Why are Medicare and Medicaid shown separately instead of combined?

They come from two different CMS data sources with no shared claim identifier, so they can't be reconciled into one number without double-counting or guessing. Every table and chart on this page keeps them fully separate.

Why is there no private/commercial revenue figure?

Private and commercial payer data comes from Transparency in Coverage files, which only publish negotiated rates — not claims or utilization volume. Without a volume figure, no revenue number can be computed for any provider from that data.

What does "Rank" mean in the Competitive Analysis & Benchmarks tables?

For a given CPT/HCPCS code, it's this provider's position by claims volume among all providers billing that same code at that geography level (State, National, or Washington for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Washington only?

Medicaid is administered per-state with no single national fee schedule, so a state or national comparison the way Medicare has one isn't available. Washington (this provider's own state) is the only grouping that's conceptually meaningful.

Why are the numbers rounded to the nearest 10?

To avoid implying more precision than the underlying data supports at a single-provider level. Ratios are kept precise since they're a relative comparison, not a volume or dollar figure.

How current is this data?

The Medicare and Medicaid tables are both single current snapshots, not refreshed on a recurring schedule yet.

Seattle Children's Hospital (NPI 1003319500)

Seattle Children's Hospital is a specialist provider located in Seattle, Washington. This profile covers 0 Medicare and 104 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Medicaid: Complete Services Breakdown

Field	Value
Entity Type	Organization
Organization	Seattle Children's Hospital
Address	4800 Sand Point Way Ne
City	Seattle
State	WA
ZIP	98105
Taxonomy	Specialist
NPI Enumerated	March 12, 2018

Payer Source	Total Paid
Medicaid	$19.9M
Medicare	$0

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

104 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99213	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…	74,240	$60	$4.2M
99214	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…	34,990	$90	$3M
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	21,250	$130	$2.7M
99203	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the provider…	35,360	$70	$2.5M
99204	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the provider…	8,620	$130	$1.1M
93306	The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent…	4,660	$160	$750.7K
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	15,930	$50	$748.5K
93303	The provider performs a complete transthoracic echocardiography to obtain images of the heart structures through the chest wall in patients born with heart defects. This study includes visualization…	4,260	$150	$651.6K
97803	The provider reassesses the dietary needs of a patient and uses specific diet therapy to treat medical conditions and related symptoms by interacting individually with the patient. This code…	18,600	$30	$613.6K
88305	The physician, typically a pathologist, performs a level IV examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally…	16,040	$30	$529.3K

Showing 1–10 of 104

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other Washington providers billing the same CPT/HCPCS codes.

Claims Volume vs. Washington Distribution

Seattle Children's Hospital — 9 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Washington

Full comparison — all codes billed, vs. Washington median

104 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	135	230	5,440	$90	$1.8M
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	76	230	6,220	$100	$1.8M
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	134	190	5,130	$100	$1.8M
93303	The provider performs a complete transthoracic echocardiography to obtain images of the heart structures through the chest wall in patients born with heart defects. This study includes visualization…	5	10	4,100	$160	$753.2K
99282	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making.	93	140	2,410	$110	$593.3K
93304	The provider performs a limited or follow–up transthoracic echocardiography to obtain images of the heart through the chest wall in patients born with heart defects. It is a limited examination of a…	5	10	2,190	$210	$533.3K
42820	The provider removes the tonsils and adenoids in a patient younger than 12 years old.	7	30	90	$1,070	$496.9K
99214	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…	60	1,820	480	$60	$379.6K
93306	The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent…	28	130	890	$100	$337.8K
69436	This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia.	10	30	110	$740	$316.7K

Showing 1–10 of 104

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Seattle Children's Hospital	WA	Children's Hospital	$0	$219.4M
Seattle Children's Hospital	WA	Home Infusion Agency	$0	$32.2M
The Association Of Chrmc And University Physicians	WA	Pediatrics Physician	$0	$25M
Seattle Children's Hospital	WA	Dental Clinic/Center	$0	$2.8M
Frank Virant	WA	Allergy & Immunology Physician	$170.6K	$0
Nicholas Weiss	WA	Psychiatry Physician	$166.1K	$0
Jeremy Neuman	NY	Diagnostic Radiology Physician	$116.6K	$10K
Manjiri Dighe	WA	Diagnostic Radiology Physician	$95.8K	$0
Ryan Bahr	WA	Surgical Physician Assistant	$59.9K	$0
Eric Krieger	WA	Cardiovascular Disease Physician	$45.5K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Kean Lawlor	WA	Dermatology Physician	$668.3K	$0
Jeremy Kampp	WA	MOHS-Micrographic Surgery Physician	$339.2K	$0
Matthew Saltzman	WA	Orthopaedic Surgery Physician	$234.7K	$39.2K
Cheryl Gustafson	WA	MOHS-Micrographic Surgery Physician	$222.8K	$0
Sand Point Pharmacy & Health	WA	Community/Retail Pharmacy	$220.2K	$0
Colin Sisco	WA	Physical Therapist	$186.8K	$0
John Falardeau	WA	Diagnostic Radiology Physician	$158.5K	$0
Fred Meyer Stores Inc	WA	Community/Retail Pharmacy	$77.8K	$74.2K
Brianne Noel	WA	Physician Assistant	$73K	$0
Timothy Carey	WA	Ophthalmology Physician	$58.9K	$0

Seattle Children's Hospital — Billing Profile & Reimbursement Data

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Seattle Children's Hospital — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

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