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NPI 1053385328 · Omaha, NE · Ambulatory Surgical Clinic/Center
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Midwest Endoscopy Services LLC is a ambulatory surgical clinic/center provider located in Omaha, Nebraska. This profile covers 12 Medicare and 6 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 | Midwest Endoscopy Services LLC |
| Address | 8901 Indian Hills Dr |
| City | Omaha |
| State | NE |
| ZIP | 68114 |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| NPI Enumerated | February 14, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $1.9M |
| Medicaid | $874.4K |
MIDWEST ENDOSCOPY SERVICES LLC operates as a high-volume ambulatory endoscopy clinic: its Medicare top revenue codes are dominated by colonoscopy and upper endoscopy procedures (45385, 45380, 43239) indicating a service line focused on diagnostic and therapeutic gastrointestinal endoscopy including polypectomy and biopsy. The code mix (large counts for 45385 and 45380 plus substantial 43239 volume) is consistent with a dedicated endoscopy center rather than a general multi-specialty practice.
Medicare revenue is highly concentrated in a small set of procedures: the precomputed top 3 Medicare codes by revenue account for 77.3% of this provider's total Medicare revenue, led by 45385 ($715.1K, 37.0%), 45380 ($559.7K, 29.0%), and 43239 ($218.6K, 11.3%). This concentration underscores that the provider’s Medicare business is driven chiefly by a few GI procedures rather than a broad mix of unrelated services.
On Medicare, this provider is a national high-volume outlier for core endoscopy codes: 45385 and 45380 each rank #7 nationally (100th percentile; extreme outlier, far above typical national volume for this code) and 43239 ranks #45 (100th percentile; extreme outlier). Those rank/percentile flags indicate the practice is operating at volumes well above typical national peers for these procedures, suggesting regional referral concentration or specialized capacity.
Medicaid revenue is even more concentrated in endoscopy procedures: the precomputed top 3 Medicaid codes by revenue account for 93.8% of this provider's total Medicaid revenue, driven by 43239 ($462K, 52.9%), 45380 ($245.4K, 28.1%), and 45385 ($112.2K, 12.8%). This indicates that Medicaid-facing activity is overwhelmingly GI procedural work, with minimal diversification into other service lines.
Within the state Medicaid market, MIDWEST ENDOSCOPY shows strong competitive positioning for specific codes: 45380 ranks #1 of 17 providers in-state (100th percentile; notably above typical state volume for this code) and 43239 ranks #3 of 29 providers in-state (93th percentile; notably above typical state volume for this code). By contrast, 45385’s state rank (#3 of 8, 71th percentile) is more typical, indicating particularly dominant state standing for some but not all of its high-volume procedures.
The payer mix favors Medicare in scale: total Medicare revenue is $1.9M compared with total Medicaid revenue of $874.4K, so Medicare represents the larger single-payer revenue stream for this entity while the provider maintains substantial Medicaid activity. Both payers show concentrated dependence on the same core GI procedures, which aligns operational focus across payers.
Preventive and screening services are a meaningful part of the Medicare case mix: screening colonoscopy codes appear among top Medicare items (G0105 $168.5K, 8.7% and G0121 $81.7K, 4.2%) with high national percentiles (G0105 ranks #22 of 8773 providers nationally, 100th percentile; G0121 ranks #53 of 7750, 99th percentile), indicating a sizable throughput of screening and surveillance colonoscopies in the Medicare population. This mix suggests the facility handles both diagnostic and screening populations rather than exclusively acute-care referrals.
The provider has a long operational tenure based on NPI enumeration: NPI enumerated 2006-02-14 (~20 years ago), indicating an established presence in the market. Coupled with the extreme-outlier volumes on multiple national Medicare codes and strong in-state Medicaid rankings, the tenure supports a picture of an established, specialized ambulatory endoscopy center with sustained high procedural 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.
12 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… | 1,580 | $450 | $715.1K |
| 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… | 1,560 | $360 | $559.7K |
| 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. | 960 | $230 | $218.6K |
| G0105 | Colorectal cancer screening; colonoscopy on individual at high risk | 400 | $420 | $168.5K |
| G0121 | Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk | 200 | $420 | $81.7K |
| 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. | 260 | $280 | $73.3K |
| 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. | 230 | $200 | $45.1K |
| 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 | $26.7K |
| 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. | 30 | $580 | $15.6K |
| 45381 | The provider inserts a flexible endoscope into the anus and navigates the scope through the entire colon. The provider performs one or more injections into the submucosa (the tissue below the mucous… | 60 | $250 | $15.2K |
Showing 1–10 of 12
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 12 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.
6 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. | 1,860 | $250 | $462K |
| 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… | 970 | $250 | $245.4K |
| 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… | 370 | $300 | $112.2K |
| 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… | 160 | $340 | $54.1K |
| 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… | 20 | $0 | $0 |
| G8918 | Patient without preoperative order for iv antibiotic surgical site infection (ssi) prophylaxis | 10 | $0 | $0 |
How this provider's Medicaid billing volume and revenue compare to other Nebraska providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Nebraska median
6 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average 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. | 3 | 30 | 280 | $450 | $266.7K |
| 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 | 180 | $290 | $96.4K |
| 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… | 1 | 20 | 100 | $320 | $82.5K |
| 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… | 2 | 10 | 160 | $470 | $56.7K |
| 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… | 14 | 20 | 40 | $1 | $10 |
| G8918 | Patient without preoperative order for iv antibiotic surgical site infection (ssi) prophylaxis | 6 | 10 | 20 | $0 | $0 |
Other providers in the same ZIP code as Midwest Endoscopy Services LLC, ranked by combined Medicare and Medicaid revenue.
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