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NPI 1043835713 · Nampa, ID · Ambulatory Surgical Clinic/Center
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Idaho Endoscopy Center LLC is a ambulatory surgical clinic/center provider located in Nampa, Idaho. This profile covers 9 Medicare and 5 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 | Idaho Endoscopy Center LLC |
| Address | 5080 E Commerce St |
| City | Nampa |
| State | ID |
| ZIP | 83687 |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| NPI Enumerated | June 9, 2020 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $717.3K |
| Medicare | $471.8K |
Service-line profile: The provider’s billing is concentrated in gastrointestinal endoscopy and therapeutic colonoscopy procedures, consistent with its Ambulatory Surgical Clinic/Center taxonomy; leading codes include 45385 (polypectomy/lesion removal), 43239 (upper endoscopy with biopsy), and 45380 (diagnostic colonoscopy with biopsy). This mix indicates the center functions primarily as an outpatient endoscopy suite performing diagnostic upper and lower endoscopies and therapeutic polypectomies rather than a broad multispecialty ambulatory center.
Medicare revenue concentration: Medicare revenue totals $471.8K and is highly concentrated — the precomputed top-3 Medicare codes account for 72.6% of this provider’s Medicare revenue. The largest single Medicare contributor is 45385 (43.4% of Medicare revenue), followed by 43239 (16.1%) and 45380 (13.2%), signaling dependence on a small set of endoscopy procedures for most Medicare receipts.
Medicaid revenue concentration: Medicaid revenue totals $717.3K and is even more concentrated on core endoscopy services, with the precomputed top-3 Medicaid codes accounting for 92.4% of Medicaid revenue. The Medicaid mix is led by 43239 (38.1%), 45385 (33.1%), and 45380 (21.2%), indicating Medicaid payments are overwhelmingly driven by the same diagnostic and therapeutic endoscopy procedures seen in Medicare.
Payer mix and scale: This provider reports larger lifetime revenue from Medicaid ($717.3K) than Medicare ($471.8K), indicating overall operations are more Medicaid-driven in scale. While both payers are represented, the higher Medicaid total suggests the center’s patient population or payer contracts tilt toward Medicaid-covered procedures.
Medicare competitive standing: For Medicare, the provider is a high-volume national performer on several key codes — 45385 ranks #350 of 16310 providers nationally (98th percentile; notably above typical national volume for this code) and 43239 ranks #639 of 17140 providers nationally (96th percentile; notably above typical national volume for this code). By contrast, 45380 ranks #1252 of 16427 providers nationally (92th percentile; typical, unremarkable volume for this code), so the center is a national outlier on polypectomy and upper endoscopy biopsy volume but more typical for diagnostic colonoscopy with biopsy.
In-state competitive standing for Medicaid: Within Idaho Medicaid billing the center ranks among the top in-state providers for its core procedures: 43239 ranks #4 of 35 providers in-state (91th percentile; typical, unremarkable volume for this code), 45385 ranks #3 of 12 providers in-state (82th percentile; typical, unremarkable volume for this code), and 45380 ranks #5 of 18 providers in-state (76th percentile; typical, unremarkable volume for this code). These placements indicate the center is a leading in-state performer for endoscopy services, capturing a meaningful share of Medicaid endoscopy volume.
Tenure and operational implication: The provider’s NPI was enumerated 2020-06-09 (~6 years ago), indicating a relatively recent market entry; despite that, the center already records concentrated, high-volume billing on several key endoscopy codes across both payers. This combination of recent enumeration and concentrated volume suggests a focused outpatient endoscopy operation that has established steady case throughput for core GI procedures.
Notable code-level outliers and procedure mix nuance: Beyond the three revenue drivers, Medicare billing shows unusually high relative volume on 43248 (ranks #75 of 2425 providers nationally, 97th percentile; notably above typical national volume for this code), pointing to a notable frequency of therapeutic esophageal dilation procedures. Other listed Medicare codes (for example 45378, 43235, 43450) appear at more typical or lower national percentiles, reinforcing that the practice’s differentiator is volume in a few specific diagnostic and therapeutic endoscopy services.
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 |
|---|---|---|---|---|
| 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… | 460 | $440 | $204.6K |
| 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. | 330 | $230 | $75.9K |
| 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… | 190 | $330 | $62.1K |
| 43248 | The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum; then through the scope, he passes a guidewire over which he passes dilators through the… | 160 | $300 | $48.5K |
| G0105 | Colorectal cancer screening; colonoscopy on individual at high risk | 70 | $410 | $29.9K |
| G0121 | Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk | 70 | $410 | $26.6K |
| 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… | 40 | $310 | $11.6K |
| 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. | 30 | $290 | $7.4K |
| 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. | 20 | $270 | $4.9K |
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
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.
5 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. | 1,260 | $220 | $273.6K |
| 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… | 660 | $360 | $237.1K |
| 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… | 480 | $320 | $152.2K |
| 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… | 90 | $310 | $27.6K |
| 43248 | The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum; then through the scope, he passes a guidewire over which he passes dilators through the… | 120 | $230 | $26.9K |
How this provider's Medicaid billing volume and revenue compare to other Idaho providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Idaho median
5 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average 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… | 3 | 10 | 20 | $340 | $94.9K |
| 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… | 5 | 20 | 70 | $260 | $77.5K |
| 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. | 4 | 40 | 180 | $170 | $75K |
| 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… | 3 | 10 | 90 | $300 | $64.8K |
| 43248 | The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum; then through the scope, he passes a guidewire over which he passes dilators through the… | 3 | 10 | 30 | $210 | $35.1K |
Other providers in the same ZIP code as Idaho Endoscopy Center LLC, ranked by combined Medicare and Medicaid revenue.
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