DR. SHAWN P FAGAN M.D.
NPI 1265448500
Surgery in Augusta, GA

Medicare Participation & PECOS Enrollment Status

Shawn Fagan is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Shawn Fagan is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

• Is the provider registered in PECOS? Yes

• PECOS PAC ID: 749284727

  What is the PECOS Associate Control ID?
  A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

• PECOS Enrollment ID: I20150305000669, I20150611001405, I20170519000215, I20210407000316

  What is the Provider Enrollment ID?
  The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

• Accepts Medicare Assignment? Yes

  What does it mean "accepts medicare assignment"?
  When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
  A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

• Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

• Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

• Eligible to Order or Refer a Home Health Agency (HHA): Yes

• Eligible to Order or Refer Power Mobility Devices: Yes

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Follow-up hospital inpatient care per day, typically 25 minutes

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

This service was performed 55 times for 27 patients

Hip replacement

A hip replacement is a surgical procedure where a worn-out or damaged hip joint is replaced with an artificial one. This procedure can greatly reduce pain and improve mobility. It's often recommended when other treatments like physical therapy or medications fail to alleviate symptoms.

This service was performed for 1-10 patients

Melanoma (skin cancer) excision

Melanoma excision is a procedure where a surgeon removes melanoma, a type of skin cancer, and some surrounding healthy tissue. Local anesthesia is applied to numb the area. The goal is to completely remove the cancer and prevent its spread. Healing time varies.

This service was performed for 1-10 patients

New patient office or other outpatient visit, 30-44 minutes

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

This service was performed 15 times for 15 patients

New patient office or other outpatient visit, 45-59 minutes

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

This service was performed 14 times for 14 patients

Partial thickness self skin graft of trunk, arms, or legs, each additional 100.0 sq cm or 1% body area for infants and children, or less

This is a procedure where a thin layer of skin is taken from a healthy area of your body and placed onto a wound on your trunk, arms, or legs. It is used to promote healing and reduce scarring. The measurement mentioned refers to the size of the graft.

This service was performed 129 times for 16 patients

Partial thickness self skin graft to face, scalp, eyelids, mouth, neck, ears, around eyes, genitals, hands, feet, fingers, or toes, 100.0 sq cm or 1% body area for infants and children, or less

A partial thickness self skin graft involves taking a thin layer of skin from a healthy part of your body and transplanting it to a damaged area. This procedure is used for areas such as the face, scalp, eyelids, mouth, neck, ears, hands, feet, fingers, or toes. It covers up to 100.0 sq cm or 1% body area for infants and children.

This service was performed 14 times for 13 patients

Partial thickness self skin graft to trunk, arms, or legs, 100.0 sq cm or 1% body area for infants and children, or less

A partial thickness self skin graft involves taking a thin layer of healthy skin from one area of your body and transplanting it to a damaged area on your trunk, arms, or legs. This procedure is used to treat a variety of skin conditions and injuries. It covers a maximum of 100.0 sq cm or 1% of body area for infants and children.

This service was performed 23 times for 22 patients

Preparation of skin graft site of face, scalp, eyelids, mouth, neck, ears, around eyes, genitals, hands, feet, fingers, or toes, 100.0 sq cm or 1% body area for infants and children, or less

This procedure involves preparing a specific area of your body, such as the face, scalp, neck, or extremities, for a skin graft. A skin graft is a surgical procedure where healthy skin is transferred to an area of the body that has lost skin. This preparation ensures the graft will take hold effectively.

This service was performed 52 times for 37 patients

Preparation of skin graft site of face, scalp, eyelids, mouth, neck, ears, around eyes, genitals, hands, feet, fingers, or toes, each additional 100.0 sq cm or 1% body area for infants and children, or less

This procedure involves preparing an area of your body for a skin graft. The graft could be on your face, scalp, eyelids, mouth, neck, ears, around eyes, hands, feet, fingers, or toes. The preparation ensures the graft will adhere properly for optimal healing.

This service was performed 41 times for 16 patients

Preparation of skin graft site of trunk, arms, or legs, 100.0 sq cm or 1% body area for infants and children, or less

This procedure involves preparing a specific area of the body (trunk, arms, or legs) for a skin graft. The area is cleaned and any dead tissue is removed to ensure a successful graft. The procedure covers an area of 100.0 sq cm or 1% of a child's body.

This service was performed 104 times for 64 patients

Preparation of skin graft site of trunk, arms, or legs, each additional 100.0 sq cm or 1% body area for infants and children, or less

This procedure involves preparing a specific area of your body (trunk, arms, or legs) for a skin graft. The area is cleaned and treated to receive new skin, usually to aid in healing from a burn or wound. The size of the area treated is up to 100.0 sq cm or 1% of a child's body area.

This service was performed 793 times for 49 patients

Removal of skin and tissue, 20.0 sq cm or less

This procedure involves the surgical removal of skin and tissue, up to 20.0 square cm in size. It's often performed to treat conditions like skin cancer or to remove moles, warts, and other skin lesions. The area is numbed and the unwanted tissue is carefully cut out.

This service was performed 30 times for 26 patients

Removal of skin and tissue, each additional 20.0 sq cm or less

This procedure involves the removal of skin and tissue, typically due to disease, injury, or abnormal growth. Each session removes an area of 20.0 square cm or less. It's performed by a trained professional and may require multiple sessions for larger areas.

This service was performed 181 times for 14 patients

Skin substitute graft to wound 100.0 sq cm or more of face, scalp, eyelids, mouth, neck, ears, around eyes, genitals, hands, feet, fingers, or toes, 100.0 sq cm or 1% body area for infants and children, or less

This procedure involves grafting a skin substitute onto a large wound, located on the face, scalp, eyelids, mouth, neck, ears, around eyes, hands, feet, fingers, or toes. The graft helps promote healing and reduces the risk of infection. It's suitable for wounds 100.0 sq cm or more, or 1% body area for infants and children.

This service was performed 15 times for 14 patients

Skin substitute graft to wound 100.0 sq cm or more of face, scalp, eyelids, mouth, neck, ears, around eyes, genitals, hands, feet, fingers, or toes, each additional 100.0 sq cm or 1% body area for infants and children, or less

This procedure involves applying a skin substitute graft to a large wound area on the face, scalp, eyelids, mouth, neck, ears, around eyes, hands, feet, fingers, or toes. The graft, made from synthetic or natural materials, aids in healing and restoring the skin's function. For infants and children, the coverage may be based on the body area percentage.

This service was performed 33 times for 13 patients

Skin substitute graft to wound 100.0 sq cm or more of trunk, arms, or legs, 100.0 sq cm or 1% body area for infants and children, or less

A skin substitute graft is a medical procedure where artificial skin is used to cover a large wound on the trunk, arms, or legs. This treatment helps promote healing and is especially useful for wounds 100.0 sq cm or more, or 1% of body area for infants and children.

This service was performed 41 times for 31 patients

Skin substitute graft to wound 100.0 sq cm or more of trunk, arms, or legs, each additional 100.0 sq cm or 1% body area for infants and children, or less

This procedure involves applying a skin substitute graft to a large wound on your trunk, arms, or legs. The graft, made from synthetic or natural materials, aids in healing by covering and protecting the wound. The size of the graft depends on the wound's area.

This service was performed 578 times for 31 patients

Therapy procedure using a special bandage and vacuum pump, surface area more than 50.0 sq cm

This procedure involves a special bandage and vacuum pump to promote healing in large wounds. The bandage is applied to the wound, then the vacuum pump removes air, creating a seal. This helps to draw out fluid and increase blood flow to the area, speeding up healing.

This service was performed 39 times for 25 patients

Physician Visit Costs

The typical physician office visit costs for Medicare beneficiaries in this area are: $20.8 for a new patient copayment and $16.72 for an established patient copayment.

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 30909 ZIP code area.

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Quality Reporting

The provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.

Find Provider Hospital Affiliations - Privileges

Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.

Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Shawn Fagan is affiliated with the following medical facilities:

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