Why are Medicare and Medicaid shown separately instead of combined?

They come from two different CMS data sources with no shared claim identifier, so they can't be reconciled into one number without double-counting or guessing. Every table and chart on this page keeps them fully separate.

Why is there no private/commercial revenue figure?

Private and commercial payer data comes from Transparency in Coverage files, which only publish negotiated rates — not claims or utilization volume. Without a volume figure, no revenue number can be computed for any provider from that data.

What does "Rank" mean in the Competitive Analysis & Benchmarks tables?

For a given CPT/HCPCS code, it's this provider's position by claims volume among all providers billing that same code at that geography level (State, National, or Vermont for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Vermont only?

Medicaid is administered per-state with no single national fee schedule, so a state or national comparison the way Medicare has one isn't available. Vermont (this provider's own state) is the only grouping that's conceptually meaningful.

Why are the numbers rounded to the nearest 10?

To avoid implying more precision than the underlying data supports at a single-provider level. Ratios are kept precise since they're a relative comparison, not a volume or dollar figure.

How current is this data?

The Medicare and Medicaid tables are both single current snapshots, not refreshed on a recurring schedule yet.

Actd,llc (NPI 1508342114)

Key Findings

Field	Value
Entity Type	Organization
Organization	Actd,llc
Address	593 Hercules Dr
City	Colchester
State	VT
ZIP	05446
Taxonomy	Ambulatory Surgical Clinic/Center
NPI Enumerated	July 17, 2018

Payer Source	Total Paid
Medicare	$634.9K
Medicaid	$0

This entity is coded as an Ambulatory Surgical Clinic/Center and its Medicare billing mix is dominated by gastrointestinal endoscopy and colorectal procedures; the top three Medicare codes (45385, 45380, 43239) account for 48.5% of total Medicare revenue and reflect a high-volume colonoscopy/polypectomy and upper endoscopy practice within an ASC setting. The single largest line-item is 45385 (404 claims, $442 avg paid/claim, $178.6K revenue; 28.1% of Medicare revenue) indicating polypectomy is the core revenue driver.

Revenue concentration is high: the precomputed top-3 share (48.5%) shows nearly half of Medicare receipts derive from a small set of endoscopy codes. In particular, 45385 alone makes up 28.1% of Medicare revenue and both G0105 (124 claims, $413 avg paid/claim, $51.2K revenue) and G0121 (96 claims, $412 avg paid/claim, $39.6K revenue) also contribute materially, underscoring dependence on screening and diagnostic colonoscopy services.

Payer mix is effectively single-payer public coverage for this profile: lifetime Medicare revenue is $634.9K while Medicaid activity is absent (none below — this provider has no Medicaid billing on file), so public reimbursement exposure is concentrated in Medicare rather than a split Medicaid/Medicare mix. That concentration means competitive or policy changes in Medicare reimbursement for endoscopy and ASC services would disproportionately affect this provider.

Competitive standing in colorectal procedures is strong: 45385 ranks #430 of 16310 providers nationally (97th percentile) and 45380 ranks #972 of 16427 (94th percentile), which the source characterizes as "notably above typical national volume" for these colonoscopy-related codes. By contrast, other lines such as ophthalmology vitrectomy and retinal repair codes (for example 67042: 20 claims, $1500 avg paid/claim, $30K revenue; 67108: 19 claims, $1509 avg paid/claim, $28.7K revenue) have lower national standings (mid-to-lower percentile ranges) consistent with a modest presence in those specialty areas relative to national peers.

Service-line breadth beyond GI is present but secondary: the Medicare top-25 list includes ophthalmic retina surgeries (67042, 67108, 67041, 67036) and hand/nerve procedures (64721, 26055), showing the ASC bills for a mix of specialties. Several of those non-GI codes feature high per-claim payments (examples: 67042 and 67108 both show ~$1500 avg paid/claim) but occur in much smaller claim volumes, indicating these specialties supplement rather than replace the core endoscopy business.

Statistical outliers and labeling support a specialist profile: multiple colonoscopy/screening codes are flagged as "notably above typical national volume" (45385, G0105, G0121), while many other listed codes are characterized as "typical, unremarkable volume." This pattern suggests the provider is a regional or national outlier specifically for colorectal screening and polypectomy activity but a routine-volume participant across other procedure lines.

Tenure is established but not long-standing compared with legacy institutions: the NPI was enumerated 2018-07-17 (~8 years ago), indicating roughly eight years of Medicare billing history under this NPI. That tenure aligns with the observed concentration in a few high-volume GI codes that likely represent the clinic’s primary procedural focus developed since enumeration.

From an analyst perspective, risk and opportunity are both concentrated: a small set of endoscopy and colorectal screening codes drive a large share of Medicare revenue (top-3 = 48.5%), creating efficiency and scale in that service line but increasing sensitivity to procedural volume shifts or Medicare policy changes affecting colonoscopy reimbursement; meanwhile the absence of Medicaid billing (none (no Medicaid billing on file)) removes one payer hedge and reinforces dependence on Medicare volumes.

Medicare: Complete Services Breakdown

The CPT/HCPCS codes generating the most Medicare revenue for this provider.

18 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…	400	$440	$178.6K
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…	220	$360	$77.4K
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.	200	$260	$51.9K
G0105	Colorectal cancer screening; colonoscopy on individual at high risk	120	$410	$51.2K
G0121	Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk	100	$410	$39.6K
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…	50	$640	$32.5K
67042	In this procedure, the provider removes vitreous humor, the gelatinous material that gives shape to the eye, using a mechanical cutting tool. He removes the internal limiting membrane of the retina…	20	$1,500	$30K
67108	The provider repairs a detached retina using heat produced by a laser beam or by freezing the tissues. He may attach a scleral buckle to simplify the passage of fluid through and behind the retina or…	20	$1,510	$28.7K
26055	Trigger finger, or stenosing tenosynovitis, is when a finger remains in a bent position. It is painful to open or close the finger. A swollen tendon or formation of knots or nodules in the tendon may…	60	$480	$27.2K
67041	In this procedure, the provider removes scar tissue from the retinal membrane that obscures vision. He removes vitreous humor, the gelatinous material that gives shape to the eye, using a mechanical…	20	$1,510	$25.7K

Showing 1–10 of 18

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Planned Parenthood Of Northern New England, Inc	VT	Obstetrics & Gynecology Physician	$0	$3.9M
Vt Center For Dental Implants And Maxillofacial Surgery LLC	VT	Oral and Maxillofacial Surgery Clinic/Center	$0	$2.6M
Kids Rehabgym Inc.	VT	Physical Therapy Clinic/Center	$0	$2.5M
Saint Michaels College Fire And Rescue Inc	VT	Land Ambulance	$281.9K	$1.5M
Dennis Sanders	VT	Medical Oncology Physician	$1.3M	$0
Robert Duwors	VT	Clinical Psychologist	$45K	$1.1M
Town Of Colchester	VT	Land Ambulance	$163.6K	$638.6K
Vermont Center For Responder Wellness LLC	VT	Clinical Social Worker	$0	$719.1K
Counseling Connection Training Institute, Plc	VT	Mental Health Counselor	$0	$619.8K
Nicholas Hunter	VT	Clinical Psychologist	$0	$581.2K

Actd,llc — Billing Profile & Reimbursement Data

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Actd,llc — Billing Profile & Reimbursement Data

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Key Findings

Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
67042	1	10	20	$1,210	$20.6K
67108	1	10	20	$1,230	$19.7K
45385	1	30	60	$230	$19.6K
67041	1	10	20	$1,200	$18.1K
64721	2	10	40	$370	$13.2K
67036	2	10	10	$920	$12.8K
45390	1	10	10	$990	$10.9K
26055	2	10	40	$250	$9.7K
58558	1	10	10	$630	$7.5K
G0121	1	20	20	$220	$6.9K