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NPI 1548844384 · Dothan, AL · Ambulatory Surgical Clinic/Center
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Gut Endo, LLC is a ambulatory surgical clinic/center provider located in Dothan, Alabama. This profile covers 21 Medicare and 3 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 | Gut Endo, LLC |
| Address | 301 Medical Park Boulevard |
| City | Dothan |
| State | AL |
| ZIP | 36301 |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| NPI Enumerated | May 7, 2021 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $1.5M |
| Medicaid | $2.4K |
GUT ENDO, LLC operates primarily as an ambulatory endoscopy/surgical clinic focused on upper and lower GI procedures; its top Medicare revenue codes are dominated by colonoscopy and endoscopy services such as 45385, 43239, and 43249, indicating a clinical mix centered on diagnostic and therapeutic GI endoscopy including polypectomy and esophageal dilation. The presence of high-volume diagnostic and interventional EGD and colonoscopy codes suggests the facility functions as a procedural hub for GI care rather than as a primary care or broad outpatient specialty clinic.
Medicare revenue is the principal payer relationship by scale: total Medicare revenue is $1.5M versus total Medicaid revenue of $2.4K, indicating the provider is effectively single-payer dominant with Medicare comprising the overwhelming share of reported lifetime public-payer revenue. Medicaid activity is minimal in absolute dollars and concentrated entirely in a single code grouping for the state-level claims on file.
Revenue concentration on Medicare is high: the precomputed top 3 Medicare codes by revenue account for 58.4% of this provider's total Medicare revenue, so over half of Medicare receipts derive from a small number of endoscopy procedures (notably 45385, 43239, 43249). This concentration implies that changes in reimbursement or referral patterns for those specific procedures would materially affect the provider’s Medicare revenue base.
At the code level the provider shows outsized national standing on several Medicare CPTs. 45385 ranks #42 of 16310 providers (100th percentile) and is described as an extreme outlier, 43239 ranks #12 of 17140 providers (100th percentile, extreme outlier), and 43249 ranks #1 of 3500 providers (100th percentile, extreme outlier). These rank/percentile positions indicate GUT ENDO performs these procedures at volumes far above typical national peers and is a major national outlier for core revenue-driving services.
While several codes are extreme outliers, not all services show the same dominance: codes such as 64561 and G0121 sit at lower percentiles (59th and 90th respectively) and are characterized as typical or unremarkable volumes, indicating a mix of both highly concentrated, high-volume core procedures and a tail of routine or less-differentiated services. This mix suggests specialization in a narrow set of high-volume endoscopic interventions alongside more typical peri-procedural or screening codes.
Medicaid activity is tiny and fully concentrated: the precomputed top 3 Medicaid codes account for 100.0% of the provider’s total Medicaid revenue, and the only Medicaid-revenue-generating code listed is 43239 (95 claims, $25 avg paid/claim, $2.4K revenue) which ranks #37 of 64 in-state (43rd percentile) and is described as typical, unremarkable volume. In-state Medicaid participation is therefore modest and not a competitive strength for this provider.
Several Medicare codes indicate procedural breadth within GI endoscopy beyond routine diagnostic work: billed codes include dilations (43249, 43248, 43450), polypectomy/snare removals (45385, 45388), and hemorrhoidectomy techniques (46945, 46946). This pattern supports that the clinic provides both diagnostic and therapeutic endoscopic services, including therapeutic esophageal interventions and colorectal polypectomy/hemorrhoid procedures.
The provider’s NPI was enumerated on 2021-05-07 (~5 years ago), so it has an established but relatively recent operational tenure in the Medicare/Medicaid data. Given the concentrated, high-volume Medicare procedural activity soon after enumeration, the facility appears to have scaled quickly in its procedural niche.
Competitive implications: nationally, GUT ENDO is a dominant performer for several high-revenue Medicare codes (multiple 100th-percentile, extreme outlier rankings), which positions it as a significant procedural outlier among national peers for core endoscopic services. Conversely, its Medicaid footprint is negligible in revenue and middling in-state rank, so it should be classified as a Medicare-focused ambulatory surgery center with limited Medicaid market presence.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
21 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… | 1,130 | $350 | $398.5K |
| 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. | 1,400 | $180 | $256.6K |
| 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. | 450 | $480 | $217.9K |
| 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… | 660 | $250 | $165.1K |
| 64561 | The provider, under imaging guidance, implants electrodes around nerves in the sacral region to reduce the pain along the path of the nerve. | 30 | $3,070 | $95.2K |
| G0105 | Colorectal cancer screening; colonoscopy on individual at high risk | 200 | $340 | $68.2K |
| 46945 | In this procedure, the provider performs one of many techniques other than a rubber band technique to remove a single hemorrhoid or group. A hemorrhoid is a small swollen vessel in the rectum or… | 70 | $800 | $54.9K |
| 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… | 150 | $260 | $38.7K |
| 43259 | An esophagogastroduodenoscopy is a procedure to view the esophagus, stomach, and duodenum by means of flexible endoscope through the mouth. During this procedure, the physician uses endoscopic… | 60 | $480 | $27.4K |
| 46946 | The provider performs one of many techniques other than the rubber band technique to remove two or more hemorrhoids or groups. Hemorrhoids are small swollen vessels in the rectum or anus. | 30 | $800 | $26.3K |
Showing 1–10 of 21
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 21 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.
3 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. | 100 | $30 | $2.4K |
| 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… | 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… | 80 | $0 | $0 |
How this provider's Medicaid billing volume and revenue compare to other Alabama providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Alabama median
3 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 | 60 | 110 | $190 | $74.7K |
| 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… | 4 | 10 | 20 | $150 | $4.9K |
| 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… | 24 | 30 | 220 | $0 | $0 |
Other providers in the same ZIP code as Gut Endo, LLC, ranked by combined Medicare and Medicaid revenue.
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