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NPI 1750616249 · Boise, ID · Ambulatory Surgical Clinic/Center
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Idaho Endoscopy Center LLC is a ambulatory surgical clinic/center provider located in Boise, Idaho. This profile covers 12 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 | Idaho Endoscopy Center LLC |
| Address | 6259 W Emerald St |
| City | Boise |
| State | ID |
| ZIP | 83704 |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| NPI Enumerated | October 16, 2009 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $1.3M |
| Medicare | $787.8K |
The provider’s taxonomy (Ambulatory Surgical Clinic/Center) and its dominant CPT mix indicate a focused GI endoscopy operation: high-volume colonoscopy with polypectomy (45385), diagnostic and biopsy colonoscopy (45380), and upper endoscopy with biopsy (43239) are the primary services billed. Additional codes for esophageal dilation (43248) and endoscopic sampling (45378) further support that this location functions as an outpatient endoscopy center rather than a general outpatient clinic.
Medicare revenue is concentrated in a small set of procedures: the top 3 Medicare codes (45385, 45380, 43239) account for 72.4% of total Medicare revenue, with 45385 alone representing 47.4% of Medicare revenue. This concentration signals that colonoscopic therapeutic procedures (especially polypectomy) are the main Medicare revenue drivers for this entity.
Medicaid revenue is even more concentrated: the top 3 Medicaid codes (45385, 43239, 45380) account for 91.3% of total Medicaid revenue, with 45385, 43239, and 45380 contributing 33.8%, 33.0%, and 24.4% respectively. The Medicaid billing profile mirrors Medicare’s focus on colonoscopy and upper endoscopy but shows an even heavier dependence on those few CPTs for overall revenue.
On scale and payer mix, this facility reports $787.8K in total Medicare revenue versus $1.3M in total Medicaid revenue, so Medicaid represents the larger single-payer revenue source. The difference in scale suggests that payers and network managers should treat this as a Medicaid-heavy ambulatory endoscopy provider in negotiations and utilization reviews.
Competitive standing for key Medicare codes shows unusually high national volume: 45385 ranks #99 of 16310 providers (99th percentile; extreme outlier, far above typical national volume for this code), while 45380 and 43239 rank in the 96th and 98th percentiles respectively (both described as notably above typical national volume). Those rank positions indicate the provider is a national high-volume outlier for colonoscopic polypectomy and maintains well-above-typical volumes for diagnostic colonoscopy and upper endoscopy on Medicare.
In-state competitive positioning on Medicaid is similarly strong for core GI services: 45385 ranks #1 of 12 providers in-state (100th percentile; notably above typical state volume for this code), 43239 ranks #3 of 35 (94th percentile; notably above typical state volume), and 45380 ranks #2 of 18 (94th percentile; notably above typical state volume). These ranks indicate the center is a dominant statewide provider for both therapeutic and diagnostic endoscopic procedures.
Claim volumes reported underscore operational throughput: Medicare shows 835 claims for 45385 (avg paid/claim $447) and 423 claims for 43239 (avg paid/claim $232), while Medicaid shows 1.2K claims for 45385 (avg paid/claim $358) and 1.9K claims for 43239 (avg paid/claim $223). The high claim counts across both payers are consistent with a high-throughput ambulatory endoscopy center and support the rank-based characterization as a major procedural site.
The practice has an established tenure with NPI enumerated 2009-10-16 (~17 years ago). On Medicaid the presence of G8907 (136 claims, $0 avg paid/claim) appears in the billing mix as a revenue-neutral safety documentation code at typical, unremarkable volumes, indicating standard reporting of peri-procedural safety events without associated reimbursement impact.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
12 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… | 840 | $450 | $373.2K |
| 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… | 290 | $340 | $99K |
| 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. | 420 | $230 | $98.1K |
| G0105 | Colorectal cancer screening; colonoscopy on individual at high risk | 180 | $410 | $73K |
| 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 | $290 | $49.1K |
| G0121 | Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk | 80 | $410 | $34.4K |
| 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… | 50 | $320 | $16.4K |
| 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. | 60 | $240 | $14.9K |
| 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. | 50 | $300 | $13.9K |
| 43251 | An esophagogastroduodenoscopy is a procedure to view the esophagus, stomach, and duodenum by means of flexible endoscope through the mouth. The physician removes one or more lesions using a snare… | 10 | $580 | $8.1K |
Showing 1–10 of 12
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 12 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 |
|---|---|---|---|---|
| 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… | 1,180 | $360 | $423.2K |
| 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. | 1,850 | $220 | $413.2K |
| 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… | 1,030 | $300 | $305.3K |
| 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… | 320 | $320 | $102.1K |
| 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… | 30 | $270 | $7.1K |
| 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… | 140 | $0 | $0 |
How this provider's Medicaid billing volume and revenue compare to other Idaho providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Idaho median
6 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… | 1 | 10 | 20 | $340 | $94.9K |
| 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… | 2 | 20 | 70 | $260 | $77.5K |
| 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. | 3 | 40 | 180 | $170 | $75K |
| 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 | 10 | 90 | $300 | $64.8K |
| 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… | 5 | 10 | 30 | $210 | $35.1K |
| 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… | 13 | 20 | 210 | $1 | $680 |
Other providers in the same ZIP code as Idaho Endoscopy Center LLC, ranked by combined Medicare and Medicaid revenue.
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