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NPI 1073079596 · Little Rock, AR · Ambulatory Surgical Clinic/Center
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Premier Gastroenterology Associates PLLC is a ambulatory surgical clinic/center provider located in Little Rock, Arkansas. This profile covers 13 Medicare and 4 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 | Premier Gastroenterology Associates PLLC |
| Address | 10915 Rodney Parham Rd |
| City | Little Rock |
| State | AR |
| ZIP | 72212 |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| NPI Enumerated | February 20, 2019 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $1.3M |
| Medicaid | $242.8K |
PREMIER GASTROENTEROLOGY ASSOCIATES PLLC presents a procedure-heavy ambulatory surgery profile consistent with its Ambulatory Surgical Clinic/Center taxonomy: the top CPT/HCPCS activity is dominated by endoscopic and colonoscopic interventions (codes such as 43239, 45385, 45380, 45384) that include biopsies, polypectomy/snare removal, and dilation procedures. The split of high-volume diagnostic and therapeutic endoscopy codes suggests the entity operates primarily as an endoscopy-focused clinic performing both screening and therapeutic GI procedures on an outpatient basis.
Medicare revenue is the primary payer for this provider at $1.3M versus Medicaid at $242.8K, indicating Medicare is the dominant revenue source by a substantial margin. This payer mix implies most procedural throughput is billed to Medicare beneficiaries rather than Medicaid enrollees, which will affect case-mix, reimbursement rates, and downstream payer negotiations.
Revenue concentration is high for both payers: the top three Medicare codes account for 66.6% of the provider's total Medicare revenue, indicating a narrow set of procedures drive most Medicare income. On the Medicaid side the concentration is even more pronounced, with the top three Medicaid codes accounting for 99.6% of total Medicaid revenue, meaning Medicaid billing is almost entirely explained by a very small set of codes.
At the code level this provider is a clear national outlier on several Medicare procedures. Code 43239 generated $330.9K (25.0% of Medicare revenue) and ranks #10 of 17140 providers nationally (100th percentile; extreme outlier), while 45385 ($333.3K, 25.1%) and 45380 ($218.1K, 16.5%) also rank in the 99th–100th percentiles and are labeled as extreme outliers. These rankings indicate the practice performs unusually high volumes of upper endoscopy with biopsy and colonoscopic polypectomy relative to typical national providers.
By contrast, Medicaid volume is concentrated in a single procedure but shows more typical in-state standing: Medicaid code 43239 accounts for $221.8K (91.4% of Medicaid revenue) and ranks #10 of 76 providers in-state (88th percentile; typical, unremarkable volume). Other Medicaid codes such as 45380 ($16.2K, 6.7%) and 45378 ($3.6K, 1.5%) are modest contributors and rank in middle-to-lower in-state percentiles, reinforcing that Medicaid billing is dominated by diagnostic upper endoscopies.
Competitive standing differs by payer and code: nationally for Medicare the practice is a major high-volume provider (multiple codes are described as extreme outliers or notably above typical national volume), which positions it as a dominant procedural site for those codes at a national-comparative level. For Medicaid, the provider is a typical to modest participant in-state for the same top procedure (43239 at the 88th percentile), indicating stronger national presence in Medicare claims than in the state Medicaid market.
The detailed Medicare code mix shows a balance of screening and therapeutic work: G0121 and G0105 together contribute meaningful screening-colonoscopy revenue ($68.3K and $65.8K respectively), while therapeutic codes (45385, 45380, 45384) drive larger shares of procedural revenue. This combination suggests the site manages both screening workflows and downstream interventions, which has implications for referral capture, pathology/lab partnerships, and capacity planning for polypectomy and biopsy services.
Operational tenure is relatively recent: the NPI was enumerated on 2019-02-20 (~7 years ago), so the provider’s current scale—especially its high national rankings on several Medicare endoscopy codes—has been built over a comparatively short operating window. That timeline is relevant when assessing growth trajectory, market expansion, or contracting leverage with payers.
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… | 820 | $410 | $333.3K |
| 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. | 1,410 | $230 | $330.9K |
| 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… | 670 | $330 | $218.1K |
| 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 | $530 | $133K |
| G0121 | Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk | 180 | $390 | $68.3K |
| G0105 | Colorectal cancer screening; colonoscopy on individual at high risk | 170 | $390 | $65.8K |
| 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… | 220 | $290 | $64.6K |
| 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 | $370 | $61K |
| 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. | 80 | $250 | $19.6K |
| 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… | 40 | $520 | $18.3K |
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.
4 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. | 1,820 | $120 | $221.8K |
| 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… | 150 | $110 | $16.2K |
| 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… | 10 | $250 | $3.6K |
| 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… | 10 | $90 | $1.1K |
How this provider's Medicaid billing volume and revenue compare to other Arkansas providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Arkansas median
4 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. | 10 | 80 | 300 | $190 | $134K |
| 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… | 8 | 20 | 140 | $170 | $34.9K |
| 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… | 21 | 20 | 40 | $130 | $17K |
| 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… | 12 | 10 | 30 | $200 | $12.2K |
Other providers in the same ZIP code as Premier Gastroenterology Associates PLLC, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Easter Seals Arkansas | AR | Developmentally Disabled Services Day Training Agency | $0 | $94.4M |
| Natural State Genomics LLC | AR | Clinical Medical Laboratory | $1.2M | $4.3M |
| Easter Seals Arkansas | AR | Physical Therapist | $0 | $2.2M |
| Bp Anesthesia, PLLC | AR | Certified Registered Nurse Anesthetist | $0 | $2M |
| Endoscopy Center Of Little Rock,llc | AR | Ambulatory Surgical Clinic/Center | $420.1K | $2.2K |
| Battle Street Surgery Center, LLC | AR | Ambulatory Surgical Clinic/Center | $382.9K | $34.4K |
| Brent James | AR | Optometrist | $71.8K | $300.3K |
| Donald Gauldin | AR | Ophthalmology Physician | $292.3K | $0 |
| Gunnar Gibson | AR | Dermatology Physician | $239.5K | $0 |
| Roy Jones | AR | Gastroenterology Physician | $196.5K | $0 |
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