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NPI 1447234919 · Bettendorf, IA · Ambulatory Surgical Clinic/Center
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Gengastro LLC is a ambulatory surgical clinic/center provider located in Bettendorf, Iowa. This profile covers 15 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 | Gengastro LLC |
| Address | 2222 53rd Ave |
| City | Bettendorf |
| State | IA |
| ZIP | 52722 |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| NPI Enumerated | November 30, 2005 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $1.1M |
| Medicaid | $1M |
GENGASTRO LLC operates as an Ambulatory Surgical Clinic/Center with a procedure mix dominated by gastrointestinal endoscopy and therapeutic interventions; the Medicare top CPTs include 45385, 45380, and 43239 which correspond to polypectomy/therapeutic colonoscopy, diagnostic/biopsy colonoscopy, and EGD with biopsy, respectively. The claim volumes listed (e.g., Medicare: 882 claims for 45385, 986 claims for 45380, 929 claims for 43239) and material average paid/claim levels indicate a throughput-focused outpatient endoscopy practice rather than a broad multispecialty surgical center.
Medicare revenue is concentrated in a small set of procedures: the precomputed top-3 Medicare codes (45385, 45380, 43239) account for 66.4% of the provider's total Medicare revenue, with those codes individually representing 29.1%, 21.9%, and 15.4% of Medicare revenue as listed. This concentration signals that clinical capacity and revenue are highly dependent on a narrow portfolio of colonoscopy and upper endoscopy services.
Medicaid revenue is even more concentrated: the precomputed top-3 Medicaid codes (43239, 45380, 45385) account for 99.0% of total Medicaid revenue, with listed shares of 48.1%, 28.3%, and 22.6% respectively. The Medicaid billing profile shows very heavy reliance on EGD with biopsy and colonoscopy/biopsy/polypectomy procedures, suggesting the provider performs nearly all of its Medicaid activity through a few high-volume endoscopy codes.
Payer mix is roughly balanced but Medicare is slightly larger in dollar scale: total Medicare revenue is $1.1M versus total Medicaid revenue of $1M, indicating the practice serves both payer populations at similar scale rather than being single-payer dependent. Given comparable revenue totals and the shared dominance of the same procedural codes across both payers, referral patterns and operational capacity likely drive utilization across payer lines.
National competitive standing for core Medicare codes is high: 45385 ranks #83 of 16310 (99th percentile, described as an extreme outlier), 45380 ranks #27 of 16427 (100th percentile, extreme outlier), and 43239 ranks #52 of 17140 (100th percentile, extreme outlier). These rank/percentile labels indicate this provider is a high-volume outlier nationally for key colonoscopy and EGD procedures and operates well above typical national volumes for those codes.
State-level competitiveness in Medicaid is also strong: 45385 ranks #1 of 25 in-state (100th percentile; notably above typical state volume for this code), 45380 ranks #3 of 23 in-state (described as notably above typical state volume), and 43239 ranks #4 of 56 in-state (95th percentile; notably above typical state volume). Collectively these standings show the provider is a major procedural site for GI services within Iowa.
The provider has an established presence with an NPI enumerated on 2005-11-30 (~21 years ago), supporting an interpretation of long-standing ambulatory endoscopy operations rather than a recent startup. Longevity combined with concentrated, high-volume procedural billing suggests stable referral relationships and sustained operational throughput.
Operational signals include very large claim counts reported for top procedures in both payers (e.g., Medicaid 43239: 2K claims; Medicaid 45380: 1.2K claims; Medicare 45380: 986 claims) and the presence of non-revenue quality/process codes in Medicaid (G8918 and G8907 with 55 claims each at $0). The combination of throughput dependence on a few high-volume endoscopy codes and zero-paid quality-reporting codes points to a procedural facility-focused business model where operational capacity, scheduling, and adherence to perioperative quality processes are likely material to payer relationships and utilization trends.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
15 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… | 880 | $370 | $326.3K |
| 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… | 990 | $250 | $245.5K |
| 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. | 930 | $190 | $172.8K |
| 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… | 260 | $520 | $136K |
| G0105 | Colorectal cancer screening; colonoscopy on individual at high risk | 170 | $360 | $60K |
| 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. | 100 | $470 | $46.8K |
| G0121 | Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk | 80 | $370 | $31.2K |
| 45390 | The provider performs flexible colonoscopy along with excision of mucous membrane tissue using an endoscope. | 30 | $880 | $28.1K |
| 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 | $200 | $25.3K |
| 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… | 80 | $270 | $21.3K |
Showing 1–10 of 15
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 15 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. | 2,020 | $240 | $482.5K |
| 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… | 1,170 | $240 | $284.3K |
| 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… | 760 | $300 | $226.6K |
| 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 | $250 | $7.1K |
| 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… | 10 | $190 | $2.6K |
| 46221 | In this procedure, the provider ligates, or ties off, the base of a hemorrhoid inside the rectum with a rubber band. The provider performs this procedure to let the hemorrhoid dry out due to a lack… | 30 | $20 | $490 |
| 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… | 60 | $0 | $0 |
| G8918 | Patient without preoperative order for iv antibiotic surgical site infection (ssi) prophylaxis | 60 | $0 | $0 |
How this provider's Medicaid billing volume and revenue compare to other Iowa providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Iowa 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. | 4 | 60 | 260 | $210 | $109.2K |
| 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 | 90 | $270 | $85.7K |
| 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… | 7 | 10 | 30 | $340 | $68.9K |
| 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 | 30 | 60 | $280 | $43.2K |
| 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… | 2 | 10 | 20 | $270 | $5.8K |
| 46221 | In this procedure, the provider ligates, or ties off, the base of a hemorrhoid inside the rectum with a rubber band. The provider performs this procedure to let the hemorrhoid dry out due to a lack… | 2 | 10 | 40 | $60 | $2.2K |
| 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 | 50 | $0 | $0 |
| G8918 | Patient without preoperative order for iv antibiotic surgical site infection (ssi) prophylaxis | 4 | 10 | 140 | $0 | $0 |
Other providers in the same ZIP code as Gengastro LLC, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| New Choices Inc | IA | Developmentally Disabled Services Day Training Agency | $0 | $72.6M |
| Bettendorf Community School District | IA | Local Education Agency (LEA) | $0 | $7.4M |
| New Choices | IA | Community/Behavioral Health Agency | $0 | $6.9M |
| Trinity Medical Center | IA | General Acute Care Hospital | $0 | $5.2M |
| Helping Hands Transporting Services,llc | IA | Non-emergency Medical Transport (VAN) | $0 | $3.5M |
| Richard Yemm | IA | Ophthalmology Physician | $2.4M | $6.1K |
| Martin O'malley | IA | Ophthalmology Physician | $1.9M | $2.7K |
| New Choices LLC | IA | Home Health Agency | $0 | $1.9M |
| Genesis Health System | IA | Home Health Agency | $0 | $1.8M |
| Hand In Hand | IA | Respite Care | $0 | $1.5M |
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