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NPI 1962059915 · Bismarck, ND · Ambulatory Surgical Clinic/Center
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Brightside Surgical, LLC is a ambulatory surgical clinic/center provider located in Bismarck, North Dakota. This profile covers 12 Medicare and 1 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 | Brightside Surgical, LLC |
| Address | 401 N 9th St |
| City | Bismarck |
| State | ND |
| ZIP | 58501 |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| NPI Enumerated | August 23, 2019 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $496.8K |
| Medicaid | $1.8K |
BRIGHTSIDE SURGICAL, LLC operates as an ambulatory surgical clinic/center focused on endoscopic procedures, with the Medicare CPT mix dominated by colonoscopy and upper GI endoscopy services (notably codes 45380, 45385, 44361, 43239). The top Medicare codes are all diagnostic or therapeutic endoscopy-related services, indicating the site primarily provides outpatient gastrointestinal procedures rather than broad multispecialty surgery.
Medicare revenue scale is substantial relative to Medicaid: total Medicare revenue is $496.8K versus total Medicaid revenue of $1.8K, so the practice is effectively Medicare-driven and functionally single-payer in scale. Medicaid activity is minimal and concentrated solely in code 45380, representing 100.0% of Medicaid revenue, which underscores the asymmetric payer mix.
Revenue concentration on Medicare is pronounced: the precomputed top 3 Medicare codes by revenue account for 64.8% of this provider’s total Medicare revenue, signaling dependence on a small set of colonoscopy/EGD codes for the majority of Medicare receipts. This concentration suggests that any changes to colonoscopy-related reimbursement or referral patterns could materially affect overall revenue.
Code-level leadership is mixed: for Medicare code 45380 the provider ranks #222 of 16427 nationally (99th percentile) and is labeled an extreme outlier, meaning BRIGHTSIDE operates at an unusually high national volume on this colonoscopy/biopsy code compared with peers. By contrast, 45385 ranks #784 of 16310 (95th percentile) and 44361 ranks #18 of 96 (82th percentile), both characterized as typical or unremarkable volume relative to national peers, indicating exceptional scale is concentrated in specific colonoscopy activity rather than across all endoscopy services.
For Medicaid in-state competitive standing, the single Medicaid code on file (45380) shows 17 claims and $1.8K revenue and ranks #4 of 8 providers in-state (57th percentile), a mid-pack position. This suggests BRIGHTSIDE is not a dominant Medicaid endoscopy provider in North Dakota despite its high Medicare volume for the same code.
Tenure is moderate: the NPI was enumerated on 2019-08-23 (~7 years ago), indicating the clinic has several years of operational history to establish referral relationships and procedure volumes. The combination of a ~7-year presence with concentrated endoscopy billing supports a stable, procedure-focused ambulatory surgical practice profile.
Payer-code alignment shows the same clinical focus across both payers: 45380 is the top code on both Medicare and Medicaid lists, accounting for 34.6% of Medicare revenue and 100.0% of Medicaid revenue respectively, reinforcing that colonoscopic biopsy/exam services are the core business line across payers. However, the relative dollar scale differs dramatically between Medicare and Medicaid.
Several higher-paying, less frequent procedures contribute to Medicare revenue beyond colonoscopy (examples include 44361 at $51.5K and 43239 at $45.1K), indicating BRIGHTSIDE performs a mix of diagnostic biopsies and upper endoscopies in addition to colonoscopies. These ancillary endoscopy services diversify case mix but do not materially dilute dependence on the top three Medicare codes.
The presence of one extreme outlier code (45380) alongside multiple codes with typical national percentiles suggests BRIGHTSIDE holds a niche competitive advantage in high-volume colonoscopy/biopsy care for Medicare beneficiaries while maintaining more standard volumes in other endoscopic procedures; this profile has implications for network negotiations, volume-based contracting, and resource planning focused on GI capacity.
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 |
|---|---|---|---|---|
| 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… | 500 | $340 | $172K |
| 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… | 270 | $360 | $98.1K |
| 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… | 100 | $540 | $51.5K |
| 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. | 200 | $230 | $45.1K |
| G0105 | Colorectal cancer screening; colonoscopy on individual at high risk | 90 | $390 | $35.1K |
| 44360 | The provider examines a portion of the small intestine for abnormalities using an endoscope, a tubular instrument with a light source and camera, which he inserts through the mouth. He includes the… | 40 | $540 | $19.4K |
| G0121 | Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk | 50 | $390 | $17.6K |
| 19301 | The provider removes a lesion, including surrounding margins, or a significant portion (a segment or quadrant) of the breast without removing the entire breast or lymph nodes. | 20 | $740 | $13.2K |
| 58558 | The provider either biopsies the lining of the uterus (endometrium) or removes polyps, or both, through a hysteroscope ; he may or may not perform a dilation and curettage (D&C). He sends all samples… | 10 | $1,050 | $12.6K |
| 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. | 20 | $510 | $11.2K |
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.
1 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… | 20 | $110 | $1.8K |
How this provider's Medicaid billing volume and revenue compare to other North Dakota providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. North Dakota median
1 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average 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… | 4 | 10 | 20 | $350 | $18.9K |
Other providers in the same ZIP code as Brightside Surgical, LLC, ranked by combined Medicare and Medicaid revenue.
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