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

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

St. Charles Health System, Inc. (NPI 1023331303)

St. Charles Health System, Inc. is a family medicine physician provider located in Bend, Oregon. This profile covers 0 Medicare and 111 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	St. Charles Health System, Inc.
Address	2500 Ne Neff Rd
City	Bend
State	OR
ZIP	97701
Taxonomy	Family Medicine Physician
NPI Enumerated	March 1, 2010

Payer Source	Total Paid
Medicaid	$8.6M
Medicare	$0

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

111 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…	92,860	$40	$3.3M
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…	72,280	$30	$2M
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…	7,850	$90	$691.1K
95810	Polysomnography refers to the continuous and simultaneous monitoring and recording of various physiological and pathophysiological parameters of sleep for six or more hours with physician review,…	1,080	$500	$539K
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…	11,270	$40	$484.7K
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…	3,570	$60	$218K
G2211	Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care…	14,220	$10	$170.7K
93010	The provider interprets and reports on the results of a routine 12–lead (or more) electrocardiogram.	28,310	$10	$141.6K
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…	1,090	$120	$131K
95806	A technologist is not in attendance during this sleep study, which involves measuring several parameters while the patient sleeps in a clinic or sleep lab to help diagnose sleep disorders.	580	$110	$65.8K

Showing 1–10 of 111

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Oregon Distribution

St. Charles Health System, Inc. — 10 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Oregon

Full comparison — all codes billed, vs. Oregon median

111 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.	121	150	7,400	$170	$2.8M
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.	127	130	2,610	$200	$2.3M
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.	115	140	10,160	$130	$2.3M
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.	69	80	1,130	$90	$327.2K
99291	Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is…	18	40	380	$130	$326.9K
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…	14	1,500	650	$70	$312.4K
T1015	Clinic visit/encounter, all-inclusive	31	60	480	$120	$291K
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.	46	60	350	$260	$251.9K
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…	12	1,590	590	$50	$236.5K
95811	During the study, the physician monitors the sleep pattern of the patient, along with different bodily functions during the sleep cycle extending over a period of six hours or more.	17	20	280	$370	$197.9K

Showing 1–10 of 111

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
St. Charles Health System, Inc.	OR	Critical Access Hospital	$0	$5M
St. Charles Health System, Inc.	OR	General Acute Care Hospital	$0	$4.4M
Natasha Tiffany	OR	Hematology & Oncology Physician	$1.7M	$0
St. Charles Health System, Inc.	OR	Critical Access Hospital	$0	$1.4M
Heather Hansen-dispenza	OR	Rheumatology Physician	$726.8K	$0
Russell Lewis	OR	Hematology & Oncology Physician	$569.3K	$0
Steven Michel	OR	Diagnostic Radiology Physician	$541.9K	$0
James Verheyden	OR	Orthopaedic Hand Surgery Physician	$519.9K	$0
Tianna Welch	OR	Physician Assistant	$507.6K	$0
Ian Riddock	OR	Cardiovascular Disease Physician	$400.7K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Ortc, LLC	OR	Substance Abuse Rehabilitation Facility	$747.3K	$16.2M
Telecare Mental Heatlh Service Of Oregon, Inc	OR	Mental Illness Community Based Residential Treatment Facility	$0	$12.8M
Bend Memorial Clinic PC	OR	Family Medicine Physician	$0	$11.7M
Pfeifer & Associates	OR	Community/Behavioral Health Agency	$0	$11.6M
Grants Pass Treatment Center	OR	Substance Abuse Rehabilitation Facility	$0	$9.5M
Deschutes County Oregon	OR	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$7.9M
Central Oregon Pediatric Associates	OR	Pediatrics Physician	$0	$7.2M
Bend Surgery Center LLC	OR	Ambulatory Surgical Clinic/Center	$4.8M	$1.7M
Adam Angeles	OR	Plastic and Reconstructive Surgery Physician	$6.5M	$0
Central Oregon Emergency Physicians LLC	OR	Emergency Medical Services (Emergency Medicine) Physician	$0	$5.2M

St. Charles Health System, Inc. — Billing Profile & Reimbursement Data

Sign up for St. Charles Health System, Inc. — Billing Profile & Reimbursement Data policy alerts

St. Charles Health System, Inc. — Billing Profile & Reimbursement Data

Sign up for St. Charles Health System, Inc. — Billing Profile & Reimbursement Data policy alerts

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References