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NPI 1245291350 · Manchester, NH · Ambulatory Surgical Clinic/Center
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Elliot 1 Day Surgery Center is a ambulatory surgical clinic/center provider located in Manchester, New Hampshire. This profile covers 19 Medicare and 9 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 | Elliot 1 Day Surgery Center |
| Address | 185 Queen City Avenue |
| City | Manchester |
| State | NH |
| ZIP | 03101 |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| NPI Enumerated | March 29, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $706.4K |
| Medicaid | $651.9K |
ELL IOT 1 DAY SURGERY CENTER reports comparable scale across payers with $706.4K in total Medicare revenue and $651.9K in total Medicaid revenue, indicating it is not effectively single‑payer but rather maintains a balanced payer mix with Medicare slightly larger on lifetime revenue. The NPI was enumerated on 2006-03-29 (~20 years ago), supporting a multi‑year operating history in the ambulatory surgical center space.
Revenue concentration differs markedly by payer: the top three Medicare codes account for 52.0% of the provider's Medicare revenue, driven primarily by 27447, 27130, and 45385; by contrast the Medicaid book is heavily concentrated with the top three codes accounting for 90.8% of Medicaid revenue, dominated by 43239 (55.6%), 69436 (18.2%), and 45380 (16.9%). These precomputed shares indicate Medicare income is moderately concentrated while Medicaid revenue is highly concentrated in a few service lines.
Service-line mix shows this ASC functions as a multi‑specialty ambulatory surgery center: Medicare top codes include major joint arthroplasty codes 27447 and 27130 alongside high-volume GI procedures (45385, 45380), while Medicaid is dominated by upper‑GI endoscopy with biopsy (43239), pediatric/ENT procedures like tympanostomy tube insertion (69436), and colonoscopy with biopsy (45380). The combination of orthopedics, gastrointestinal endoscopy, and pediatric ENT/ophthalmic procedures suggests the center hosts multiple surgical specialties rather than focusing on a single procedure type.
Competitive standing on Medicare is mixed by specialty: the facility reports notably above‑typical national volume for colonoscopy with biopsy 45380 (306 claims; ranks in the 96th percentile) and strong relative volume for polypectomy 45385 (255 claims; 95th percentile), whereas major arthroplasty codes 27447 and 27130 are at more modest national positions (26th and 22th percentiles respectively) and labeled typical, unremarkable volume. This pattern implies the center is a regional outlier for GI endoscopy within the Medicare universe but a modest participant in joint replacement nationally.
On Medicaid the provider is a regional leader for upper‑GI endoscopy: 43239 accounts for 1.6K claims and $362.2K (55.6% of Medicaid revenue) and ranks #2 of 26 in‑state (96th percentile), described as notably above typical state volume. Tympanostomy 69436 (451 claims, $118.6K; 18.2% of Medicaid revenue) also ranks #2 in‑state and the facility ranks highly for colonoscopy with biopsy 45380 (533 claims, $110.3K; 16.9% of Medicaid revenue) at the 88th percentile in‑state, together indicating market strength in pediatric ENT and endoscopy for Medicaid patients.
The Medicaid billing profile includes a very large count of nominally zero‑paid administrative or supply lines (A4649: 3K claims, $0 revenue) and several quality/measure codes with $0 paid (G8907, G8918), which suggests a high volume of ancillary reporting/supply claims in the Medicaid record that do not directly drive revenue. Analysts should be aware these high claim counts for $0 items can inflate activity metrics without changing dollar performance.
Given the heavy Medicaid concentration in a single EGD code (43239 = 55.6% of Medicaid revenue) and strong state ranking, contracting or network strategies aimed at Medicaid populations should prioritize capacity and access around GI endoscopy and pediatric ENT services. Conversely, payer negotiations for Medicare should emphasize the center's high GI procedural volumes (45380, 45385) where it is an above‑typical provider nationally, while recognizing joint replacement volumes are comparatively modest.
Tenure and operational implications: with an NPI active since 2006-03-29 (~20 years ago) and diversified but concentrated clinical mix, the facility appears to have established referral relationships in GI and pediatric ENT that drive Medicaid volume and has developed sufficient endoscopy throughput to sit at high national percentiles for several colonoscopy/EGD codes. Any capacity planning, quality review, or network inclusion analysis should weigh this entrenched endoscopy/ENT footprint alongside the center’s smaller but present orthopedic and ophthalmic caseloads.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
19 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 27447 | In this procedure, the provider replaces the damaged weight bearing surfaces of both the medial and lateral compartments in the knee joint using implants of metal or other strong materials. The… | 20 | $7,140 | $142.8K |
| 27130 | In this procedure, the provider surgically replaces the hip joint by prosthesis, or artificial hip joint. He replaces both the femoral and acetabular components with or without using an autograft or… | 20 | $7,280 | $116.5K |
| 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… | 260 | $430 | $108.4K |
| 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… | 310 | $280 | $86.9K |
| 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. | 170 | $210 | $36K |
| 49650 | The provider performs laparoscopic repair of an initial inguinal hernia. | 20 | $1,710 | $32.5K |
| 45390 | The provider performs flexible colonoscopy along with excision of mucous membrane tissue using an endoscope. | 30 | $970 | $29.2K |
| 64721 | Neuroplasty or transposition of the median nerve at the carpal tunnel is done to treat a condition called carpal tunnel syndrome (CTS). The carpal tunnel is a narrow tunnel in the wrist through which… | 40 | $610 | $25.7K |
| G0121 | Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk | 60 | $410 | $25.2K |
| 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 | $550 | $22.2K |
Showing 1–10 of 19
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 19 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
19 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| 66984 | 58 | 60 | 220 | $310 | $144.6K |
| 27447 | 70 | 90 | 40 | $1,310 | $57.7K |
| 27130 | 51 | 70 | 30 | $1,580 | $55.3K |
| 45385 | 8 | 100 | 80 | $250 | $26.5K |
| 64721 | 8 | 30 | 40 | $450 | $19.3K |
| 19301 | 10 | 10 | 20 | $530 | $16K |
| 26055 | 15 | 30 | 30 | $300 | $12.3K |
| 50590 | 1 | 10 | 10 | $1,090 | $12K |
| 45380 | 2 | 90 | 50 | $150 | $10.7K |
| 45390 | 2 | 10 | 20 | $470 | $10K |
Showing 1–10 of 19
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.
9 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. | 1,620 | $220 | $362.2K |
| 69436 | This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia. | 450 | $260 | $118.6K |
| 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… | 530 | $210 | $110.3K |
| 42820 | The provider removes the tonsils and adenoids in a patient younger than 12 years old. | 90 | $320 | $29.7K |
| 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… | 110 | $190 | $21.3K |
| 41899 | Use this code to report a procedure on the teeth and adjoining alveolar structures for which there is no specific code available. | 30 | $340 | $9.3K |
| A4649 | Surgical supply; miscellaneous | 3,020 | $0 | $0 |
| 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… | 130 | $0 | $0 |
| G8918 | Patient without preoperative order for iv antibiotic surgical site infection (ssi) prophylaxis | 20 | $0 | $0 |
How this provider's Medicaid billing volume and revenue compare to other New Hampshire providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. New Hampshire median
9 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 41899 | Use this code to report a procedure on the teeth and adjoining alveolar structures for which there is no specific code available. | 6 | 10 | 70 | $560 | $204.3K |
| 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. | 2 | 30 | 210 | $200 | $104.6K |
| 69436 | This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia. | 2 | 10 | 120 | $230 | $66.6K |
| 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… | 3 | 20 | 70 | $230 | $39K |
| 42820 | The provider removes the tonsils and adenoids in a patient younger than 12 years old. | 2 | 10 | 140 | $270 | $38.2K |
| 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… | 7 | 10 | 120 | $260 | $33.2K |
| A4649 | Surgical supply; miscellaneous | 1 | 10 | 200 | $20 | $17.9K |
| 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… | 5 | 10 | 120 | $0 | $0 |
| G8918 | Patient without preoperative order for iv antibiotic surgical site infection (ssi) prophylaxis | 6 | 10 | 40 | $0 | $0 |
Other providers in the same ZIP code as Elliot 1 Day Surgery Center, ranked by combined Medicare and Medicaid revenue.
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