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

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

Upmc Memorial (NPI 1063945707)

Upmc Memorial is a general acute care hospital provider located in York, Pennsylvania. This profile covers 0 Medicare and 174 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

(source: NPPES NPI Registry)

Medicaid: Complete Services Breakdown

Field	Value
Entity Type	Organization
Organization	Upmc Memorial
Address	1701 Innovation Dr
City	York
State	PA
ZIP	17408
Taxonomy	General Acute Care Hospital
NPI Enumerated	April 10, 2017

Payer Source	Total Paid
Medicaid	$6.7M
Medicare	$0

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

174 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	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.	19,880	$100	$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.	10,250	$70	$748.3K
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.	5,350	$140	$721.8K
74177	The provider performs computed tomography of the abdomen and pelvis with contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	2,010	$190	$374K
G0378	Hospital observation service, per hour	500	$520	$258K
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	8,460	$30	$245.3K
66984	The provider inserts an artificial lens after removing an extracapsular cataract by aspiration or use of ultrasonic waves. This procedure is done without the use of an endoscopic laser probe to…	190	$980	$189.3K
80053	The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel.	16,390	$10	$180.3K
93005	The provider records the electrical conduction of the heart to examine any abnormality in its functioning, based on signals from at least 12 leads, wires that connect the recording device to…	10,210	$10	$122.5K
85025	A complete blood count (better known as a CBC) is a blood test request by a doctor that provides detailed information about various types of cells in a patient's blood. Usually a pathologist or a…	20,190	$10	$121.1K

Showing 1–10 of 174

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Pennsylvania Distribution

Upmc Memorial — 2 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Pennsylvania

Full comparison — all codes billed, vs. Pennsylvania median

174 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
G0378	Hospital observation service, per hour	77	150	510	$870	$1.4M
T1015	Clinic visit/encounter, all-inclusive	1,306	1,690	760	$170	$1.2M
G0480	Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but…	44	130	310	$60	$769.3K
80307	The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date.	79	210	730	$40	$689.7K
U0003	Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high…	116	200	990	$70	$517.5K
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.	69	1,600	270	$120	$409.7K
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.	96	1,060	150	$130	$405.4K
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.	108	1,230	250	$130	$284K
X0621	N/A	27	30	300	$230	$175.5K
G0463	Hospital outpatient clinic visit for assessment and management of a patient	87	100	330	$40	$166K

Showing 1–10 of 174

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Colonial House, Inc	PA	Substance Abuse Rehabilitation Facility	$0	$9.2M
Wellspan Ems LLC	PA	Ambulance	$983.8K	$2M
Kyle Chapman	PA	Physical Medicine & Rehabilitation Physician	$409.6K	$0
Snehal Patel	PA	Family Medicine Physician	$199.4K	$35.2K
Preeti Murudkar	PA	Family Medicine Physician	$117K	$45.3K
Zhenhui Li	PA	Neurology Physician	$83.7K	$820
Kimberlee Mudge	PA	Surgery Physician	$82.9K	$0
Ravi Dukkipati	PA	Neurology Physician	$76.2K	$0
So Ri Park	PA	Optometrist	$47.2K	$0
Ignacio Prats	PA	Surgery Physician	$32.3K	$0

Upmc Memorial — Billing Profile & Reimbursement Data

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Upmc Memorial — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References