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NPI 1992741300 · Lincoln, NE · Ambulatory Surgical Clinic/Center
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Lincoln Endoscopy Center, LLC is a ambulatory surgical clinic/center provider located in Lincoln, Nebraska. This profile covers 13 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 | Lincoln Endoscopy Center, LLC |
| Address | 4545 R St |
| City | Lincoln |
| State | NE |
| ZIP | 68503 |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| NPI Enumerated | June 22, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $1.7M |
| Medicaid | $612.5K |
LINCOLN ENDOSCOPY CENTER, LLC operates as an ambulatory surgical clinic/center with a procedure mix heavily concentrated in upper and lower gastrointestinal endoscopy; the top billed CPTs include 45385 (therapeutic colonoscopy/polypectomy), 45380 (diagnostic colonoscopy with biopsy), G0105 (high‑risk screening colonoscopy), and 43239 (EGD with biopsy), indicating a focus on screening, diagnostic and therapeutic endoscopy rather than broad multispecialty outpatient services. The presence of esophageal dilation codes (43450, 43248, 43249) further supports an endoscopy-focused procedural portfolio.
Medicare revenue is highly concentrated in a small set of endoscopy codes: the top three Medicare codes by revenue account for 76.9% of this provider's total Medicare revenue, led by 45385 at $955.5K (56.8% of total Medicare revenue), followed by 45380 at $189.5K (11.3%) and G0105 at $149.9K (8.9%). This concentration signals that changes to colonoscopy-related reimbursement or screening guidelines would disproportionately affect the provider's Medicare revenue stream.
On Medicare procedural volumes the provider appears nationally prominent: 45385 ranks #4 of 16310 providers nationally (100th percentile; extreme outlier), 45380 ranks #190 of 16427 (99th percentile; extreme outlier), and G0105 ranks #40 of 8773 (100th percentile; extreme outlier). Those rank/percentile labels indicate the center is an extreme volume outlier for core colonoscopy services compared with national peers, consistent with a high-capacity, specialized endoscopy operation.
Medicaid billing is similarly concentrated: the top three Medicaid codes account for 90.2% of this provider's total Medicaid revenue, with 45385 generating $289.7K (47.3% of Medicaid revenue), 43239 $180.8K (29.5%), and 45380 $82.4K (13.5%). This indicates that Medicaid revenue is largely driven by the same colonoscopy and EGD service lines that dominate Medicare billing.
Within the Nebraska Medicaid market the provider is a leading state-level performer on core colonoscopy codes: 45385 ranks #1 of 8 providers in-state (100th percentile; notably above typical state volume), and 45378 ranks #1 of 4 providers in-state (100th percentile; typical). Other Medicaid ranks such as 43239 at #10 of 29 (68th percentile; typical) show a mix of both dominant and typical state-level positions across different endoscopy procedures.
Payer mix shows Medicare predominance in lifetime revenue, with Medicare totaling $1.7M versus Medicaid $612.5K; Medicare is the larger revenue source for this provider. That asymmetry means shifts in Medicare policy or patient volumes would have a larger absolute impact on the business compared with equivalent changes in Medicaid.
The provider has an established operating history, with its NPI enumerated on 2006-06-22 (~20 years ago), which together with consistently high procedural volumes suggests a long-standing referral base and operational continuity as an ambulatory endoscopy center. Longevity combined with extreme national volume ranks for core codes is consistent with an established, high-throughput specialty center rather than a low-volume or new entrant practice.
High concentration of revenue in a handful of endoscopy codes (Medicare top 3 = 76.9% of Medicare revenue; Medicaid top 3 = 90.2% of Medicaid revenue) represents a business concentration risk: reimbursement changes, screening guideline shifts, or capacity changes among referral sources that affect colonoscopy/EGD utilization could materially affect overall revenues. At the same time, the provider's status as an ‘‘extreme outlier’’ or ‘‘notably above typical’’ volume performer for several codes indicates competitive strength in those specific service lines, suggesting market leadership in high-volume procedural endoscopy within its operational footprint.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
13 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… | 2,110 | $450 | $955.5K |
| 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… | 540 | $350 | $189.5K |
| G0105 | Colorectal cancer screening; colonoscopy on individual at high risk | 360 | $410 | $149.9K |
| 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. | 590 | $230 | $136.9K |
| G0121 | Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk | 140 | $420 | $59.9K |
| 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. | 140 | $280 | $40.2K |
| 45390 | The provider performs flexible colonoscopy along with excision of mucous membrane tissue using an endoscope. | 40 | $970 | $38.7K |
| 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. | 140 | $230 | $32.9K |
| 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… | 90 | $300 | $27.2K |
| 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. | 40 | $580 | $22.6K |
Showing 1–10 of 13
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 13 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… | 1,070 | $270 | $289.7K |
| 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. | 770 | $240 | $180.8K |
| 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… | 330 | $250 | $82.4K |
| 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… | 160 | $370 | $59.8K |
| 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… | 990 | $0 | $0 |
| G8918 | Patient without preoperative order for iv antibiotic surgical site infection (ssi) prophylaxis | 20 | $0 | $0 |
How this provider's Medicaid billing volume and revenue compare to other Nebraska providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Nebraska 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. | 10 | 30 | 280 | $450 | $266.7K |
| 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… | 1 | 10 | 180 | $290 | $96.4K |
| 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… | 6 | 20 | 100 | $320 | $82.5K |
| 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… | 1 | 10 | 160 | $470 | $56.7K |
| 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 | 20 | 40 | $1 | $10 |
| G8918 | Patient without preoperative order for iv antibiotic surgical site infection (ssi) prophylaxis | 4 | 10 | 20 | $0 | $0 |
Other providers in the same ZIP code as Lincoln Endoscopy Center, LLC, ranked by combined Medicare and Medicaid revenue.
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