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NPI 1033246459 · Topeka, KS · Ambulatory Surgical Clinic/Center
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Cotton-oneil Clinic Endoscopy Center Rvoc Tr is a ambulatory surgical clinic/center provider located in Topeka, Kansas. This profile covers 13 Medicare and 7 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 | Cotton-oneil Clinic Endoscopy Center Rvoc Tr |
| Address | 720 Sw Lane St |
| City | Topeka |
| State | KS |
| ZIP | 66606 |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| NPI Enumerated | February 27, 2007 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $1.4M |
| Medicaid | $118K |
Business profile and service mix: Listed as an Ambulatory Surgical Clinic/Center, this provider’s top-billed codes are dominated by GI endoscopy procedures, including colonoscopy with polypectomy (45385), diagnostic colonoscopy with biopsy (45380), and upper endoscopy with biopsy (43239). The presence of therapeutic codes such as 43249 (esophageal dilation) and 43450 (esophageal dilation with bougie) alongside screening codes G0105 and G0121 indicates a mix of diagnostic, screening, and therapeutic outpatient endoscopy services concentrated at this site.
Medicare revenue concentration: The practice reports $1.4M in lifetime Medicare revenue, with the top 3 Medicare codes accounting for 58.0% of that total. Those top three — 45385 ($496.5K, 36.3%), 45380 ($155.8K, 11.4%), and 43239 ($140.9K, 10.3%) — drive the majority of Medicare billings, underscoring a revenue profile tightly focused on colonoscopy and upper endoscopy procedures.
Medicaid revenue concentration: The provider’s Medicaid billing is much more concentrated, with $118K in lifetime Medicaid revenue and the top 3 Medicaid codes making up 91.5% of that sum. The Medicaid mix is led by 43239 ($70.4K, 59.7%), followed by 45385 ($27K, 22.9%) and 43235 ($10.5K, 8.9%), indicating a small set of high-impact CPTs account for nearly all Medicaid revenue.
Payer mix and scale: Medicare is the dominant payer in absolute terms, with $1.4M in Medicare revenue versus $118K in Medicaid revenue, signaling that this site operates primarily within the Medicare market rather than as a Medicaid-focused facility. Analysts should treat Medicaid as a secondary revenue stream with highly concentrated code-level exposure when modeling payer-dependent volume or pricing risk.
National competitive standing for Medicare volumes: For Medicare, this provider is an outlier on several high-value codes and appears highly active relative to national peers. Notably, 45385 ranks #31 of 16310 providers (100th percentile; extreme outlier), 45380 ranks #141 of 16427 (99th percentile; extreme outlier), and 43239 ranks #127 of 17140 (99th percentile; extreme outlier), which together suggest the site is a major national-volume performer for core endoscopy services.
State-level competitive standing for Medicaid: Medicaid ranks show the provider is among the top in-state billers for key endoscopy procedures, but the peer pools are small. For example, 45385 is #1 of 2 in-state (100th percentile; typical, unremarkable volume), 43239 is #3 of 34 in-state (94th percentile; typical, unremarkable volume), and 43235 is #1 of 6 in-state (100th percentile; notably above typical state volume), indicating leadership on select CPTs in Kansas Medicaid despite limited statewide competition for some codes.
Heterogeneous statistical profile across codes: While many high-revenue Medicare codes are labeled as "extreme outlier" versus national peers, a few CPTs show typical or unremarkable percentile rankings (for example, 45390 at the 68th percentile and 45388 at the 24th percentile). This mixed pattern suggests concentrated, high-volume expertise in specific endoscopic procedures alongside a broader catalog of more typical outpatient GI services.
Tenure and operational implication: The NPI was enumerated on 2007-02-27 (~19 years ago), indicating long tenure as an outpatient endoscopy operation. Combined with the concentrated revenue mix and high national percentiles on core CPTs, this tenure supports a profile of an established, procedure-centered ambulatory endoscopy center focused on colonoscopy and upper endoscopy throughput.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
13 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 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… | 1,240 | $400 | $496.5K |
| 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… | 610 | $260 | $155.8K |
| 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. | 690 | $200 | $140.9K |
| 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. | 250 | $500 | $126.8K |
| G0105 | Colorectal cancer screening; colonoscopy on individual at high risk | 320 | $380 | $121.8K |
| 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. | 340 | $210 | $69.6K |
| 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… | 120 | $540 | $64.7K |
| G0121 | Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk | 150 | $380 | $55.6K |
| 43450 | The provider passes long thin tubular devices of increasing diameter to dilate, or widen, a stricture in the patient’s esophagus to improve swallowing. | 170 | $280 | $46.5K |
| 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… | 130 | $290 | $37.2K |
Showing 1–10 of 13
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 13 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
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.
7 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | 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. | 670 | $110 | $70.3K |
| 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… | 290 | $90 | $27K |
| 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. | 110 | $90 | $10.5K |
| 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… | 90 | $90 | $7.9K |
| 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… | 10 | $160 | $2.1K |
| 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… | 770 | $0 | $0 |
| G8918 | Patient without preoperative order for iv antibiotic surgical site infection (ssi) prophylaxis | 770 | $0 | $0 |
How this provider's Medicaid billing volume and revenue compare to other Kansas providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Kansas median
7 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 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… | 3 | 10 | 90 | $190 | $98.5K |
| 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. | 3 | 30 | 60 | $160 | $52.1K |
| 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… | 1 | 10 | 150 | $90 | $14.1K |
| 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. | 1 | 10 | 20 | $80 | $2.9K |
| 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… | 1 | 10 | 10 | $160 | $2.1K |
| 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… | 2 | 20 | 60 | $0 | $0 |
| G8918 | Patient without preoperative order for iv antibiotic surgical site infection (ssi) prophylaxis | 2 | 10 | 40 | $0 | $0 |
Other providers in the same ZIP code as Cotton-oneil Clinic Endoscopy Center Rvoc Tr, ranked by combined Medicare and Medicaid revenue.
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