Rocky Mountain Gastroenterology Associates, PLLC

Rocky Mountain Gastroenterology Associates, PLLC was paid $3.66M by Medicaid between Jan 2018 and Dec 2024, across 20 billing codes. Its largest line is 88305, Level IV - Surgical pathology, gross and microscopic examination — 35% of everything it billed.

33Billing provider infoROCKY MOUNTAIN GASTROENTEROLOGY ASSOCIATES, PLLC
LAKEWOOD, CO 80227

33aNPI1669414272assigned 06/11/2006

33bProvider typeGastroenterology Physician

28Total paid$3.66M

24GClaims64,223

24DCodes billed20

24AFirst – last monthJan 2018 – Dec 2024

Compared with peers

Next to other Gastroenterology Physician providers in Colorado

Rank by total paid#2 of 34

Median peer was paid$75K

This provider vs. median49×

Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.

Box 24A · Dates of service

Paid by month

Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider

By year, as a table

Year	Claims	Paid
2018	7,323	$336K
2019	8,192	$355K
2020	5,620	$253K
2021	8,892	$406K
2022	7,642	$344K
2023	16,506	$1.20M
2024incomplete	10,048	$768K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
88305	Level IV - Surgical pathology, gross and microscopic examination	35%	23,954	15,994	$1.27M
43239	Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple	16%	6,762	4,768	$583K
88342		8.8%	9,842	6,847	$321K
45378	Colonoscopy, flexible; diagnostic, including collection of specimen(s)	7.8%	1,513	1,272	$284K
99204	Doctor's office visit, new patient (more involved)Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity	7.7%	3,693	2,788	$283K
99214	Doctor's office visit, returning patient (more involved)Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity	7.0%	4,651	3,640	$257K
45380	Colonoscopy, flexible; with biopsy, single or multiple	5.9%	1,405	1,081	$216K
45385	Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s)	3.5%	605	497	$128K
88313		3.0%	7,309	5,444	$110K
99203	Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity	1.1%	656	511	$40K
99222	Initial hospital care, per day, moderate complexity	1.1%	543	459	$40K
99213	Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity	1.0%	865	766	$38K

8 more codes

88312		<1%	721	$36K
99232	Hospital visit by a doctor, follow-up day	<1%	661	$20K
43248		<1%	123	$14K
99231	Subsequent hospital care, per day, straightforward or low complexity	<1%	740	$12K
43235		<1%	58	$7K
99221		<1%	41	$2K
99223	Prolong inpt eval add15 m	<1%	23	$1K
G0500	Moderate sedation services provided by the same physician or other qualified health care professional performing a gastrointestinal endoscopic service that sedation supports, requiring the presence of an independent trained observer to assist in the monitoring of the patient's level of consciousness and physiological status; initial 15 minutes of intra-service time; patient age 5 years or older (additional time may be reported with 99153, as appropriate)	<1%	58	$63.90

Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.

From NPPES

Who's on the registration

Authorized officialCMIL, ALEXANDER (CFO)