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NPI 1700879467 · West Des Moines, IA · Endoscopy Clinic/Center
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The Iowa Clinic Endoscopy Center LLC is a endoscopy clinic/center provider located in West Des Moines, Iowa. This profile covers 10 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 | The Iowa Clinic Endoscopy Center LLC |
| Address | 5950 University Ave |
| City | West Des Moines |
| State | IA |
| ZIP | 50266 |
| Taxonomy | Endoscopy Clinic/Center |
| NPI Enumerated | August 29, 2005 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $1.1M |
| Medicaid | $130.1K |
The Iowa Clinic Endoscopy Center LLC is an established endoscopy-focused outpatient center (Taxonomy: Endoscopy Clinic/Center) with NPI enumeration on 2005-08-29 (~21 years ago), indicating long-standing operations in the West Des Moines market. The facility’s Medicare and Medicaid billing patterns are concentrated in endoscopic diagnostic and therapeutic procedures, consistent with an ambulatory endoscopy service line.
Medicare dominates the payer mix by scale: the provider reported Total Medicare revenue of $1.1M versus Total Medicaid revenue of $130.1K, making Medicare the principal revenue source. This imbalance suggests the center’s commercial and Medicare-facing volumes are the primary drivers of its business, while Medicaid represents a much smaller portion of activity.
Revenue concentration on Medicare is high: the precomputed top-3 Medicare codes account for 74.6% of this provider’s total Medicare revenue, driven mainly by 45385, 45380, and 43239. Specifically, 45385 generated $488.9K (46.2% of Medicare revenue; 1.1K claims, $427 avg paid/claim), 45380 generated $175.8K (16.6%; 558 claims, $315 avg paid/claim), and 43239 generated $125.2K (11.8%; 478 claims, $262 avg paid/claim), indicating dependence on a narrow set of high-value endoscopic services.
Procedure mix shows a therapeutic and screening emphasis: top Medicare codes include 45385 (polypectomy/snare removal), 45380 (colonoscopy with biopsy), and screening-specific codes G0121 and G0105 (colorectal cancer screening for average- and high-risk individuals). The presence of both therapeutic polypectomy (45385) and screening colonoscopy codes suggests the center performs a blend of screening and intervention-focused colonoscopies rather than only diagnostic evaluations.
Competitive standing on Medicare indicates unusually high volume for core procedures: 45385 ranks #37 of 16310 providers nationally (100th percentile; extreme outlier), 45380 ranks #181 of 16427 (99th percentile; extreme outlier), and 43239 ranks #316 of 17140 (98th percentile; extreme outlier). Those rank/percentile labels signal this center is a major national outlier in volume for several flagship endoscopy services, likely reflecting a high-throughput ambulatory endoscopy operation.
By contrast, Medicaid activity is fully concentrated in the top three codes: the precomputed top-3 Medicaid codes account for 100.0% of this provider’s Medicaid revenue, with 43239 ($83.8K, 296 claims, $283 avg paid/claim) accounting for 64.4% of Medicaid revenue, 45385 ($27.6K, 72 claims, $383 avg paid/claim) for 21.2%, and 45380 ($18.8K, 65 claims, $289 avg paid/claim) for 14.4%. Statewide rankings for these Medicaid codes are middling: 43239 ranks #27 of 56 in-state (53th percentile; typical, unremarkable volume), 45385 ranks #10 of 25 (63th percentile; typical, unremarkable volume), and 45380 ranks #14 of 23 (41th percentile; typical, unremarkable volume), indicating the practice is not a dominant Medicaid provider in Iowa even though it is high-volume on Medicare.
Operational implications include a likely workflow optimized for high-volume colonoscopy and upper endoscopy procedures with associated pathology (biopsy) and therapeutic capabilities (polypectomy and dilation). The presence of 43249 (esophageal dilation, $68.2K Medicare revenue) and both screening codes G0121 ($83.3K Medicare revenue) and G0105 ($68.4K Medicare revenue) further suggests the center provides both therapeutic interventions and organized screening services.
Risk/variance signal: the provider’s Medicare rank and percentile labels describe it as an “extreme outlier” on several high-revenue codes, which is an important competitive marker rather than an implication of improper practice. Analysts should interpret these labels as evidence of unusually high procedure volumes relative to national peers and consider them when benchmarking capacity, referral patterns, or regional market share for endoscopy services.
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… | 1,150 | $430 | $488.9K |
| 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… | 560 | $320 | $175.8K |
| 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. | 480 | $260 | $125.2K |
| G0121 | Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk | 210 | $400 | $83.3K |
| G0105 | Colorectal cancer screening; colonoscopy on individual at high risk | 170 | $390 | $68.4K |
| 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. | 130 | $530 | $68.2K |
| 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. | 70 | $300 | $21.6K |
| 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… | 60 | $300 | $16.9K |
| 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… | 20 | $270 | $6.2K |
| 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 | $300 | $4.8K |
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.
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. | 300 | $280 | $83.8K |
| 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… | 70 | $380 | $27.6K |
| 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… | 70 | $290 | $18.8K |
How this provider's Medicaid billing volume and revenue compare to other Iowa providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Iowa 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. | 27 | 60 | 260 | $210 | $109.2K |
| 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… | 14 | 20 | 90 | $270 | $85.7K |
| 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… | 10 | 30 | 60 | $280 | $43.2K |
Other providers in the same ZIP code as The Iowa Clinic Endoscopy Center LLC, ranked by combined Medicare and Medicaid revenue.
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