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NPI 1558753095 · Honolulu, HI · Ambulatory Surgical Clinic/Center
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Pacific Endoscopy Center LLC is a ambulatory surgical clinic/center provider located in Honolulu, Hawaii. This profile covers 8 Medicare and 4 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 | Pacific Endoscopy Center LLC |
| Address | 1401 S Beretania St Ste 200 |
| City | Honolulu |
| State | HI |
| ZIP | 96814 |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| NPI Enumerated | February 20, 2015 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $724K |
| Medicare | $337.2K |
Business profile: PACIFIC ENDOSCOPY CENTER LLC (Ambulatory Surgical Clinic/Center) bills predominantly for GI endoscopy services across both payers, with high-revenue codes concentrated in colonoscopy and upper endoscopy procedures (notably 45385, 45380, 45384 and 43239/43252). The mix of therapeutic colonoscopy codes (polypectomy/snare and hot biopsy) and diagnostic EGD/biopsy procedures indicates the facility operates primarily as a focused endoscopy center rather than a broad multispecialty surgical clinic, consistent with its taxonomy and the procedure-level revenue profile reported to Medicare ($337.2K) and Medicaid ($724K).
Medicare revenue concentration: Medicare activity is highly concentrated in three colonoscopy-related codes—45385 (31.0%), 45380 (26.3%), and 45384 (13.1%)—which together account for 70.3% of the provider's total Medicare revenue. This concentration shows that a small set of therapeutic and diagnostic colonoscopy services drive the majority of the provider's Medicare billing.
Medicaid revenue concentration: Medicaid billing is even more concentrated, with 43239 (44.8%), 45385 (33.1%), and 45380 (12.2%) together representing 90.2% of total Medicaid revenue. The dominance of 43239 (upper endoscopy with biopsy) and 45385 (colonoscopic polypectomy/snare) on the Medicaid side suggests the center’s Medicaid caseload is driven by a mix of upper GI diagnostics and interventional colonoscopy.
Payer mix and scale: The provider receives materially more revenue from Medicaid ($724K) than from Medicare ($337.2K), indicating a Medicaid-heavy payer mix in absolute dollars. This scale difference implies operational dependence on Medicaid referrals and volume for overall revenue, rather than being effectively single-payer.
Competitive standing — Medicare: For its top Medicare colonoscopy codes the center ranks in the upper national percentiles (45385 at 92th percentile, 45380 at 94th percentile, 45384 at 88th percentile), which signals a stronger-than-average national presence for these procedures. Despite these upper-percentile ranks, the dataset characterizes the volumes for several of these codes as "typical, unremarkable," so the facility appears to be a notable but not extreme national participant for core colonoscopy services.
Competitive standing — Medicaid: In-state standings show 43239 ranks #5 of 31 providers in-state (87th percentile) and 45380 ranks #5 of 20 (79th percentile), indicating above-average state-level volume for upper endoscopy and diagnostic colonoscopy. The center is the statewide leader for 43252 (rank #1 of 2; 100th percentile) and posts respectable positions for 45385 (#7 of 19; 67th percentile), which together indicate it holds a meaningful but not monopolistic role in Hawaii’s Medicaid endoscopy market.
Statistical outliers and notable volume signals: On the Medicare side, code 45378 is flagged as "notably above typical national volume" (95th percentile) and contributes 8.9% of the provider’s Medicare revenue, implying disproportionately high use of colonoscopy brush/washings relative to peers. Conversely, 43252 shows divergent standing across payers—22th percentile nationally on Medicare but ranked #1 of 2 (100th percentile) in-state on Medicaid—highlighting a specific in-state specialization in advanced endomicroscopy for EGD when treating Medicaid patients.
Tenure and operational implication: The NPI was enumerated on 2015-02-20 (~11 years ago), indicating the center has an established operating history in the market. Combined with the strong revenue concentration in a few GI endoscopy codes, this tenure supports the view that the entity is a focused, veteran ambulatory endoscopy operator serving both Medicare and Medicaid populations.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
8 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… | 200 | $510 | $104.3K |
| 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… | 220 | $400 | $88.5K |
| 45384 | The provider examines the rectum and colon using a flexible colonoscope, a tubular instrument with a light source and camera. He removes one or more tumors, polyps, or other lesions using hot biopsy… | 100 | $430 | $44.3K |
| 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. | 130 | $240 | $32.7K |
| 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… | 80 | $380 | $30.1K |
| 43252 | An esophagogastroduodenoscopy is a procedure to view the esophagus, stomach, and duodenum by means of a flexible endoscope passed through the mouth. The provider uses an endomicroscopy system to… | 20 | $1,370 | $23.3K |
| G0121 | Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk | 20 | $490 | $8.4K |
| 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 | $260 | $5.5K |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 8 CPT/HCPCS codes.
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.
4 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. | 1,170 | $280 | $324.7K |
| 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… | 420 | $570 | $239.8K |
| 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… | 670 | $130 | $88.4K |
| 43252 | An esophagogastroduodenoscopy is a procedure to view the esophagus, stomach, and duodenum by means of a flexible endoscope passed through the mouth. The provider uses an endomicroscopy system to… | 60 | $1,110 | $71.2K |
How this provider's Medicaid billing volume and revenue compare to other Hawaii providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Hawaii median
4 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average 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… | 7 | 20 | 90 | $550 | $222.1K |
| 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 | 190 | $340 | $177.3K |
| 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. | 5 | 30 | 100 | $280 | $111.1K |
| 43252 | An esophagogastroduodenoscopy is a procedure to view the esophagus, stomach, and duodenum by means of a flexible endoscope passed through the mouth. The provider uses an endomicroscopy system to… | 1 | 10 | 60 | $630 | $37.1K |
Other providers in the same ZIP code as Pacific Endoscopy Center LLC, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Walgreen Co | HI | Pharmacy | $0 | $25.3M |
| Mastercare Inc | HI | Nursing Care Agency | $0 | $10.8M |
| Attention Plus Private Nursing, Inc. | HI | Nursing Care Agency | $0 | $7.7M |
| Heaven's Helpers, Inc. | HI | In Home Supportive Care Agency | $0 | $4.5M |
| Heaven's Helpers, Inc. | HI | Nursing Care Agency | $0 | $4M |
| Honolulu Imaging Center, LLC | HI | Diagnostic Radiology Physician | $2.6M | $1.1M |
| Eugene W M Ng Md LLC | HI | Ophthalmology Physician | $0 | $3.7M |
| Bayada Home Care | HI | In Home Supportive Care Agency | $0 | $3.6M |
| B Homecare L.L.C. | HI | In Home Supportive Care Agency | $0 | $3.5M |
| Hawaii Diagnostic Radiology Services LLC | HI | Diagnostic Radiology Physician | $0 | $3.2M |
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