Loading...
NPI 1548249675 · Santa Fe, NM · Ambulatory Surgical Clinic/Center
Customize your policy alerts
Get alerted when relevant policies change without checking for updates manually.
Monitor payer policy activity
Endoscopy Center Of Santa Fe LP is a ambulatory surgical clinic/center provider located in Santa Fe, New Mexico. This profile covers 10 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 | Endoscopy Center Of Santa Fe LP |
| Address | 1630 Hospital Dr |
| City | Santa Fe |
| State | NM |
| ZIP | 87505 |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| NPI Enumerated | January 17, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $1.3M |
| Medicare | $795.7K |
ENDOSCOPY CENTER OF SANTA FE LP operates as an ambulatory surgical/endoscopy-focused clinic: its Medicare top three codes are dominated by colonoscopy polypectomy and screening codes (45385, G0105, 45380), and those three codes account for 65.0% of the provider's $795.7K in total Medicare revenue. The code mix — heavy on polypectomy and screening colonoscopy — signals an outpatient GI procedural center that likely depends on scheduled endoscopic procedures rather than inpatient or broad ambulatory services.
Revenue concentration on Medicare is high and concentrated in a few procedural codes: 45385 alone contributes $331.8K (41.7% of the provider’s Medicare revenue) from 712 claims with an average paid per claim of $466, and the precomputed top-three share is 65.0% of Medicare revenue. National benchmarking shows 45385 ranks #161 of 16310 providers (99th percentile; extreme outlier), indicating unusually large national volume for this specific procedure relative to peers.
On Medicaid the provider is even more concentrated: the precomputed top-three Medicaid codes (45385, 45378, 43239) account for 76.6% of its $1.3M Medicaid revenue, with 45385 contributing $392.8K (30.2%), 45378 $330.6K (25.4%), and 43239 $273K (21.0%). This pattern reflects a Medicaid patient mix similarly reliant on colonoscopy and upper endoscopy procedures, suggesting Medicaid reimbursement trends and utilization flows are material drivers of overall revenue.
The payer mix favors Medicaid in scale: total Medicaid revenue ($1.3M) exceeds total Medicare revenue ($795.7K), indicating the center derives a larger absolute volume of revenue from Medicaid patients. Operationally, this asymmetry implies the practice’s financial exposure is more sensitive to state Medicaid policy and reimbursement than to Medicare alone.
Competitive standing versus national Medicare peers is mixed but notable: the provider is a clear national outlier on key colonoscopy measures (45385 ranks #161 of 16310, 99th percentile and labelled an "extreme outlier"; G0105 ranks #137 of 8773, 98th percentile and "extreme outlier"), and several upper endoscopy codes (e.g., 43235) also appear as extreme outliers. These rankings signal that, for certain high-revenue Medicare procedures, the center operates at much higher volumes than typical national peers.
State-level competitive positioning on Medicaid is strong but not uniformly dominant: 45385 ranks #5 of 16 in-state (73rd percentile; typical), 45378 ranks #4 of 29 (89th percentile; typical), and 43239 ranks #21 of 53 (62nd percentile; typical). In other words, the center is among the higher-volume Medicaid providers for colonoscopy sampling and related procedures in New Mexico, but it is not the singular statewide leader across all top codes.
The provider’s long tenure supports an established local presence: its NPI was enumerated on 2006-01-17 (~20 years ago), which is consistent with an operation that has sustained procedural volumes and payer relationships over an extended period. That longevity increases confidence that observed volume patterns reflect enduring service-lines rather than a short-term fluctuation.
Concentration and reimbursement mix create operational sensitivity: because the Medicare top three codes represent 65.0% of Medicare revenue and the Medicaid top three represent 76.6% of Medicaid revenue, changes to screening guidelines, colonoscopy referral patterns, or reimbursement for codes like 45385 and 45378 could materially affect overall revenue. The differing average paid/claim between payers for the same procedures (for example, 45385 average paid/claim is $466 for Medicare versus $313 for Medicaid) further underscores how payer composition will influence financial outcomes.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
10 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… | 710 | $470 | $331.8K |
| G0105 | Colorectal cancer screening; colonoscopy on individual at high risk | 240 | $420 | $100.7K |
| 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… | 230 | $360 | $84.8K |
| 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. | 310 | $260 | $79.9K |
| G0121 | Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk | 160 | $430 | $67.5K |
| 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. | 90 | $580 | $52.2K |
| 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. | 180 | $260 | $47.3K |
| 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… | 60 | $310 | $16.8K |
| 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. | 30 | $320 | $8.9K |
| 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 | $230 | $5.8K |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 10 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 |
|---|---|---|---|---|
| 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… | 1,260 | $310 | $392.8K |
| 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… | 1,060 | $310 | $330.6K |
| 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. | 1,090 | $250 | $273K |
| 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. | 690 | $230 | $160.5K |
| 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… | 470 | $300 | $143.6K |
| 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… | 180 | $0 | $0 |
How this provider's Medicaid billing volume and revenue compare to other New Mexico providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. New Mexico 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. | 21 | 50 | 300 | $260 | $436.4K |
| 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… | 14 | 30 | 420 | $320 | $352.7K |
| 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… | 5 | 20 | 490 | $330 | $292.2K |
| 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… | 4 | 30 | 70 | $330 | $122K |
| 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. | 3 | 20 | 110 | $270 | $81.7K |
| 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… | 7 | 10 | 210 | $1 | $40 |
Other providers in the same ZIP code as Endoscopy Center Of Santa Fe LP, 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.