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NPI 1720262405 · Baton Rouge, LA · Ambulatory Surgical Clinic/Center
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Baton Rouge La Endoscopy Asc LLC is a ambulatory surgical clinic/center provider located in Baton Rouge, Louisiana. This profile covers 17 Medicare and 6 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 | Baton Rouge La Endoscopy Asc LLC |
| Address | 9103 Jefferson Hwy |
| City | Baton Rouge |
| State | LA |
| ZIP | 70809 |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| NPI Enumerated | December 18, 2007 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $1.7M |
| Medicaid | $125.2K |
Business profile: BATON ROUGE LA ENDOSCOPY ASC LLC is registered as an Ambulatory Surgical Clinic/Center and its CPT mix is dominated by gastrointestinal endoscopy procedures (colonoscopies, colonoscopic polypectomy/biopsy, and upper endoscopy with biopsy), led by 45385, 45380 and 43239. The presence of therapeutic codes (45385 snare polypectomy, 43249 dilation) alongside diagnostic biopsy codes indicates an ASC-focused, procedure-driven GI practice that performs both screening and interventional endoscopy on an ongoing basis.
Medicare revenue concentration: Medicare billing is concentrated in a few high-revenue codes — the precomputed top‑3 Medicare codes account for 60.9% of this provider's total Medicare revenue. Specifically, 45385 ($562.6K, 33.6%), 45380 ($238.5K, 14.3%) and 43239 ($217.6K, 13.0%) together form the core of the $1.7M Medicare portfolio, signaling reliance on colonoscopy and upper endoscopy services for Medicare income.
Medicaid revenue concentration: Medicaid billing is extremely concentrated, with the precomputed top‑3 Medicaid codes accounting for 98.0% of total Medicaid revenue. The Medicaid mix is dominated by 43239 ($72.5K, 57.7%) and 45385 ($41K, 32.6%), with 45380 contributing $9.7K (7.7%) to a total Medicaid revenue of $125.2K, indicating that nearly all Medicaid receipts come from the same endoscopy service lines as Medicare.
Payer mix and scale: The provider’s Medicare footprint ($1.7M) is substantially larger than its Medicaid footprint ($125.2K), making Medicare the primary revenue source by scale. This disparity suggests the ASC’s business is largely driven by Medicare patients while Medicaid represents only a modest portion of overall billing.
Medicare competitive standing: For multiple high‑revenue Medicare codes the provider ranks among national leaders — 45385 ranks #15 of 16310 (100th percentile; extreme outlier), 45380 ranks #70 of 16427 (100th percentile; extreme outlier), and 43239 ranks #28 of 17140 (100th percentile; extreme outlier). These ranks and percentile labels indicate the facility is a high‑volume national outlier for core colonoscopy and EGD procedures relative to peers.
Medicaid competitive standing: By contrast, in-state Medicaid rankings show the provider is a typical or modest participant for its top Medicaid codes — 43239 ranks #28 of 163 in-state (83th percentile), 45385 ranks #19 of 68 in-state (73th percentile), and 45380 ranks #32 of 72 in-state (56th percentile). Those percentiles suggest normal to above‑median Medicaid activity statewide but not the same national outlier status observed in Medicare.
Procedure-level outlier signals: Beyond the top three, several additional Medicare codes are flagged at very high national percentiles or described as extreme outliers (for example G0105, 43249, G0121, 43248, 45378, 43235), which reinforces that high procedural volume spans both diagnostic and therapeutic endoscopy. The pattern of extreme outlier labels across multiple codes points to sustained, broad throughput in GI procedures rather than isolated spikes in a single code.
Tenure and operational implication: The NPI was enumerated 2007-12-18 (~19 years ago), indicating the ASC has been operational for nearly two decades. Combined with persistent, high-volume Medicare billing, this tenure supports an interpretation of an established GI-focused ambulatory surgical center with mature referral and case-flow processes.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
17 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… | 1,410 | $400 | $562.6K |
| 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… | 780 | $310 | $238.5K |
| 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. | 1,080 | $200 | $217.6K |
| G0105 | Colorectal cancer screening; colonoscopy on individual at high risk | 520 | $370 | $189.9K |
| 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. | 210 | $510 | $109.1K |
| G0121 | Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk | 210 | $370 | $78.5K |
| 44361 | The provider uses an endoscope to examine the intestines for abnormalities, going past the second part of the duodenum but not including the ileum, the last part of the small intestine. He also takes… | 150 | $520 | $77.7K |
| 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… | 230 | $250 | $57.3K |
| 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… | 130 | $250 | $31.5K |
| 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. | 130 | $230 | $30.1K |
Showing 1–10 of 17
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 17 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.
6 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. | 1,810 | $40 | $72.5K |
| 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… | 860 | $50 | $41K |
| 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 | $40 | $9.7K |
| 44361 | The provider uses an endoscope to examine the intestines for abnormalities, going past the second part of the duodenum but not including the ileum, the last part of the small intestine. He also takes… | 30 | $60 | $1.9K |
| 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… | 10 | $50 | $650 |
| 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… | 570 | $0 | $0 |
How this provider's Medicaid billing volume and revenue compare to other Louisiana providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Louisiana median
6 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. | 28 | 160 | 380 | $170 | $194.7K |
| 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… | 19 | 70 | 230 | $190 | $115.1K |
| 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… | 32 | 70 | 190 | $160 | $98K |
| 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… | 9 | 10 | 770 | $50 | $78.4K |
| 44361 | The provider uses an endoscope to examine the intestines for abnormalities, going past the second part of the duodenum but not including the ileum, the last part of the small intestine. He also takes… | 1 | 10 | 20 | $80 | $1.8K |
| 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… | 21 | 50 | 320 | $0 | $0 |
Other providers in the same ZIP code as Baton Rouge La Endoscopy Asc LLC, ranked by combined Medicare and Medicaid revenue.
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