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 Massachusetts for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Massachusetts 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. Massachusetts (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.

The General Hospital Corporation (NPI 1023049236)

Field	Value
Entity Type	Organization
Organization	The General Hospital Corporation
Address	55 Fruit St
City	Boston
State	MA
ZIP	02114
Taxonomy	General Acute Care Hospital
NPI Enumerated	July 5, 2006

Payer Source	Total Paid
Medicaid	$438M
Medicare	$0

Key Findings

THE GENERAL HOSPITAL CORPORATION is effectively a Medicaid-centric provider: there is no Medicare billing on file and the facility has reported $438M in total Medicaid revenue. The absence of Medicare activity makes Medicaid the dominant, near-exclusive payer exposure for this entity and concentrates its revenue and contracting risk on state Medicaid programs.

Revenue concentration is high at the code level: the precomputed top three Medicaid codes (99211, 96361, 99285) account for 37.3% of the provider’s total Medicaid revenue. In particular, 99211 alone represents $52.3M (22.2% of Medicaid revenue), signaling heavy reliance on a single high-volume outpatient visit code rather than a diversified set of mid-size revenue drivers.

The code mix indicates a large acute-care hospital with substantial emergency and observation workload: high-revenue emergency department E/M codes 99285 ($17.1M), 99284 ($14.8M) and 99283 ($8.3M) appear among top billers, and hospital observation service G0378 ($12.1M, 5.2%) is material. These volumes, combined with top-state percentiles for several ED/observation codes (for example 99285 ranks #10 of 521 providers in-state, 98th percentile), point to a busy ED and inpatient-through-observation throughput.

The provider also shows a major infusion, chemotherapy, and oncology footprint: high-revenue infusion/chemotherapy codes 96361 ($18.4M), 96365 ($10.8M), 96366 ($4.6M), 96413 ($6.3M) and high-priced drug and biologic codes (J9271 $7.6M; J1569 $4.4M; Q5103 $3.2M) place substantial revenue in specialty infusion and oncology services. Several of these codes rank at or near the top in-state (for example 96365 ranks #1 of 84 providers in-state, 100th percentile), indicating the provider is a major regional infusion/oncology hub.

Ambulatory and outpatient clinic activity is another clear service line: high volumes for office/outpatient E/M codes 99211 (458.4K claims), 99213 (262.9K claims), 99214 (239.5K claims) and 99215 (49.6K claims) plus a large count for G0463 (296.8K claims) suggest an extensive outpatient clinic network supporting primary and specialty follow-up care. Many of these codes are described as “extreme outlier” or “far above typical state volume” (for example 99211 ranks #2 of 413 providers in-state, 100th percentile; 99213 ranks #8 of 5303 providers, 100th percentile), consistent with a substantial ambulatory volume tied to the hospital.

Statewide competitive standing is dominant across multiple service lines: numerous top Medicaid codes place the provider in top ranks and percentiles — examples include 99211 (#2 of 413, 100th percentile; extreme outlier), 96365 (#1 of 84, 100th percentile; extreme outlier), 97110 (#4 of 746, 100th percentile; extreme outlier) and 99285 (#10 of 521, 98th percentile). These rank/percentile signals indicate the hospital is a major, often dominant provider in Massachusetts for ED, infusion/oncology, physical therapy, and outpatient clinic services.

The organization has long tenure in federal enrollment: NPI enumerated 2006-07-05 (~20 years ago), indicating sustained operation and an established billing presence in the state Medicaid market. That longevity, coupled with $438M in Medicaid revenue, supports characterization as a large, mature acute-care system with deep ties to state Medicaid patients.

From an operational and contract-management perspective, the provider shows both concentration risks and negotiating leverage: with 99211 accounting for $52.3M (22.2%) and the top three codes accounting for 37.3% of Medicaid revenue, a sizable share of income is driven by a few high-volume services. At the same time, high-state rankings on costly infusion/oncology codes (e.g., 96361, 96365, J9271, J1569, 77386) denote specialist services that create opportunities for targeted value-based contracting, oncology pathway management, and payor engagement to manage high-dollar care lines.

Medicaid: Complete Services Breakdown

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

1127 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99211	An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.	458,420	$110	$52.3M
96361	The provider administers intravenous, or IV, fluids with electrolytes through an already established intravenous route for each additional hour to treat more severe dehydration.	46,840	$390	$18.4M
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.	83,400	$210	$17.1M
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…	262,910	$70	$17.1M
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.	88,970	$170	$14.8M
G0378	Hospital observation service, per hour	62,230	$200	$12.1M
96365	The provider administers the initial intravenous infusion of a medication or other substance for a period up to one hour to prevent, treat, or diagnose a condition or disease.	46,360	$230	$10.8M
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…	239,490	$40	$10.3M
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.	58,190	$140	$8.3M
J9271	Injection, pembrolizumab, 1 mg	1,980	$3,840	$7.6M

Showing 1–10 of 1127

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Massachusetts Distribution

The General Hospital Corporation — 22 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Massachusetts

Full comparison — all codes billed, vs. Massachusetts median

1127 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
41899	Use this code to report a procedure on the teeth and adjoining alveolar structures for which there is no specific code available.	7	10	470	$2,670	$6.3M
J9271	Injection, pembrolizumab, 1 mg	3	10	210	$5,200	$5.5M
96361	The provider administers intravenous, or IV, fluids with electrolytes through an already established intravenous route for each additional hour to treat more severe dehydration.	3	90	7,560	$350	$4.2M
J2350	Injection, ocrelizumab, 1 mg	3	10	130	$7,900	$3.9M
S9485	Crisis intervention mental health services, per diem	27	110	1,250	$540	$3.2M
J9299	Injection, nivolumab, 1 mg	4	10	250	$3,570	$3M
J2506	Injection, pegfilgrastim, excludes biosimilar, 0.5 mg	4	10	590	$1,880	$2.8M
J1745	Injection, infliximab, excludes biosimilar, 10 mg	5	10	1,380	$1,380	$2.7M
J1561	Injection, immune globulin, (gamunex-c/gammaked), non-lyophilized (e.g., liquid), 500 mg	3	10	2,050	$1,240	$2.6M
J9144	Injection, daratumumab, 10 mg and hyaluronidase‑fihj	3	10	1,520	$1,910	$2.6M

Showing 1–10 of 1127

Related Providers

Other providers that share a Tax Identification Number (TIN) with The General Hospital Corporation, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Community Physicians Of Indiana Inc	IN	Family Medicine Physician	$0	$185M
Massachusetts General Physicians Organization Inc	MA	Dermatology Physician	$0	$60.2M
Boston Emergency Physician Foundation, Inc.	MA	Emergency Medicine Physician	$0	$24.3M
Colorado Permanente Medical Group, P.C.	CO	Internal Medicine Physician	$0	$23.2M
David Reed	MA	Retina Specialist (Ophthalmology) Physician	$7.7M	$0
Torsten Wiegand	MA	Retina Specialist (Ophthalmology) Physician	$7.6M	$0
Chirag Shah	MA	Retina Specialist (Ophthalmology) Physician	$5M	$0
Miriam Englander-paschalis Ilios	MA	Retina Specialist (Ophthalmology) Physician	$4.5M	$0
Babak Jian Seyedahmadi	MA	Ophthalmology Physician	$4.4M	$0
Jeffrey Heier	MA	Retina Specialist (Ophthalmology) Physician	$3.6M	$0

Nearby Providers

Other providers in the same ZIP code as The General Hospital Corporation, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Massachusetts Eye And Ear Infirmary	MA	General Acute Care Hospital	$0	$68.1M
Bay Cove Human Services, Inc	MA	Community/Behavioral Health Agency	$630.5K	$36.4M
Jewish Family & Children's Service	MA	Case Management Agency	$0	$12.5M
Commonwealth Of Massachusetts	MA	Case Management Agency	$0	$10.4M
Massachusetts Eye And Ear Associates, Inc.	MA	Ophthalmology Physician	$0	$6.6M
Adam Chin	MA	Ophthalmology Physician	$3.4M	$870
Tina Cleary	MA	Retina Specialist (Ophthalmology) Physician	$2.8M	$0
Boston Eye Surgery & Laser Center Trust	MA	Ambulatory Surgical Clinic/Center	$2.1M	$415.8K
Marianeli Rodriguez	MA	Ophthalmology Physician	$2.4M	$0
Scott Brannan	MA	Diagnostic Radiology Physician	$1.8M	$0

The General Hospital Corporation — Billing Profile & Reimbursement Data

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The General Hospital Corporation — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References