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NPI 1710315619 · Ogden, UT · Ambulatory Surgical Clinic/Center
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Ridgeline Surgicenter, LLC is a ambulatory surgical clinic/center provider located in Ogden, Utah. This profile covers 9 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 | Ridgeline Surgicenter, LLC |
| Address | 6028 S Ridgeline Dr |
| City | Ogden |
| State | UT |
| ZIP | 84405 |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| NPI Enumerated | October 31, 2013 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $560.8K |
| Medicaid | $175.7K |
RIDGELINE SURGICENTER, LLC is classified as an Ambulatory Surgical Clinic/Center and its Medicare and Medicaid billing mix is concentrated in endoscopy and GI procedural work. The top billed CPT/HCPCS codes across both payers are colonoscopy and upper endoscopy procedures (examples include 45385, 45380, 43239 and 43249), indicating the facility operates as a focused GI endoscopy center performing diagnostic and therapeutic procedures such as polypectomy, biopsy, and esophageal dilation.
Medicare revenue is $560.8K with a strong concentration in three codes: 45385 ($160.4K, 28.6%), 43239 ($102.1K, 18.2%), and 45380 ($95.8K, 17.1%). Those top three Medicare codes together account for 63.9% of this provider's total Medicare revenue, highlighting reliance on a small set of high-yield endoscopy services for Medicare income.
Medicaid revenue totals $175.7K and is entirely accounted for by the provider's three highest Medicaid codes: 43239 ($142K, 80.7%), 45380 ($28K, 15.9%), and 45385 ($6K, 3.4%). The precomputed metric shows the top three Medicaid codes represent 100.0% of Medicaid revenue, indicating Medicaid billing is almost exclusively for the same narrow set of GI procedures.
Comparing payer scale, the provider reports substantially larger Medicare revenue ($560.8K) than Medicaid revenue ($175.7K), so Medicare is the dominant payer by dollar volume in the available data. This is not a single-payer operation; both payers are active, but Medicare drives the majority of reported revenue.
Competitive standing differs by payer and by code: for Medicare the provider is a high-volume national performer on several codes — 43239 ranks #331 of 17140 providers nationally (98th percentile) and is classified as an "extreme outlier, far above typical national volume," while 43249 ranks #44 of 3500 (99th percentile) and is also labeled an "extreme outlier." Codes 45385 and 45380 rank in high national percentiles as well (97th and 96th respectively) and are described as "notably above typical national volume," signaling strong national-level activity for selected endoscopy procedures.
By contrast, Medicaid ranks are modest within the state: 43239 is #7 of 48 in-state (87th percentile) but described as "typical, unremarkable volume" for Medicaid peers, 45380 is mid-ranked (#13 of 26, 52nd percentile), and 45385 is lower-ranked (#10 of 13, 25th percentile). In short, this center appears to be a national high-volume outlier on specific Medicare-coded endoscopy services while holding a more typical or modest position among in-state Medicaid providers for the same procedures.
There is a clear procedural specialization: the top-revenue CPTs indicate routine performance of colonoscopy with polypectomy/therapy (45385), colonoscopy with biopsy (45380 and G0105/G0121 screening codes), and upper endoscopy with biopsy (43239), plus esophageal dilation (43249 and 43450). This mix suggests case throughput centered on screening, diagnostic biopsies, and endoscopic therapeutic interventions rather than a broad surgical portfolio.
The provider's NPI was enumerated on 2013-10-31 (~13 years ago), indicating an established operating history; combined with sustained high national percentiles on key Medicare endoscopy codes, this suggests a stable, specialized ambulatory endoscopy practice that has maintained significant volume for several years.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
9 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… | 370 | $430 | $160.4K |
| 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. | 460 | $220 | $102.1K |
| 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… | 260 | $360 | $95.8K |
| 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. | 150 | $550 | $81.4K |
| G0105 | Colorectal cancer screening; colonoscopy on individual at high risk | 130 | $400 | $52.3K |
| G0121 | Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk | 80 | $400 | $29.7K |
| 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. | 80 | $260 | $19.4K |
| 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… | 40 | $310 | $13.5K |
| 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 | $250 | $6K |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 9 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. | 1,300 | $110 | $142K |
| 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… | 120 | $230 | $28K |
| 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… | 30 | $210 | $6K |
How this provider's Medicaid billing volume and revenue compare to other Utah providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Utah 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. | 7 | 50 | 250 | $80 | $40.9K |
| 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 | 10 | 90 | $110 | $30.9K |
| 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… | 13 | 30 | 120 | $70 | $24.9K |
Other providers in the same ZIP code as Ridgeline Surgicenter, LLC, ranked by combined Medicare and Medicaid revenue.
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