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NPI 1417957796 · Monroe, LA · Ambulatory Surgical Clinic/Center
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Endoscopy Center Of Monroe is a ambulatory surgical clinic/center provider located in Monroe, Louisiana. This profile covers 17 Medicare and 8 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 | Endoscopy Center Of Monroe |
| Address | 316 S 6th St |
| City | Monroe |
| State | LA |
| ZIP | 71201 |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| NPI Enumerated | July 28, 2005 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $1.3M |
| Medicaid | $187.1K |
This facility’s payer mix is Medicare-dominant: lifetime Medicare revenue is $1.3M compared with $187.1K in Medicaid, so Medicare is the primary revenue source and Medicaid is a much smaller contributor to overall billing. The gap in scale implies the center’s financial performance and growth levers are driven more by Medicare volume and reimbursement than by its Medicaid business.
Medicare revenue is concentrated in endoscopic procedures, with the top three Medicare codes accounting for 65.4% of total Medicare revenue. Those top drivers are 45385 (40.9%), 43239 (13.2%), and 45380 (11.3%), indicating a business organized around therapeutic and diagnostic colonoscopy plus upper‑GI endoscopy with biopsy and polypectomy services.
Medicaid revenue is even more highly concentrated in the same small set of endoscopy services: the top three Medicaid codes account for 95.2% of total Medicaid revenue. The Medicaid mix is dominated by 43239 (51.0%), 45385 (36.9%), and 45380 (7.4%), signaling that nearly all Medicaid dollars for this provider come from core endoscopic procedures rather than ancillary services.
Against national Medicare peers this center shows unusually high procedural volumes for several codes: 45385 ranks #25 of 16310 providers nationally (100th percentile; extreme outlier), 43239 ranks #75 of 17140 (100th percentile; extreme outlier), and 45380 ranks #193 of 16427 (99th percentile; extreme outlier). These rankings indicate the center is a national outlier and a major volume provider for colonoscopy with polypectomy and upper endoscopic biopsy procedures.
By contrast, the provider’s standing among in‑state Medicaid peers is modest-to-typical: 43239 ranks #37 of 163 in-state (78th percentile), 45385 ranks #20 of 68 in-state (72nd percentile), and 45380 ranks #36 of 72 in-state (51st percentile). That state-level profile suggests the center is not a dominant Medicaid player regionally even though it is a high-volume Medicare performer nationally.
There are notable per-claim payment differentials between payers for the same services: for 43239 the Medicare average paid/claim is $201 versus Medicaid $65, and for 45385 the Medicare average paid/claim is $402 versus Medicaid $85. These disparities indicate that Medicaid will require substantially higher procedure volumes to generate the same revenue as Medicare, reinforcing Medicare-driven economics for the practice.
The procedure mix includes a meaningful volume of esophageal dilation and related upper-GI work: 43450 accounts for $114K (9.0% of Medicare revenue) and ranks #7 of 1569 nationally (100th percentile; extreme outlier). Coupled with high-volume colonoscopy and polypectomy codes, the data suggest this ambulatory surgical clinic operates as a focused endoscopy center handling both lower- and upper-GI therapeutic procedures.
The provider has an established operating history, with its NPI enumerated on 2005-07-28 (~21 years ago). That longevity, together with highly concentrated Medicare procedure volumes and national outlier ranks on multiple codes, is consistent with a long-standing specialty ASC that has developed referral and throughput capabilities for endoscopic services.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
17 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… | 1,290 | $400 | $519K |
| 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. | 830 | $200 | $167.6K |
| 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… | 540 | $270 | $143.6K |
| 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. | 450 | $260 | $114K |
| G0105 | Colorectal cancer screening; colonoscopy on individual at high risk | 270 | $370 | $100.3K |
| 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… | 170 | $380 | $63.4K |
| 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. | 210 | $180 | $37.1K |
| 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… | 100 | $290 | $29.4K |
| G0121 | Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk | 60 | $350 | $21.2K |
| 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 | $510 | $18.9K |
Showing 1–10 of 17
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 17 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.
8 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. | 1,470 | $70 | $95.4K |
| 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… | 810 | $90 | $69K |
| 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… | 190 | $70 | $13.8K |
| 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. | 370 | $20 | $7.4K |
| 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 | $130 | $1.5K |
| 00811 | The provider performs anesthesia services for a patient undergoing an unspecified lower intestinal endoscopic procedure where the surgical provider introduces an endoscope into the intestines up to… | 10 | $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… | 1,370 | $0 | $0 |
| G8918 | Patient without preoperative order for iv antibiotic surgical site infection (ssi) prophylaxis | 70 | $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
8 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. | 37 | 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… | 20 | 70 | 230 | $190 | $115.1K |
| 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… | 36 | 70 | 190 | $160 | $98K |
| 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… | 81 | 90 | 120 | $180 | $83.8K |
| 00811 | The provider performs anesthesia services for a patient undergoing an unspecified lower intestinal endoscopic procedure where the surgical provider introduces an endoscope into the intestines up to… | 35 | 40 | 90 | $40 | $21.6K |
| 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. | 9 | 20 | 370 | $20 | $13K |
| 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… | 9 | 50 | 320 | $0 | $0 |
| G8918 | Patient without preoperative order for iv antibiotic surgical site infection (ssi) prophylaxis | 24 | 40 | 190 | $0 | $0 |
Other providers in the same ZIP code as Endoscopy Center Of Monroe, ranked by combined Medicare and Medicaid revenue.
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