Loading...
NPI 1326114364 · Lafayette, LA · Endoscopy Clinic/Center
Customize your policy alerts
Get alerted when relevant policies change without checking for updates manually.
Monitor payer policy activity
Acadiana Endoscopy Center, Inc. is a endoscopy clinic/center provider located in Lafayette, Louisiana. This profile covers 11 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 | Acadiana Endoscopy Center, Inc. |
| Address | 443 Heymann Blvd |
| City | Lafayette |
| State | LA |
| ZIP | 70503 |
| Taxonomy | Endoscopy Clinic/Center |
| NPI Enumerated | November 28, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $998.8K |
| Medicaid | $8.3K |
ACADIANA ENDOSCOPY CENTER, INC. presents as a focused ambulatory endoscopy operation: its Medicare top procedures are dominated by colonoscopy and upper endoscopy codes (notably 45385, 43239 and 45380), which together account for the bulk of the center’s procedural revenue. The mix includes both diagnostic and therapeutic interventions — polypectomy and biopsy (45385, 45380, 43239) plus esophageal dilation (43450) — indicating a service line built around GI endoscopy and same-day procedural care rather than primary care or broad multispecialty services.
Revenue is highly concentrated on Medicare: total Medicare revenue is $998.8K while total Medicaid revenue is $8.3K, so the practice is effectively Medicare-dominant in scale. At the code level this is reflected by the precomputed fact that the top 3 Medicare codes account for 67.6% of Medicare revenue, whereas the top 3 Medicaid codes account for 100.0% of the much smaller Medicaid take.
The single largest Medicare revenue driver is 45385 (1K claims, $407 avg paid/claim, $416K revenue; 41.6% of Medicare revenue) and the next two Medicare drivers are 43239 (643 claims, $213 avg, $137K; 13.7%) and 45380 (397 claims, $308 avg, $122.3K; 12.2%). These three codes collectively explain the provider’s procedural focus and align with the precomputed 67.6% concentration in Medicare revenue, making colonoscopic polypectomy and related colonoscopy services the core business.
Several Medicare procedure volumes position this center as a high-volume outlier nationally: 45385 ranks #56 of 16310 providers nationally (100th percentile; extreme outlier) and 43239 ranks #151 of 17140 providers nationally (99th percentile; extreme outlier). Additional Medicare codes with unusually high national standing include G0105 and G0121 (both 99th percentile; extreme outlier), and 45380 (98th percentile; notably above typical), which together indicate the center is a major national player for selected endoscopy procedures rather than a modest local-volume clinic.
By contrast, Medicaid activity is negligible in absolute dollars and modest in-state relative standing: the provider reported $8.3K total Medicaid revenue with 43239 contributing $6K (72.5% of the provider’s Medicaid revenue) and 45385 contributing $2.3K (27.5%). In-state ranks for those Medicaid codes are unremarkable (43239 at #109 of 163, 33th percentile; 45385 at #52 of 68, 24th percentile), signaling that the center is not a leading Medicaid endoscopy provider within Louisiana.
Operational tenure appears well established: the NPI was enumerated on 2006-11-28 (~20 years ago), which supports a long-standing presence in the local market and could explain the accumulated high procedural volumes and referral relationships observed on the Medicare side. That tenure, combined with concentrated Medicare volume, suggests a mature, procedure-focused outpatient endoscopy practice.
The provider’s competitive position differs sharply by payer: nationally, it is a dominant/high-volume specialty provider for several Medicare endoscopy codes (multiple codes labeled ‘extreme outlier’ or ‘notably above typical’), which likely confers market recognition among referral sources for Medicare patients. For Medicaid the provider is a marginal participant in-state, contributing only $8.3K total and ranking in lower-to-mid percentiles on the two Medicaid-billed clinical codes, so Medicaid does not appear to be a growth or strategic focus based on the current billing profile.
The code mix combining high-volume screening and diagnostic colonoscopies (G0105, G0121, 45380/45385) with therapeutic endoscopy and dilation (45385, 43450, 43249) indicates the center performs both preventive and intervention-focused services. This combination typically supports steady, procedure-driven revenue from Medicare and explains why a small set of codes accounts for the majority of Medicare receipts; continued reliance on a concentrated code set could increase exposure to reimbursement or referral shifts affecting those specific GI procedures.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
11 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… | 1,020 | $410 | $416K |
| 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. | 640 | $210 | $137K |
| 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 | $310 | $122.3K |
| G0105 | Colorectal cancer screening; colonoscopy on individual at high risk | 290 | $380 | $108.4K |
| 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 | $250 | $67.1K |
| G0121 | Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk | 170 | $380 | $63.2K |
| 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… | 130 | $290 | $37.2K |
| 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. | 100 | $180 | $17.5K |
| 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 | $520 | $15.1K |
| 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… | 40 | $220 | $8.9K |
Showing 1–10 of 11
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 11 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. | 130 | $50 | $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… | 30 | $70 | $2.3K |
| 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… | 850 | $0 | $0 |
| G8918 | Patient without preoperative order for iv antibiotic surgical site infection (ssi) prophylaxis | 680 | $0 | $0 |
How this provider's Medicaid billing volume and revenue compare to other Louisiana providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Louisiana 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. | 109 | 160 | 380 | $170 | $194.7K |
| 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… | 52 | 70 | 230 | $190 | $115.1K |
| 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… | 16 | 50 | 320 | $0 | $0 |
| G8918 | Patient without preoperative order for iv antibiotic surgical site infection (ssi) prophylaxis | 10 | 40 | 190 | $0 | $0 |
Other providers in the same ZIP code as Acadiana Endoscopy Center, Inc., ranked by combined Medicare and Medicaid revenue.
Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.