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NPI 1114912102 · Boise, ID · Ambulatory Surgical Clinic/Center
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Boise Endoscopy Center LLC is a ambulatory surgical clinic/center provider located in Boise, Idaho. This profile covers 8 Medicare and 7 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 | Boise Endoscopy Center LLC |
| Address | 425 W Bannock St |
| City | Boise |
| State | ID |
| ZIP | 83702 |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| NPI Enumerated | September 15, 2005 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $1.8M |
| Medicare | $362.9K |
BOISE ENDOSCOPY CENTER LLC appears to operate primarily as a GI-focused ambulatory surgical center: the highest-volume Medicare and Medicaid CPTs are colonoscopy and upper endoscopy procedures (45385, 45380, 43239, 43248), indicating routine diagnostic and therapeutic endoscopy and polypectomy services are the core service line. The prevalence of snare polypectomy (45385) and diagnostic upper endoscopy with biopsy (43239) in both payer lists supports a practice model centered on endoscopic procedures rather than broad multispecialty ambulatory care.
Revenue concentration is high for both payers. On Medicare, the top three CPTs account for 66.2% of total Medicare revenue, driven by 45385 (38.1%), 45380 (15.5%), and 43239 (12.7%), showing a focused set of services captures most Medicare payments. On Medicaid, the top three CPTs account for 79.7% of total Medicaid revenue, with 43239 (31.3%), 45380 (27.9%), and 45385 (20.5%) together making up the bulk of Medicaid payments, signaling even greater revenue dependence on a narrow set of endoscopy procedures.
Payer mix is skewed toward Medicaid by scale: total Medicare revenue is $362.9K versus total Medicaid revenue of $1.8M, indicating the facility derives substantially more lifetime revenue from Medicaid than from Medicare and functions, in practical terms, as Medicaid-dominant in volume. This suggests operational emphasis or referral patterns that generate far higher utilization among Medicaid-insured patients.
Competitive standing differs by payer and code: for Medicare, 45385 ranks #646 of 16310 providers nationally (96th percentile), placing the provider well above typical national volume for that code and implying strong national-level specialization in polypectomy procedures. Several other Medicare codes (45380, 43239, G0105, G0121) sit in the ~88th–94th percentile range, indicating consistently above-typical national volumes across common colonoscopy and upper endoscopy codes.
In-state Medicaid rankings show BOISE ENDOSCOPY CENTER as a dominant provider for multiple codes: 43239, 45380, 45378, and 43248 all rank #1 of their respective state peer groups (100th percentile), with 45385 ranking #2 of 12 providers (91th percentile). These rankings mark the center as a major statewide supplier of endoscopic procedures and an outlier in procedural volume within Idaho.
Several codes are flagged as statistical outliers or notably above typical volume: Medicaid 43239 is described as an "extreme outlier, far above typical state volume" and the provider ranks #1 in-state; Medicare 45385 and Medicaid 45380/45385 are described as "notably above typical" national or state volume. These characterizations indicate the provider routinely reports procedure counts that exceed peers by wide margins for its top procedures.
Operational and clinical implications include high throughput of diagnostic biopsies and therapeutic colonoscopies: large claim counts for 43239 (2.6K Medicaid claims) and 45380/45385 (1.5K and 987 Medicaid claims respectively) imply a steady referral stream for both diagnostic upper endoscopy with biopsy and colonoscopic polypectomy. This likely requires dedicated endoscopy staffing, procedure-room availability, and pathology coordination to support the volumes reported.
Tenure is long enough to establish market presence: the NPI was enumerated on 2005-09-15 (~21 years ago), indicating the entity has operated for two decades, which provides time to build referral relationships and the high volumes seen in state and national rankings. Long tenure combined with concentrated procedure mix supports a specialized ambulatory endoscopy center profile.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
8 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… | 310 | $450 | $138.3K |
| 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 | $380 | $56.2K |
| 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. | 220 | $210 | $46K |
| G0105 | Colorectal cancer screening; colonoscopy on individual at high risk | 100 | $410 | $41K |
| 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 | $280 | $34.3K |
| G0121 | Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk | 70 | $410 | $29.5K |
| 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… | 30 | $320 | $9.2K |
| 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 | $260 | $8.6K |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 8 CPT/HCPCS codes.
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.
7 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. | 2,640 | $220 | $567K |
| 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… | 1,510 | $330 | $505K |
| 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… | 990 | $380 | $370.1K |
| 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… | 600 | $310 | $187.8K |
| 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… | 740 | $240 | $179.6K |
| 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… | 210 | $0 | $0 |
| G8918 | Patient without preoperative order for iv antibiotic surgical site infection (ssi) prophylaxis | 230 | $0 | $0 |
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
7 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… | 2 | 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… | 1 | 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. | 1 | 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… | 1 | 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… | 1 | 10 | 30 | $210 | $35.1K |
| G8918 | Patient without preoperative order for iv antibiotic surgical site infection (ssi) prophylaxis | 8 | 10 | 260 | $1 | $740 |
| 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… | 10 | 20 | 210 | $1 | $680 |
Other providers in the same ZIP code as Boise Endoscopy Center LLC, ranked by combined Medicare and Medicaid revenue.
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