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NPI 1104246446 · Honolulu, HI · Ambulatory Surgical Clinic/Center
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Pacific Endoscopy Center LLC is a ambulatory surgical clinic/center provider located in Honolulu, Hawaii. This profile covers 9 Medicare and 3 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 | Pacific Endoscopy Center LLC |
| Address | 2226 Liliha St |
| City | Honolulu |
| State | HI |
| ZIP | 96817 |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| NPI Enumerated | April 25, 2014 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $732.2K |
| Medicare | $476.5K |
PACIFIC ENDOSCOPY CENTER LLC appears to operate as an ambulatory surgical/endoscopy center focused on gastrointestinal diagnostic and therapeutic procedures: its highest-revenue codes are 45385 (polypectomy/snare colonoscopy), 45380 (colonoscopy with biopsy), and 43239 (EGD with biopsy), which together describe a mix of screening/diagnostic endoscopy and lesion removal. The CPT mix indicates the facility’s core service line is endoscopic GI care rather than broader surgical specialties.
Medicare revenue is concentrated in a small set of therapeutic/diagnostic endoscopy codes: the provider’s top three Medicare codes (45385, 45380, 43239) account for 71.0% of its total Medicare revenue, with 45385 generating $146.4K (30.7%), 45380 $133.8K (28.1%), and 43239 $57.9K (12.2%). This concentration implies Medicare income is heavily dependent on colonoscopy and upper endoscopy procedures.
Medicaid billing shows even greater concentration in the same endoscopy mix: the top three Medicaid codes (45385, 45380, 43239) account for 100.0% of the provider’s Medicaid revenue, with 45385 at $354.7K (48.5%), 45380 at $245.4K (33.5%), and 43239 at $131.4K (18.0%). For Medicaid payers, the practice’s financial profile is effectively defined by those three endoscopy services.
Payer mix favors Medicaid by scale: total Medicaid revenue is $732.2K versus total Medicare revenue of $476.5K, so the provider draws noticeably more revenue from Medicaid than from Medicare. This imbalance suggests Medicaid patients form the larger part of the center’s volume and revenue base.
On national Medicare benchmarks the center is a high-volume specialist for several colonoscopy codes: 45385 ranks #700 of 16310 providers (96th percentile) and 45380 ranks #370 of 16427 providers (98th percentile), both described as notably above typical national volume. At the same time 43239 ranks at the 91th percentile (typical, unremarkable volume), indicating strongest national competitive position in colonoscopy/polypectomy work rather than routine EGD biopsies.
Within state Medicaid comparisons the center is a leading in-state performer for colonoscopy services: 45380 ranks #2 of 20 providers in-state (95th percentile) and 45385 ranks #3 of 19 providers in-state (89th percentile), which positions the center as a major regional provider for these procedures. These in-state ranks align with the facility’s large Medicaid revenue share coming from colonoscopy-related codes.
There is at least one pronounced utilization outlier in the Medicare claims mix: code 45381 ranks #19 of 1725 providers nationally (99th percentile) and is labeled an extreme outlier, indicating the center’s injection/submucosal procedure volume for that code is far above typical peers. Together with the notably above typical ranks for 45385 and 45380, this suggests concentrated, high-intensity use of therapeutic colonoscopy techniques relative to national peers.
The provider’s NPI was enumerated on 2014-04-25 (~12 years ago), which indicates it has an established operating history; the sustained, procedure-heavy revenue pattern across both payers supports that this is a stable, endoscopy-focused ambulatory surgical center rather than a recently formed practice.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
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… | 290 | $500 | $146.4K |
| 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… | 400 | $340 | $133.8K |
| 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. | 200 | $280 | $57.9K |
| 43250 | The provider examines the esophagus, stomach, and first portion of the small intestine with a flexible esophagogastroduodenoscope, a tubular instrument with a light source and camera, which he… | 60 | $670 | $41.5K |
| 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… | 120 | $300 | $34.5K |
| 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… | 100 | $260 | $26.6K |
| 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… | 20 | $660 | $12.6K |
| 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. | 40 | $300 | $12.2K |
| 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… | 30 | $370 | $11K |
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.
3 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… | 940 | $380 | $354.7K |
| 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… | 1,600 | $150 | $245.4K |
| 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. | 560 | $240 | $131.4K |
How this provider's Medicaid billing volume and revenue compare to other Hawaii providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Hawaii median
3 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 | 20 | 90 | $550 | $222.1K |
| 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… | 2 | 20 | 190 | $340 | $177.3K |
| 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. | 6 | 30 | 100 | $280 | $111.1K |
Other providers in the same ZIP code as Pacific Endoscopy Center LLC, ranked by combined Medicare and Medicaid revenue.
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