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    OpenPayerNPI Medicare & MedicaidGem State Endoscopy
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    Gem State Endoscopy — Billing Profile & Reimbursement Data

    NPI 1821459496 · Lewiston, ID · Ambulatory Surgical Clinic/Center

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    Gem State Endoscopy is a ambulatory surgical clinic/center provider located in Lewiston, Idaho. 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)

    FieldValue
    Entity TypeOrganization
    OrganizationGem State Endoscopy
    Address3709 14th Street
    CityLewiston
    StateID
    ZIP83501
    TaxonomyAmbulatory Surgical Clinic/Center
    NPI EnumeratedMarch 10, 2016

    Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)

    Payer SourceTotal Paid
    Medicare$295.3K
    Medicaid$71.1K

    Medicare: Total Revenue Breakdown by CPT/HCPCS Code

    Medicare revenue breakdown by CPT/HCPCS procedure code.

    View: Bar Chart1 / 2

    Medicare: Complete Services Breakdown

    The CPT/HCPCS codes generating the most Medicare revenue for this provider.

    10 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    45385The 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…210$430$91.8K
    43248The 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…160$310$50K
    43239The 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.210$230$47.7K
    45380The 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…150$290$43.4K
    43249The 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.50$550$26.2K
    G0105Colorectal cancer screening; colonoscopy on individual at high risk40$400$15.6K
    43235The 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$6.9K
    G0121Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk20$400$6.8K
    45378The 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…10$300$4.2K
    45381The 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…10$240$2.6K

    Medicare: Competitive Analysis & Benchmarks

    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

    10 rows

    CPT/HCPCS CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    45385780100$270$28.8K
    45380129060$150$11.8K
    4324845040$170$9.4K
    4323968080$100$9.2K
    G0105115030$240$8.4K
    G0121326020$240$5.9K
    4324962030$150$5.4K
    45378293020$170$4.1K
    43235175020$110$2.9K
    45381141020$60$1.4K

    Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

    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

    Medicaid: Complete Services Breakdown

    Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.

    3 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    43239The 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.370$180$65.7K
    43248The 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$210$5.5K
    G8907Patient 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…40$0$0

    Medicaid: Competitive Analysis & Benchmarks

    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

    3 rows

    CPT/HCPCS CodeDescriptionRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    43239The 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.1240180$170$75K
    43248The 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…51030$210$35.1K
    G8907Patient 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…1720210$1$680

    Nearby Providers

    Other providers in the same ZIP code as Gem State Endoscopy, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Alternative Nursing Services, Inc.IDAdult Day Care Clinic/Center$0$29.3M
    Catalyst Medical Group, PLLCIDMulti-Specialty Clinic/Center$0$11.4M
    Opportunities Unlimited, Inc.IDSpecialist$0$9.1M
    St. Joseph Hospital LLCIDGeneral Acute Care Hospital$0$4.7M
    County Of Nez Perce Independent School District No 1IDLocal Education Agency (LEA)$0$3.5M
    Community Health Association Of SpokaneIDFederally Qualified Health Center (FQHC)$0$3.2M
    City Of LewistonIDLand Ambulance$697.3K$1.9M
    Riverside Recovery LLCIDAddiction (Substance Use Disorder) Counselor$0$2.1M
    Addus Healthcare (idaho), IncIDIn Home Supportive Care Agency$0$2M
    Emeritus Properties Ii, Inc.IDAssisted Living Facility$0$1.9M

    Frequently Asked Questions

    References

    1. 1.Medicare Physician & Other Practitioner by Provider and Service. CMS.gov.Provider-level Medicare Part B utilization and payment data.
    2. 2.NPPES NPI Registry. CMS.gov.National Provider Identifier registry used for provider enumeration and taxonomy metadata.

    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.

    Medicare Revenue by CPT/HCPCS Code
    Claims Volume vs. Idaho Distribution
    Gem State Endoscopy — 0 of 10 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Idaho
    Medicaid Revenue by Year vs. Idaho Providers
    0 of 7 years billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Claims Volume vs. Idaho Distribution
    Gem State Endoscopy — 0 of 2 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Idaho