | VA | Orthopaedic Surgery of the Spine Physician | $607.7K | $0 |
| Ahmad Noori | VA | Nephrology Physician | $341.1K | $190.1K |
| Mark Tekrony | VA | Neurology Physician | $349.6K | $0 |
| Theodore Sebastien | VA | MOHS-Micrographic Surgery Physician | $335.3K | $0 |
| Andrew Siegel | VA | Ophthalmology Physician | $333.2K | $0 |
| James Reeves | VA | Orthopaedic Surgery Physician | $307.6K | $0 |
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