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

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

Baylor College Of Medicine (NPI 1053352914)

Baylor College Of Medicine is a family medicine physician provider located in Houston, Texas. This profile covers 0 Medicare and 129 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	Baylor College Of Medicine
Address	1504 Taub Loop
City	Houston
State	TX
ZIP	77030
Taxonomy	Family Medicine Physician
NPI Enumerated	June 9, 2006

Payer Source	Total Paid
Medicaid	$18.1M
Medicare	$0

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

129 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…	79,970	$40	$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…	47,550	$60	$2.6M
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	17,480	$70	$1.3M
01967	The provider performs neuraxial anesthesia services for a patient undergoing a planned vaginal delivery.	1,180	$900	$1.1M
99460	The provider evaluates and manages the care of a normal newborn infant, typically immediately after birth, in a hospital or birthing center.	7,890	$80	$655K
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	7,270	$90	$632.8K
99480	The provider directs the care of a recovering low birth weight infant, whose current weight is between 2501 and 5000 grams.	4,680	$130	$584.8K
99477	The provider performs the initial day of inpatient hospital evaluation and management for a neonate, age 28 days or younger, who requires intensive care and observation as well as frequent…	1,320	$390	$510.8K
99381	The provider performs a well–baby visit for a child under the age of one.	5,460	$80	$447.3K
99238	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends 30 minutes or less on the service on the…	6,620	$60	$417.1K

Showing 1–10 of 129

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Texas Distribution

Baylor College Of Medicine — 9 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Texas

Full comparison — all codes billed, vs. Texas median

129 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99469	The provider evaluates and manages the subsequent care of a newborn or infant less than 28 days of age in a neonatal critical care setting, after the first day.	19	30	1,410	$340	$2.5M
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.	405	710	1,790	$200	$2.1M
99479	The provider directs the care of a recovering low birth weight infant, whose current weight is between 1500 and 2500 grams.	19	30	3,360	$120	$1.2M
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.	513	730	1,960	$100	$1M
99480	The provider directs the care of a recovering low birth weight infant, whose current weight is between 2501 and 5000 grams.	12	40	1,860	$110	$997.5K
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.	216	590	740	$170	$969.2K
01967	The provider performs neuraxial anesthesia services for a patient undergoing a planned vaginal delivery.	36	80	1,160	$220	$768.8K
59409	In this procedure, the provider provides admission to the hospital for delivery, labor management, including induction of labor, fetal monitoring, use of low forceps, and episiotomy, vaginal delivery…	113	270	130	$570	$318.8K
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.	235	370	360	$120	$279.5K
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	36	370	550	$80	$249.6K

Showing 1–10 of 129

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Huiping Xu	TX	Psychiatry Physician	$998.1K	$2.4K
Brigid Marshall	TN	Retina Specialist (Ophthalmology) Physician	$909.4K	$0
Richa Shukla	TX	Gastroenterology Physician	$653.2K	$0
John Chancellor	TX	Ophthalmology Physician	$647.3K	$0
Katherine Sanchez	NM	Medical Oncology Physician	$562.4K	$0
George Hutton	TX	Neurology Physician	$405.8K	$0
Trenton Bowen	AZ	Glaucoma Specialist (Ophthalmology) Physician	$328.1K	$0
Ganesh Rao	IN	Urology Physician	$322.4K	$0
Peter Chang	TX	Ophthalmology Physician	$301.6K	$0
Arjun Tarakad	TX	Neurology Physician	$291K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Texas Children's Hospital	TX	Children's Hospital	$0	$277.4M
Texas Children's Physician Group	TX	Pediatrics Physician	$0	$160.6M
Ut Physicians	TX	Anesthesiology Physician	$0	$94.4M
Texas Children's Urgent Care	TX	Pediatrics Physician	$0	$63.7M
Memorial Hermann Health System	TX	General Acute Care Hospital	$0	$39.5M
Harris County Hospital District	TX	General Acute Care Hospital	$0	$27.7M
Igor Cherches	TX	Neurology Physician	$6.7M	$0
David Brown	TX	Ophthalmology Physician	$5.7M	$0
Tien Wong	TX	Ophthalmology Physician	$4.5M	$0
Ankoor Shah	TX	Ophthalmology Physician	$3.7M	$0

Baylor College Of Medicine — 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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