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NPI 1043283906 · Waterbury, CT · Ambulatory Surgical Clinic/Center
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Naugatuck Valley Endoscopy Center, LLC is a ambulatory surgical clinic/center provider located in Waterbury, Connecticut. This profile covers 16 Medicare and 8 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 | Naugatuck Valley Endoscopy Center, LLC |
| Address | 1312 West Main St |
| City | Waterbury |
| State | CT |
| ZIP | 06708 |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| NPI Enumerated | February 10, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $710.6K |
| Medicaid | $509.3K |
This center bills materially to both Medicare and Medicaid, with lifetime Medicare revenue of $710.6K and Medicaid revenue of $509.3K, so Medicare is the larger single payer but Medicaid represents a substantial portion of total reported revenue. The coexistence of sizable revenue from both programs means analyses should consider payer-specific service mixes rather than treating the facility as effectively single-payer.
Medicare revenue is highly concentrated: the precomputed top‑3 Medicare codes account for 60.4% of this provider's Medicare revenue, driven primarily by 66984 ($323.9K, 45.6%), followed by 45385 ($57.6K, 8.1%) and G0121 ($47.4K, 6.7%). This pattern shows cataract extraction with IOL insertion (66984) is the single largest Medicare revenue driver at the center, making ophthalmic surgery a key Medicare service line in this ASC.
Medicaid revenue is extremely concentrated in GI endoscopy: the precomputed top‑3 Medicaid codes account for 94.7% of Medicaid revenue, led by 45378 ($276.7K, 54.4%), 43239 ($186.8K, 36.7%), and 43235 ($18K, 3.5%). These figures indicate the center operates as a high-volume digestive endoscopy site for Medicaid patients, with colonoscopy/biopsy and upper endoscopy representing the vast majority of its Medicaid billing.
Competitive standing differs by payer and code: for Medicare the largest code 66984 ranks #3540 of 15965 (78th percentile) and is described as typical, unremarkable volume nationally, while G0121 ranks #301 of 7750 (96th percentile) and is labeled notably above typical national volume. In practice this means the facility is a modest national participant for cataract surgery but reports an unusually high relative volume of screening colonoscopies (G0121) to Medicare compared with peers.
Within Connecticut Medicaid the provider is a strong in‑state participant for 45378 (rank #5 of 42, 88th percentile), indicating a major state-level role for that colonoscopy code, while 43239 sits near the middle of in‑state peer volume (rank #40 of 83, 52th percentile). This contrast—dominant in-state for specific colonoscopy work but more middling for upper endoscopy—suggests local referral concentration for particular GI procedures.
The code mix across payers and the provider taxonomy (Ambulatory Surgical Clinic/Center) point to a multi‑specialty ASC model: Medicare revenue is driven by ophthalmology-focused surgical codes (e.g., 66984, 66982) whereas Medicaid revenue is dominated by gastroenterology procedures (e.g., 45378, 43239, 43235). Operationally, that implies the center supports both outpatient surgical ophthalmology and endoscopy service lines, with payer-specific demand shaping which specialties dominate reimbursements.
Ancillary and low‑unit items appear as high-claim but low-revenue contributors: for Medicare J0585 shows 2.6K claims but only $12.9K in revenue (rank #3147 of 3636, 13th percentile), and C9290 shows 2K claims but only $2K in revenue (rank #414 of 451, 8th percentile). These entries indicate substantial claim volume for small‑unit drug or supply codes with low per‑claim payment; analysts should separate these throughput-driven items from the facility’s higher-revenue procedures when modeling margins.
The NPI has been enumerated since 2006-02-10 (~20 years ago), establishing a long tenure in the market; combined with the heavy revenue concentration in a few codes (60.4% of Medicare and 94.7% of Medicaid from the top three codes), the provider’s financial performance is sensitive to volume shifts in those specific service lines. For payers and network planners, this concentration highlights where utilization management or contracting focus could have the greatest impact.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
16 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… | 370 | $890 | $323.9K |
| 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… | 130 | $460 | $57.6K |
| G0121 | Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk | 110 | $450 | $47.4K |
| G0105 | Colorectal cancer screening; colonoscopy on individual at high risk | 90 | $450 | $40.1K |
| 66982 | The provider inserts an intraocular lens prosthesis after extracapsular cataract extraction using complex techniques and devices. He may perform this by means of an iris expansion device, providing… | 40 | $910 | $40K |
| 66183 | The provider inserts a small device into the anterior chamber of the eye that helps to reduce the intraocular pressure of the eye in patients with glaucoma. | 10 | $2,420 | $33.9K |
| 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. | 20 | $1,640 | $27.9K |
| 15823 | In this procedure, the provider surgically trims excessive skin that weighs down the upper eyelid, typically to improve the cosmetic appearance of the face and due to the interference of the tissue… | 50 | $560 | $27.8K |
| 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. | 90 | $250 | $23.4K |
| 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… | 60 | $420 | $22.9K |
Showing 1–10 of 16
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 16 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
16 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| 66984 | 15 | 150 | 90 | $400 | $87.8K |
| J0585 | 56 | 60 | 6,710 | $1 | $47.6K |
| 65820 | 8 | 10 | 30 | $910 | $34.5K |
| 66183 | 3 | 10 | 10 | $1,850 | $29.7K |
| 66982 | 6 | 40 | 30 | $740 | $27.5K |
| 45385 | 24 | 240 | 50 | $290 | $19.3K |
| 15823 | 4 | 10 | 30 | $600 | $18.8K |
| 67904 | 5 | 10 | 20 | $600 | $14.4K |
| 45380 | 85 | 240 | 40 | $190 | $11.5K |
| C9290 | 10 | 10 | 4,680 | $1 | $10.9K |
Showing 1–10 of 16
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.
8 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… | 1,470 | $190 | $276.7K |
| 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. | 1,180 | $160 | $186.8K |
| 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. | 210 | $90 | $18K |
| 69436 | This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia. | 50 | $310 | $15K |
| 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… | 90 | $130 | $11.8K |
| 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 | $0 | $0 |
| 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… | 310 | $0 | $0 |
| G8918 | Patient without preoperative order for iv antibiotic surgical site infection (ssi) prophylaxis | 300 | $0 | $0 |
How this provider's Medicaid billing volume and revenue compare to other Connecticut providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Connecticut median
8 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… | 61 | 70 | 570 | $480 | $626.7K |
| 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. | 40 | 80 | 990 | $260 | $592K |
| 69436 | This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia. | 8 | 10 | 270 | $510 | $521.4K |
| 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… | 37 | 60 | 370 | $460 | $368K |
| 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… | 5 | 40 | 290 | $460 | $264.7K |
| 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. | 4 | 10 | 80 | $370 | $133.6K |
| 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… | 7 | 30 | 110 | $0 | $0 |
| G8918 | Patient without preoperative order for iv antibiotic surgical site infection (ssi) prophylaxis | 3 | 20 | 90 | $0 | $0 |
Other providers in the same ZIP code as Naugatuck Valley Endoscopy Center, LLC, ranked by combined Medicare and Medicaid revenue.
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