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Dr. Burt  Cagir  Md image

Dr. Burt Cagir Md

1 Guthrie Sq
Sayre PA 18840
570 885-5858
Medical School: Other - 1978
Accepts Medicare: Yes
Participates In eRX: Yes
Participates In PQRS: Yes
Participates In EHR: Yes
License #:
NPI: 1467426031
Taxonomy Codes:
208600000X

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Awards & Recognitions

About Us

Practice Philosophy

Conditions

Dr. Burt Cagir is associated with these group practices

Procedure Pricing

HCPCS Code Description Average Price Average Price
Allowed By Medicare
HCPCS Code:44160 Description:Removal of colon Average Price:$4,491.19 Average Price Allowed
By Medicare:
$1,284.23
HCPCS Code:99205 Description:Office/outpatient visit new Average Price:$391.00 Average Price Allowed
By Medicare:
$193.22
HCPCS Code:99204 Description:Office/outpatient visit new Average Price:$304.39 Average Price Allowed
By Medicare:
$155.23
HCPCS Code:99215 Description:Office/outpatient visit est Average Price:$270.00 Average Price Allowed
By Medicare:
$134.81
HCPCS Code:99203 Description:Office/outpatient visit new Average Price:$223.68 Average Price Allowed
By Medicare:
$100.97
HCPCS Code:99214 Description:Office/outpatient visit est Average Price:$188.25 Average Price Allowed
By Medicare:
$100.17
HCPCS Code:99212 Description:Office/outpatient visit est Average Price:$108.71 Average Price Allowed
By Medicare:
$40.52
HCPCS Code:99213 Description:Office/outpatient visit est Average Price:$124.00 Average Price Allowed
By Medicare:
$67.66
HCPCS Code:36415 Description:Routine venipuncture Average Price:$17.00 Average Price Allowed
By Medicare:
$3.00

HCPCS Code Definitions

99203
Office or other outpatient visit for the evaluation and management of a new patient, which requires these 3 key components: A detailed history; A detailed examination; Medical decision making of low complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of moderate severity. Typically, 30 minutes are spent face-to-face with the patient and/or family.
99204
Office or other outpatient visit for the evaluation and management of a new patient, which requires these 3 key components: A comprehensive history; A comprehensive examination; Medical decision making of moderate complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of moderate to high severity. Typically, 45 minutes are spent face-to-face with the patient and/or family.
99215
Office or other outpatient visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: A comprehensive history; A comprehensive examination; Medical decision making of high complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of moderate to high severity. Typically, 40 minutes are spent face-to-face with the patient and/or family.
44160
Colectomy, partial, with removal of terminal ileum with ileocolostomy
99212
Office or other outpatient visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: A problem focused history; A problem focused examination; Straightforward medical decision making. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are self limited or minor. Typically, 10 minutes are spent face-to-face with the patient and/or family.
99205
Office or other outpatient visit for the evaluation and management of a new patient, which requires these 3 key components: A comprehensive history; A comprehensive examination; Medical decision making of high complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of moderate to high severity. Typically, 60 minutes are spent face-to-face with the patient and/or family.
99214
Office or other outpatient visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: A detailed history; A detailed examination; Medical decision making of moderate complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of moderate to high severity. Typically, 25 minutes are spent face-to-face with the patient and/or family.
99213
Office or other outpatient visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: An expanded problem focused history; An expanded problem focused examination; Medical decision making of low complexity. Counseling and coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of low to moderate severity. Typically, 15 minutes are spent face-to-face with the patient and/or family.

Medical Malpractice Cases

None Found

Medical Board Sanctions

None Found

Referrals

NPI
Doctor Name
Specialty
Count
1447225008
Diagnostic Radiology
814
1578536876
Diagnostic Radiology
548
1518949080
Hematology/Oncology
536
1598731549
Family Practice
532
1871568923
Cardiovascular Disease (Cardiology)
518
1912972597
Internal Medicine
495
1366478364
Radiation Oncology
436
1205829181
Interventional Radiology
435
1295798502
Diagnostic Radiology
402
1467414920
Urology
350
*These referrals represent the top 10 that Dr. Cagir has made to other doctors

Publications

Ventral hernia repair: outcomes change with long-term follow-up. - JSLS : Journal of the Society of Laparoendoscopic Surgeons / Society of Laparoendoscopic Surgeons
Ventral hernia repairs continue to have high recurrence rates. The surgical literature is lacking data assessing the time trend to hernia recurrence after ventral hernia repairs and whether over time the recurrence rates change with laparoscopic technique compared to open repairs. Our aim was to carry out a long-term comparative analysis of ventral hernia repairs performed at our hospital over the last 10-y period to assess if outcomes change during the follow-up period.We conducted a retrospective observational study analyzing electronic medical records of all consecutive patients who had a ventral hernia repair from January 2001 to February 2010 at our hospital.During the study period, 436 ventral hernia repairs were performed: laparoscopic repairs (n=156; 36%), laparoscopic converted to open (n=8; 2%), and open repairs (n=272; 62%). We analyzed the time distribution to hernia recurrence after surgery and found that 85% of recurrences after laparoscopic repairs and 77% of recurrences after open repairs occurred within 2 y of surgery. We did a Kaplan-Meier analysis for the subgroup of patients for whom we had a minimum 4-y follow-up and found that there continued to be a low subsequent yearly recurrence rate for open repairs after the initial 2-y follow-up.Most hernia recurrences occur within 2 y after surgery for ventral hernias. There appears to be a continued although low subsequent yearly rate of recurrence for open repairs.
Comparison of conventional and nonconventional strictureplasties in Crohn's disease: a systematic review and meta-analysis. - Diseases of the colon and rectum
The Heineke-Mikulicz and Finney techniques are conventional strictureplasties that have been used to manage short (<10 cm) and medium-length (>10 cm and <20 cm) strictures from Crohn's disease. Nonconventional strictureplasty techniques have emerged to facilitate bowel conservation for atypical strictures. These techniques include the modified Finney, combined Heineke-Mikulicz and Finney, modified Heineke-Mikuliczs, Michelassi, and modifications of it and others.The aim of this study is to compare conventional vs nonconventional strictureplasties with respect to short-term complications and long-term results.A MEDLINE search was performed using "Crohn's disease", "surgical therapy", "strictureplasty", "complications", "reoperation", and "recurrence" as medical subject headings. Studies conducted between 1975 and June 31, 2010 were found via PubMed, Ovid, Embase, and Cochrane databases and categorized into 3 groups. These groups consist of centers performing conventional strictureplasties, nonconventional strictureplasties, or both. Studies with at least 3 patients were reviewed.A mixed-effects meta-analysis for each outcome was performed by use of Supermix software by SSI Scientific Software International.We focused on immediate and long-term complication rates among the groups. The 6 immediate complications include small-bowel obstructions, sepsis, other infections, reoperations, early postoperative GI bleeds, and other early complications. The 5 long-term complications include recurrent strictures, small-bowel obstructions, reoperations, carcinoma, and deaths.We reviewed 32 studies with 1616 patients who underwent 4538 strictureplasties. One thousand one hundred fifty-seven patients underwent conventional strictureplasties with an early complication rate of 15%; 459 patients underwent nonconventional strictureplasties with an early complication rate of 8%. A late complication rate of 29% for the conventional strictureplasty group and 17% for the nonconventional strictureplasty group was noted.We are limited by the data published with the inherent risk of finding and analyzing mostly articles with positive results.The nonconventional strictureplasty techniques were noninferior to the conventional strictureplasty procedures with respect to all prespecified outcomes.
Full-thickness skin graft anoplasty: novel procedure. - Diseases of the colon and rectum
We describe a novel technique to treat anal stenosis by reconstructing the anal canal by the use of a full-thickness skin graft from the abdominal wall. This treatment was successfully applied in our institution and showed positive results.
Biliary dyskinesia: how effective is cholecystectomy? - Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract
Studies on biliary dyskinesia have been based on short-term surgical follow-up and do not take into consideration that most patients are discharged from surgical follow-up after the first postoperative visit and that for persistent or recurrent symptoms they are frequently seen by primary care providers and subsequently referred to gastroenterologists. We aimed to study this pattern and assess which factors predict patients that will benefit from cholecystectomy.This is a retrospective analysis of medical records of patients who underwent cholecystectomy for biliary dyskinesia from February 2001 to January 2010 with a minimum postoperative follow-up of 6 months.At initial surgical follow-up, 19 of 141 (13.4%) patients said they had persistent symptoms. However, when subsequent visits were analyzed, 61 of 141 (43.3%) patients with persistent or recurrent symptoms saw their primary care provider. These symptoms were epigastric or right upper quadrant pain in 43 patients or 30% of those undergoing cholecystectomy. The only factor that distinguished patients with and without resolution of symptoms after cholecystectomy was the pathologic finding of inflammation (p = 0.02).Cholecystectomy does not appear to be as effective for biliary dyskinesia when long-term follow-up is evaluated.
A comprehensive review of strictureplasty techniques in Crohn's disease: types, indications, comparisons, and safety. - Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract
Crohn's disease is one of the chronic inflammatory diseases of the gastrointestinal tract that is often complicated by stricture formation with resulting obstructive symptoms. The technical repertoire of strictureplasty procedures has increased over the years in an effort to manage the diverse presentations of this condition while limiting the need for bowel resection. In this comprehensive review, we describe, compare, categorize, and appraise the strengths and weaknesses of 15 unique strictureplasty techniques.To identify all unique strictureplasty procedures, a Medline search utilizing "Crohn's disease," "surgical therapy," "strictureplasty," "enteroenterostomy," "Heineke-Mikulicz," and "side-to-side isoperistaltic" strictureplasty as medical subject headings was completed. PubMed, Ovid, Embase, and Cochrane database searches were conducted. Relevant articles between 1980 to December 2010 were reviewed. We initially selected 58 articles, but only 18 introduced novel surgical procedures related to 15 types of strictureplasty in Crohn's disease.We identified 15 types of strictureplasty techniques. These were categorized into three main groups. The revised nomenclature will facilitate the reader to understand the differences and utility of each technique. These groups include the Heineke-Mikulicz-like strictureplasties, the intermediate procedures, and the enteroenterostomies. Heineke-Mikulicz strictureplasty was the most frequently used technique.Various techniques of strictureplasty have been reported in the published literature. Strictureplasty has been shown to be a safe and efficacious technique that is comparable to bowel resection for stricturing Crohn's disease. This technique spares bowel length and puts the Crohn's disease patient at a lower risk of developing short bowel syndrome with repeated resections.
Characteristics of perforated appendicitis: effect of delay is confounded by age and gender. - Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract
The effect of age and gender on time to perforation in acute appendicitis has not been well characterized. This study examined the relationship between duration of disease and appendiceal perforation in different subgroups of age and gender.This study is a retrospective analysis of 380 patients who underwent an appendectomy from January 2000 to June 2005 at a rural teaching hospital.Factors associated with perforated appendicitis included age, symptom duration, CT scan, and distance from the hospital. Factors associated with increased patient time included age, temperature >101.5 F, and referral from an outside institution. Factors associated with shorter system time included right lower quadrant tenderness, classic or severe presentation, and leading diagnosis of acute appendicitis. Preoperative CT scan increased system time by approximately 3 h. Analyzing symptom duration and time to perforation, males have a higher prevalence of perforated appendicitis compared to females with similar duration of symptoms. In patients older than 55 years of age, 29% had perforated appendicitis at 36 h of symptoms and 67% at 36 to 48 h of symptoms. In a multivariate regression analysis, age greater than 55 years (odds ratio (OR) 3.0, P value 0.007), fever (OR 4.3, P 0.007), and symptom duration more than 24 h (OR 4.1, P 0.001) were significant predictors of perforated appendicitis.There is an early risk of perforated appendicitis even within the first 36 h of symptoms. This risk appears to be higher in males and patients older than 55 years, a quarter of whom are perforated within the first 36 h of symptom duration. Additionally, perforation in acute appendicitis may be more of a continuous phenomena worsening exponentially with duration of symptoms rather than a threshold phenomenon.
Malignant transformation in perianal fistulas of Crohn's disease: a systematic review of literature. - Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract
Malignant transformation of perineal fistula in Crohn's disease has rarely been reported. The aim of this study is to define the patient's characteristics and clinical presentation of this rare disease.A systematic review of case series and reports published in English language between 1950 and 2008 was conducted. All cases with malignancy in low pelvic/perineal fistula in patients with Crohn's disease were included. All selected cases were then analyzed with respect to age, gender, duration of Crohn's disease and fistula, location of fistula, presenting symptoms, method of diagnosis, delay in diagnosis, histopathology, treatment, and outcome. Data analyses were done using chi-squared or Fisher's exact test and the Mann-Whitney test.Literature review revealed 61 cases of carcinomas arising in perineal fistulas in Crohn's disease. Sixty-one percent (37) of the patients were females. Females were significantly younger than males at the time of diagnosis of cancer (47 vs. 53 years, P < 0.032). Males were also noted to have significantly longer duration of Crohn's disease compared to females (24 vs. 18 years, P = 0.005). However, females were noted to have the fistula for significantly shorter duration prior to cancer transformation when compared to males (8.3 vs. 16 years, P = 0.0035). On initial examination, malignancy was suspected and proven only in 20% of patients (n = 12). Adenocarcinoma was the most common histology (59%, n = 36), followed by squamous cell carcinoma (31%, n = 19). In most patients (59%, n = 36), the fistula was rectal in origin.A high suspicion for malignancy in chronic perineal fistulas associated with Crohn's disease should be maintained in spite of negative biopsies. Especially in women, the shorter duration of Crohn's fistulas prior to malignant degeneration necessitates an aggressive approach to rule out cancer.
CT scans and acute appendicitis: a five-year analysis from a rural teaching hospital. - Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract
Studies examining the relationship between computed tomography (CT) scans and appendiceal perforation have largely been conducted in urban centers. The present study sought to evaluate this relationship in a rural hospital.This is a retrospective analysis of 445 patients who underwent appendectomies from January 2000 to June 2005 at a rural teaching hospital.Four hundred forty-five patients were analyzed in two groups; those who underwent CT scans (N = 245) and those who did not (N = 200). Patients undergoing CT scans were significantly older (median age 38 vs. 22 years, P < 0.0001), were more likely to have perforated appendicitis (P 0.001), were less likely to undergo a negative appendectomy (P = 0.003), and had a significantly longer length of stay than those who did not (P 0.009). Analysis by gender showed that perforation rates continued to be significantly higher in males undergoing CT scans (P 0.004). To examine the possibility that sicker patients were more likely to receive CT scans and also be found to have perforated appendicitis, a sensitivity analysis was performed. Patients showing perforated appendicitis on initial CT scans were excluded and the analysis was repeated. The difference in perforation rates continued to remain significant (P 0.037).Males undergoing CT scans are significantly more likely to have perforated appendicitis. A protocol-driven rational approach to CT evaluation of suspected appendicitis may lower perforation rates, especially in males.
The safety and efficacy of the artificial bowel sphincter for fecal incontinence: results from a multicenter cohort study. - Diseases of the colon and rectum
The aim of this trial was to evaluate the safety, efficacy, and impact on quality of life of the Acticon trade mark artificial bowel sphincter for fecal incontinence.A multicenter, prospective, nonrandomized clinical trial was conducted under a common protocol. Patients were evaluated with anal physiology, endoanal ultrasonography, a fecal incontinence scoring system, fecal incontinence quality of life assessment, and overall health evaluation. Patients with a fecal incontinence score of 88 or greater (scale, 1-120) were considered candidates for the study. Implanted patients underwent identical reevaluation at 6 and 12 months postimplant.One hundred twelve of 115 patients (86 females) enrolled were implanted. Mean age was 49 (range, 18-81) years. A total of 384 device-related or potentially device-related adverse events were reported in 99 enrolled patients. Of these events, 246 required no intervention or only noninvasive intervention. Seventy-three revisional operations were required in 51 (46 percent) of the 112 implanted patients. Infection rate necessitating surgical revision was 25 percent. Forty-one patients (37 percent) have had their devices completely explanted, of which 7 have had successful reimplantations. In patients with a functioning neosphincter, improvement in quality of life and anal continence was documented. Mean matched fecal incontinence scores in 63 patients at 6 months follow-up was improved from 105 preimplant to 51 postimplant. In 55 patients at 12 months follow-up, mean matched fecal incontinence scores were 105 preimplant 48 postimplant. A successful outcome was achieved in 85 percent of patients with a functioning device. Intention to treat success rate was 53 percent.Although morbidity and the need for revisional surgery are high, the artificial bowel sphincter can improve anal incontinence and quality of life in patients with severe fecal incontinence.
Risk of second cancers in patients with colorectal carcinoids. - Diseases of the colon and rectum
It is often stated that patients with colorectal carcinoid tumors have an increased risk of developing other malignancies. However, this risk has not been conclusively documented. A comprehensive evaluation is needed to more thoroughly assess the risk of second cancers in patients with colorectal carcinoids.A search of the National Cancer Institute Surveillance, Epidemiology, and End Result database from 1973 to 1996 revealed 2,086 patients with colorectal carcinoids. This subset of patients was examined for occurrence of second cancers. The observed incidence of cancer for each site was compared with the expected incidence based on the gender-adjusted and age-adjusted cancer rates in the remaining Surveillance, Epidemiology, and End Result file. A Poisson distribution probability was used to determine the significance of these comparisons.Patients with colorectal carcinoids had an increased rate of cancer in the colon and rectum (P < 0.001), small bowel (P < 0.001), esophagus/stomach (P = 0.02), lung/bronchus (P < 0.001), urinary tract (P = 0.005), and prostate (P < 0.001), when compared with a control population. Most of the gastrointestinal tract cancers were synchronous cancers, whereas lesions outside the gastrointestinal tract were most commonly metachronous tumors.A significantly increased risk of synchronous colorectal, small-bowel, gastric, and esophageal cancers and metachronous lung, prostate, and urinary tract neoplasms is clearly demonstrated. After the diagnosis of colorectal carcinoid tumors, patients should undergo appropriate screening and surveillance for cancer at these sites.

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1 Guthrie Sq Sayre, PA 18840
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