Loading...
NPI 1811437882 · Coos Bay, OR · Ambulatory Surgical Clinic/Center
Customize your policy alerts
Get alerted when relevant policies change without checking for updates manually.
Monitor payer policy activity
Nbmc Day Surgery Inc is a ambulatory surgical clinic/center provider located in Coos Bay, Oregon. This profile covers 26 Medicare and 13 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 | Nbmc Day Surgery Inc |
| Address | 1900 Woodland Dr |
| City | Coos Bay |
| State | OR |
| ZIP | 97420 |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| NPI Enumerated | February 24, 2017 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $1.1M |
| Medicaid | $830.1K |
This facility reports nontrivial volumes to both payers, with Total Medicare revenue of $1.1M and Total Medicaid revenue of $830.1K. Medicare is the larger single payer but the two payers are comparable in scale, indicating the center serves both Medicare-aged and Medicaid populations rather than being effectively single-payer. The NPI was enumerated 2017-02-24 (~9 years ago), indicating an established operation with nearly a decade of billing history.
The provider’s CPT mix is characteristic of an ambulatory surgical center that emphasizes gastrointestinal endoscopy and outpatient surgical procedures. High-volume codes across payers include colonoscopy and EGD-related services (45380, 45378, 43239) and urologic cystoscopy/implant work (C9740, 52000), while neurostimulation implant codes (64590, 64555) also appear in Medicare billing, indicating the center performs both diagnostic/therapeutic endoscopy and selected implant procedures. These code types align with the listed taxonomy of Ambulatory Surgical Clinic/Center and suggest a multi-specialty ASC model.
On Medicare the top three codes by revenue are 64590, 45380, and C9740 and top 3 Medicare codes by revenue account for 40.0% of this provider's total Medicare revenue. That concentration shows a meaningful share of Medicare dollars tied to a small group of higher-reimbursement procedures, with 64590 (neurostimulator pulse generator insertion) contributing the single largest Medicare line item ($195.1K, 17.5% of Medicare revenue) while 45380 (colonoscopic biopsy) and C9740 (transprostatic implant) supply the remainder of that top-third.
Medicaid revenue is highly concentrated in gastrointestinal procedures: 45380, 43239, and 45378 are the top three Medicaid codes and those top 3 Medicaid codes by revenue account for 94.3% of this provider's total Medicaid revenue. That extreme concentration means Medicaid dollars are dominated by routine and therapeutic endoscopy (colonoscopies and EGD biopsies), with 45380 accounting for $343.9K (41.5% of Medicaid revenue) and 43239 for $274.3K (33.1%).
Competitive standing is mixed between payers and procedure types. For Medicare, 45380 ranks #555 of 16427 providers nationally (97th percentile) and 52000 ranks #243 of 8548 (97th percentile), indicating notably above-typical national volumes for key endoscopy procedures, whereas implant-related codes such as 64590 and 64555 rank in low percentiles (12th and 21st percentiles respectively), signaling modest national presence for neuromodulation compared with peers.
Within the state Medicaid market the provider functions as a regional endoscopy hub: 45380 ranks #11 of 51 providers in-state (80th percentile), 43239 ranks #18 of 60 (71th percentile), and 45378 ranks #4 of 26 (88th percentile). Those in-state ranks show the center captures above-typical Medicaid volume for colonoscopy and EGD work in Oregon and is a material Medicaid endoscopy provider for its region.
The Medicaid dataset includes a cluster of quality/administrative G-codes with large claim counts but $0 paid (for example, G8907 has 4.3K claims and is labeled an extreme outlier, 100th percentile). This pattern is consistent with active reporting of ambulatory surgical center safety and discharge metrics rather than direct revenue generation, and it indicates the facility submits many non-revenue quality/administrative lines alongside billed procedures.
Given the revenue profiles and payer concentration, the center’s financial exposure is skewed toward a few high-volume endoscopy codes on the Medicaid side and a mix of endoscopy plus select higher-dollar implants on the Medicare side. The precomputed shares—top 3 Medicare codes account for 40.0% and top 3 Medicaid codes account for 94.3%—highlight that Medicaid revenue is far more concentrated, which could make payer-mix or procedure-volume shifts in GI services particularly impactful to overall Medicaid revenue.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
26 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 64590 | The provider inserts or replaces a peripheral, sacral, or gastric neurostimulator pulse generator or receiver. The system is one that requires surgical creation of a pocket for placement and that… | 10 | $16,260 | $195.1K |
| 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… | 310 | $430 | $135.8K |
| C9740 | Cystourethroscopy, with insertion of transprostatic implant; 4 or more implants | 20 | $5,770 | $115.5K |
| 64555 | A neurostimulator includes electrodes which are inserted under the skin and induced by a generator to stimulate the nerve tissue. Use of this stimulator involves implantation of electrodes around a… | 20 | $4,320 | $95K |
| 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… | 180 | $490 | $86.8K |
| 52000 | In this procedure, the provider performs an examination of the interior of the bladder, the urethra, and the ureteric openings by means of a cystourethroscope, a thin flexible or rigid tube with a… | 280 | $210 | $58.7K |
| 36561 | A central venous access catheter is a device that the physician inserts beneath the skin to draw blood or administer medication/nutrients to the patient. The catheter's tip must terminate in the… | 40 | $1,190 | $48.8K |
| 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. | 170 | $280 | $46.8K |
| G0105 | Colorectal cancer screening; colonoscopy on individual at high risk | 90 | $460 | $42.8K |
| 64721 | Neuroplasty or transposition of the median nerve at the carpal tunnel is done to treat a condition called carpal tunnel syndrome (CTS). The carpal tunnel is a narrow tunnel in the wrist through which… | 60 | $680 | $42.3K |
Showing 1–10 of 26
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 26 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
26 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| C9740 | 3 | 10 | 20 | $5,930 | $130.4K |
| 64590 | 3 | 10 | 10 | $8,170 | $114.4K |
| 64555 | 3 | 10 | 30 | $2,980 | $80.4K |
| 45385 | 17 | 230 | 50 | $310 | $25.2K |
| 64635 | 55 | 80 | 40 | $430 | $24K |
| G0260 | 6 | 20 | 60 | $220 | $23.9K |
| 64493 | 45 | 90 | 50 | $210 | $16.9K |
| 64721 | 5 | 40 | 30 | $470 | $16.5K |
| 52000 | 4 | 100 | 80 | $150 | $16.4K |
| 45380 | 5 | 220 | 30 | $200 | $12K |
Showing 1–10 of 26
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.
13 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 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… | 1,110 | $310 | $343.9K |
| 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. | 1,280 | $210 | $274.3K |
| 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… | 550 | $300 | $163.8K |
| 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… | 140 | $260 | $37K |
| 52000 | In this procedure, the provider performs an examination of the interior of the bladder, the urethra, and the ureteric openings by means of a cystourethroscope, a thin flexible or rigid tube with a… | 40 | $140 | $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. | 20 | $300 | $4.5K |
| 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… | 4,310 | $0 | $0 |
| G8909 | Patient documented not to have received a burn prior to discharge | 170 | $0 | $0 |
| G8911 | Patient documented not to have experienced a fall within ambulatory surgical center | 190 | $0 | $0 |
| G8913 | Patient documented not to have experienced a wrong site, wrong side, wrong patient, wrong procedure or wrong implant event | 190 | $0 | $0 |
Showing 1–10 of 13
How this provider's Medicaid billing volume and revenue compare to other Oregon providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Oregon median
13 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… | 23 | 40 | 310 | $420 | $325.7K |
| 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. | 18 | 60 | 350 | $260 | $251.9K |
| 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… | 11 | 50 | 200 | $370 | $238.2K |
| 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… | 4 | 30 | 70 | $390 | $111.2K |
| 52000 | In this procedure, the provider performs an examination of the interior of the bladder, the urethra, and the ureteric openings by means of a cystourethroscope, a thin flexible or rigid tube with a… | 12 | 20 | 60 | $140 | $57.4K |
| 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. | 9 | 20 | 20 | $250 | $46.8K |
| G8918 | Patient without preoperative order for iv antibiotic surgical site infection (ssi) prophylaxis | 4 | 20 | 250 | $1 | $10 |
| 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… | 1 | 40 | 110 | $1 | $1 |
| G8909 | Patient documented not to have received a burn prior to discharge | 1 | 10 | 170 | $0 | $0 |
| G8911 | Patient documented not to have experienced a fall within ambulatory surgical center | 1 | 10 | 190 | $0 | $0 |
Showing 1–10 of 13
Other providers in the same ZIP code as Nbmc Day Surgery Inc, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| North Bend Medical Center Inc | OR | Multi-Specialty Clinic/Center | $0 | $12.4M |
| Bay Cities Ambulance | OR | Land Ambulance | $1.7M | $9.5M |
| Bay Area Hospital District | OR | General Acute Care Hospital | $0 | $8.7M |
| Coos County Oregon | OR | Clinic/Center | $0 | $8.5M |
| Cep America LLC | OR | Emergency Medicine Physician | $0 | $5.7M |
| Lincare Inc. | OR | Durable Medical Equipment & Medical Supplies | $0 | $3.4M |
| Coos County Oregon | OR | Public Health or Welfare Agency | $15.8K | $3.2M |
| Coquille Indian Tribe | OR | Clinic/Center | $0 | $2.1M |
| Bay Clinic | OR | Specialist | $0 | $2M |
| Coastal Center, LLC. | OR | Mental Health Counselor | $0 | $1.7M |
Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.