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NPI 1033195912 · Aberdeen, SD · Ambulatory Surgical Clinic/Center
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Surgical Associates Endoscopy Clinic LLC is a ambulatory surgical clinic/center provider located in Aberdeen, South Dakota. This profile covers 9 Medicare and 0 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 | Surgical Associates Endoscopy Clinic LLC |
| Address | 310 S Pennsylvania St |
| City | Aberdeen |
| State | SD |
| ZIP | 57401 |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| NPI Enumerated | December 21, 2005 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $309.3K |
| Medicaid | $0 |
Service-line profile: The provider's top revenue codes are colonoscopy and upper endoscopy procedures (45378, 43239, 45384) with revenue of $72.2K, $65.4K, and $62.1K respectively, consistent with an ambulatory endoscopy clinic/center that performs diagnostic and therapeutic GI procedures including biopsies and polypectomies. The presence of dilation (43249) and both hot snare/forceps polypectomy codes (45384, 45385) further supports a procedure mix that includes both diagnostic endoscopy and therapeutic lesion removal rather than primary office-based care.
Revenue concentration: This provider's Medicare revenue is highly concentrated in a small set of procedural codes — the top 3 Medicare codes (45378, 43239, 45384) account for 64.5% of total Medicare revenue. That concentration indicates the business is driven predominantly by a few high-volume endoscopy services rather than a broadly diversified set of Medicare billings.
Payer mix and scale: Lifetime Medicare revenue on file is $309.3K while there is no Medicaid billing on file, so this entity operates effectively as a Medicare-focused (single-payer) outpatient endoscopy provider in the claims data. The absence of Medicaid activity means any market risk or growth tied to Medicaid patients is not visible in this dataset.
Competitive standing — colonoscopy volume: The provider is an extreme national outlier on 45378 (colonoscopic exam with washings), ranking #18 of 8675 providers nationally (100th percentile; extreme outlier), which signals unusually high colonoscopy volume for that specific billed code compared with peers. For other high-revenue codes, the provider also ranks well above typical national volumes: 43239 is #758 of 17140 (96th percentile; notably above typical) and 45384 is #49 of 929 (95th percentile; notably above typical), indicating strong competitive standing across both upper and lower endoscopy procedures.
Screening services visibility: Screening colonoscopy codes are a meaningful part of revenue — G0121 accounts for $34.5K (11.1% of Medicare revenue, 91 claims) and G0105 accounts for $18.2K (5.9% of Medicare revenue, 48 claims). This mix shows the clinic performs a substantial volume of both average-risk and high-risk screening colonoscopies in addition to diagnostic/therapeutic procedures.
Procedure-level throughput: High claim counts for core procedures show operational throughput behind the revenue figures (e.g., 43239 had 300 claims and 45378 had 249 claims), indicating steady procedural volume even though total Medicare revenue is $309.3K. The combination of many moderate-pay claims (e.g., $218 avg for 43239) and higher-pay therapeutic claims (e.g., $381 avg for 45384) is consistent with a procedure-driven ambulatory surgical workflow.
Therapeutic emphasis within colonoscopy mix: Polypectomy and lesion removal represent a material component of the clinic’s work — 45384 alone is 20.1% of Medicare revenue and 45385 contributes additional revenue — suggesting the site is not limited to diagnostic scopes but performs endoscopic interventions regularly. That therapeutic mix can affect staffing, equipment needs, and reimbursement profile relative to a purely diagnostic endoscopy practice.
Tenure and operational history: The provider’s NPI was enumerated on 2005-12-21 (~21 years ago), indicating a long-established presence in the market. Combined with concentrated Medicare billing and the outlier national rankings on key colonoscopy codes, the data portray an experienced, Medicare-focused ambulatory endoscopy operation rather than a newly established or Medicaid-oriented clinic.
Medicare revenue breakdown by CPT/HCPCS procedure code.
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The CPT/HCPCS codes generating the most Medicare revenue for this provider.
9 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 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… | 250 | $290 | $72.2K |
| 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. | 300 | $220 | $65.4K |
| 45384 | The provider examines the rectum and colon using a flexible colonoscope, a tubular instrument with a light source and camera. He removes one or more tumors, polyps, or other lesions using hot biopsy… | 160 | $380 | $62.1K |
| G0121 | Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk | 90 | $380 | $34.5K |
| 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… | 70 | $380 | $27.4K |
| G0105 | Colorectal cancer screening; colonoscopy on individual at high risk | 50 | $380 | $18.2K |
| 43249 | The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum and dilates (widens) the esophagus with a balloon less than 30 mm in diameter. | 20 | $530 | $11.6K |
| 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… | 30 | $370 | $9.6K |
| 43235 | The provider inserts an endoscope through the mouth and down into the esophagus, stomach, and duodenum for diagnostic purposes; the provider may collect specimens by brushing or washing. | 40 | $220 | $8.5K |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 9 CPT/HCPCS codes.
View: State1 / 2
Other providers in the same ZIP code as Surgical Associates Endoscopy Clinic LLC, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Adjustment Training Center, Inc. | SD | Developmentally Disabled Services Day Training Agency | $0 | $40.3M |
| Northeastern Mental Health Center | SD | Mental Health Counselor | $0 | $10.1M |
| Vision Care Associates, LLP | SD | Optometrist | $0 | $6M |
| Sanford Health Network | SD | General Acute Care Hospital | $0 | $4.4M |
| John Bormes | SD | Ophthalmology Physician | $2.6M | $0 |
| Sanford Health Network | SD | General Acute Care Hospital | $0 | $1.9M |
| Avera At Home | SD | Home Health Agency | $0 | $1.6M |
| Ty Hanson | SD | Dermatology Physician | $1.2M | $0 |
| Fettig And Drake Dds PC | SD | General Practice Dentistry | $0 | $1M |
| Isurgery, LLC | SD | Ambulatory Surgical Clinic/Center | $998.3K | $0 |
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