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NPI 1508835299 · Anchorage, AK · Ambulatory Surgical Clinic/Center
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Alaska Digestive Center, LLC is a ambulatory surgical clinic/center provider located in Anchorage, Alaska. This profile covers 11 Medicare and 6 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 | Alaska Digestive Center, LLC |
| Address | 4048 Laurel St |
| City | Anchorage |
| State | AK |
| ZIP | 99508 |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| NPI Enumerated | March 15, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $1.6M |
| Medicare | $759.7K |
ALASKA DIGESTIVE CENTER, LLC operates like a gastrointestinal ambulatory surgical clinic focused on endoscopy: its Medicare and Medicaid revenue is dominated by colonoscopy and upper endoscopy procedures (notably 45385, 45380 and 43239), consistent with its taxonomy as an Ambulatory Surgical Clinic/Center. The top-revenue CPTs are procedures for polypectomy, diagnostic colonoscopy with biopsy, and EGD with biopsy, indicating the facility’s primary service line is diagnostic and therapeutic endoscopy rather than broad outpatient surgery services.
Medicare revenue is concentrated in a very small set of CPTs: the top 3 Medicare codes by revenue account for 73.7% of this provider's total Medicare revenue, with 45385 generating $326.5K (43.0% of Medicare revenue), 45380 generating $121.9K (16.0%), and 43239 generating $111.8K (14.7%). This concentration, on a total Medicare revenue base of $759.7K, means a handful of endoscopy procedures drive most Medicare payments to the clinic.
On Medicaid the concentration is even more pronounced: the top 3 Medicaid codes by revenue account for 96.9% of this provider's total Medicaid revenue. Those codes are 43239 ($820.5K, 51.5% of Medicaid revenue), 45385 ($459.5K, 28.8%), and 45380 ($264.1K, 16.6%), against a total Medicaid revenue of $1.6M, indicating that virtually all Medicaid billing is for the same narrow set of endoscopic services.
This provider’s payer mix is skewed toward Medicaid: reported lifetime Medicaid revenue is $1.6M versus total Medicare revenue of $759.7K, so Medicaid represents the larger single payer relationship on file. Analysts should treat the clinic as effectively Medicaid-weighted for scale and potential reimbursement impact in this market.
Competitive standing differs by payer scope: nationally for Medicare the provider is an outlier on 45385 (ranks #198 of 16310, 99th percentile; characterized as an "extreme outlier") and is notably above typical national volume on 45380 and 43239 (97th percentile ranks). In-state for Medicaid the practice ranks among the leaders for these same services—43239 ranks #4 of 30 in-state (90th percentile; notably above typical state volume) and 45385 ranks #2 of 10 in-state (89th percentile)—marking it as a major in-state supplier of endoscopy and EGD care.
The provider has an established presence, with NPI enumeration dated 2006-03-15 (~20 years ago), which supports interpretation of these billing patterns as the output of a stable ambulatory endoscopy practice rather than a recent entrant or short-term program. Longevity strengthens the signal that high volumes reflect sustained clinical focus.
High procedural concentration presents operational and reimbursement sensitivity: because top-3 Medicare codes account for 73.7% of Medicare revenue and top-3 Medicaid codes account for 96.9% of Medicaid revenue, changes in endoscopy reimbursement, referral patterns, or screening guidelines could disproportionately affect overall revenue. This limited service diversification increases exposure to payer policy shifts or changes in utilization of colonoscopy/EGD services.
Medicaid billing includes large counts for zero-paid quality/administrative codes (G8918: 268 claims, $0 revenue, ranked #1 of 6 in-state; G8907: 254 claims, $0 revenue, ranked #2 of 9 in-state), which suggests consistent use of facility-level quality/documentation codes in state reporting. These zero-paid items do not drive revenue but are notable operational signals that the clinic is actively submitting quality/administrative claims alongside high-volume procedural billing.
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… | 640 | $510 | $326.5K |
| 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… | 330 | $380 | $121.9K |
| 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. | 400 | $280 | $111.8K |
| G0105 | Colorectal cancer screening; colonoscopy on individual at high risk | 160 | $460 | $73K |
| G0121 | Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk | 130 | $470 | $58.6K |
| 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… | 90 | $330 | $28.3K |
| 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… | 50 | $350 | $16.3K |
| 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… | 30 | $290 | $7.3K |
| 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… | 10 | $620 | $6.8K |
| 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. | 20 | $310 | $5.8K |
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.
6 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. | 1,610 | $510 | $820.5K |
| 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… | 990 | $470 | $459.5K |
| 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… | 510 | $520 | $264.1K |
| 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… | 70 | $710 | $49.4K |
| 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… | 250 | $0 | $0 |
| G8918 | Patient without preoperative order for iv antibiotic surgical site infection (ssi) prophylaxis | 270 | $0 | $0 |
How this provider's Medicaid billing volume and revenue compare to other Alaska providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Alaska median
6 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 | 30 | 50 | $510 | $233.5K |
| 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… | 5 | 20 | 100 | $470 | $215.5K |
| 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… | 2 | 10 | 70 | $440 | $200.5K |
| 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… | 2 | 10 | 20 | $610 | $157.9K |
| 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… | 2 | 10 | 90 | $0 | $0 |
| G8918 | Patient without preoperative order for iv antibiotic surgical site infection (ssi) prophylaxis | 1 | 10 | 40 | $0 | $0 |
Other providers in the same ZIP code as Alaska Digestive Center, LLC, ranked by combined Medicare and Medicaid revenue.
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