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NPI 1598042343 · Las Cruces, NM · Endoscopy Clinic/Center
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Lohman Endoscopy Center, LLC is a endoscopy clinic/center provider located in Las Cruces, New Mexico. This profile covers 11 Medicare and 10 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 | Lohman Endoscopy Center, LLC |
| Address | 4381 E Lohman Ave |
| City | Las Cruces |
| State | NM |
| ZIP | 88011 |
| Taxonomy | Endoscopy Clinic/Center |
| NPI Enumerated | November 8, 2011 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $4.5M |
| Medicare | $787.8K |
LOHMAN ENDOSCOPY CENTER, LLC’s code mix is characteristic of an ambulatory endoscopy center focused on both diagnostic and therapeutic GI procedures: its highest-revenue Medicare codes are 45385 (polypectomy, $235.4K, 29.9%), 45380 (colonoscopy with biopsy, $163.3K, 20.7%) and 43239 (EGD with biopsy, $157.4K, 20.0%), and Medicaid billing is similarly dominated by 43239 (EGD with biopsy), 45385 and 45380. The presence of screening codes G0121 and G0105 across payers and the procedural codes 43248 (esophageal dilation) and 45378 (colonic brush/washings) indicate the site performs a mix of routine screening, diagnostic endoscopy, and therapeutic interventions rather than only consults or outpatient diagnostics. This operational profile implies high procedure throughput and endoscopy-specific staffing, equipment, and pathology utilization.
Revenue concentration is high on both payers: the top three Medicare codes account for 70.6% of the provider’s Medicare revenue, and the top three Medicaid codes account for 80.9% of the provider’s Medicaid revenue. At the Medicare level those top codes are 45385 ($235.4K, 29.9%), 45380 ($163.3K, 20.7%) and 43239 ($157.4K, 20.0%), while at the Medicaid level the top drivers are 43239 ($1.8M, 41.0%), 45385 ($888.2K, 20.0%) and 45380 ($886.2K, 19.9%), indicating a concentrated revenue base around a small set of endoscopic procedures. High concentration around a few codes increases sensitivity of total revenue to changes in volume, reimbursement, or referral patterns for those procedures.
Payer mix is heavily weighted toward Medicaid: total Medicaid revenue is $4.5M versus total Medicare revenue of $787.8K, so Medicaid is the larger payer relationship for this facility. While Medicare is not absent, the scale of Medicaid billing suggests the center operates primarily within networks or referral streams that generate state-program volume, and contracting or policy changes at the state Medicaid level would have outsized impact on overall revenue. The provider therefore appears effectively Medicaid-dominant in scale.
On Medicare measures this provider reports volumes that are extreme relative to national peers: 45385 ranks #274 of 16310 providers nationally (98th percentile; extreme outlier), 45380 ranks #235 of 16427 (99th percentile; extreme outlier), and 43239 ranks #119 of 17140 (99th percentile; extreme outlier). Those national percentile positions indicate this site delivers far higher per-provider volumes for key colonoscopy and upper endoscopy procedures than typical national peers, consistent with a high-throughput specialty endoscopy operation. Analysts should therefore view Medicare volumes as substantially concentrated and above typical national facility-level throughput for these codes.
Within New Mexico Medicaid the provider is a leading in-state performer on its throughput-heavy codes: 45385 ranks #1 of 16 providers in-state (100th percentile; notably above typical state volume), 45380 ranks #2 of 28 (96th percentile; notably above typical), and 43239 ranks #4 of 53 (94th percentile; notably above typical). These statewide ranks show the center plays a major role in delivering both colonoscopic polypectomy and diagnostic EGD services for Medicaid enrollees in-state, and it is often the top or near-top billing site for those services. For payers and competitors, this signals a strong local market position for high-revenue endoscopy procedures.
The statistical labels attached to specific codes reinforce the operational story: multiple Medicare codes are labeled “extreme outlier” and several Medicaid codes are “notably above typical,” which in plain terms means the provider’s procedure volumes are unusually high relative to peers. That pattern suggests concentrated referral sources and sustained procedural throughput rather than sporadic or occasional endoscopy activity, and it implies predictable downstream needs (pathology, anesthesia, recovery bed turnover) tied to these high-volume procedures. Risk and capacity planning for networks contracting with this site should account for that sustained, above-typical procedural load.
The provider has an established operating history with an NPI enumeration date of 2011-11-08 (~15 years ago), indicating over a decade of presence in the market. This tenure, combined with the concentrated, high-volume code mix and top in-state rankings, supports the interpretation of a stable, specialized endoscopy center rather than a new or transient practice. For payer network strategy and utilization management, the facility’s longevity plus concentrated volume underlines its potential importance as a regional endoscopy hub.
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… | 550 | $430 | $235.4K |
| 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… | 490 | $330 | $163.3K |
| 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. | 710 | $220 | $157.4K |
| G0121 | Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk | 160 | $400 | $64.1K |
| G0105 | Colorectal cancer screening; colonoscopy on individual at high risk | 140 | $400 | $56K |
| 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… | 170 | $280 | $47.6K |
| 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… | 110 | $310 | $33.6K |
| 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. | 60 | $260 | $14.5K |
| 45331 | In this procedure, the provider examines the inner part of the rectum and the sigmoid colon using a sigmoidoscope, a flexible, narrow tube with a camera at its one end. He then takes one or more… | 20 | $310 | $7.4K |
| 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 | $250 | $6.9K |
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.
10 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. | 7,550 | $240 | $1.8M |
| 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… | 2,940 | $300 | $888.2K |
| 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… | 3,320 | $270 | $886.2K |
| 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… | 1,770 | $300 | $523.9K |
| 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… | 620 | $210 | $131.9K |
| G0121 | Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk | 420 | $290 | $121.3K |
| 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. | 310 | $220 | $67.5K |
| G0105 | Colorectal cancer screening; colonoscopy on individual at high risk | 10 | $250 | $3.5K |
| 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… | 830 | $1 | $830 |
| G8918 | Patient without preoperative order for iv antibiotic surgical site infection (ssi) prophylaxis | 800 | $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
10 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 | 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… | 2 | 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… | 1 | 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… | 2 | 30 | 70 | $330 | $122K |
| G0121 | Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk | 2 | 10 | 140 | $380 | $93.8K |
| 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. | 7 | 20 | 110 | $270 | $81.7K |
| 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… | 1 | 10 | 390 | $180 | $72.8K |
| G0105 | Colorectal cancer screening; colonoscopy on individual at high risk | 2 | 10 | 40 | $410 | $15.1K |
| 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… | 3 | 10 | 210 | $1 | $40 |
| G8918 | Patient without preoperative order for iv antibiotic surgical site infection (ssi) prophylaxis | 2 | 10 | 560 | $0 | $0 |
Other providers in the same ZIP code as Lohman Endoscopy Center, LLC, ranked by combined Medicare and Medicaid revenue.
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