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

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

Rutland Hospital, Inc. (NPI 1083678833)

Rutland Hospital, Inc. is a specialist provider located in Rutland, Vermont. This profile covers 0 Medicare and 43 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	Rutland Hospital, Inc.
Address	160 Allen St
City	Rutland
State	VT
ZIP	05701
Taxonomy	Specialist
NPI Enumerated	April 17, 2006

Payer Source	Total Paid
Medicaid	$1M
Medicare	$0

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

43 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	12,690	$30	$368K
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…	15,880	$20	$333.6K
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…	2,270	$30	$72.7K
90960	The provider manages all the services associated with the monthly care of a patient who is 20 years old or older and has a condition known as end stage renal disease or ESRD. For this service, the…	710	$70	$46.4K
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…	750	$50	$34.4K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	2,560	$10	$30.7K
92557	The provider assesses a patient’s hearing with a series of tones at varying intensities to identify the softest level at which the patient can hear. He also measures the patient’s ability to…	2,040	$10	$22.4K
99205	The provider sees a new 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 provider…	290	$50	$13.6K
92567	In this procedure, the provider measures the functioning of the middle ear by varying the pressure of air presented to the ear to identify the reason for hearing loss.	3,730	$1	$11.2K
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,…	380	$30	$11K

Showing 1–10 of 43

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Vermont Distribution

Rutland Hospital, Inc. — 8 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Vermont

Full comparison — all codes billed, vs. Vermont median

43 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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…	18	320	680	$30	$146.1K
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…	28	320	760	$20	$88.2K
92004	The provider performs a comprehensive level ophthalmological evaluation of a new patient and initiates a diagnostic and treatment program for one or more visits.	55	60	170	$100	$52.9K
90960	The provider manages all the services associated with the monthly care of a patient who is 20 years old or older and has a condition known as end stage renal disease or ESRD. For this service, the…	2	10	870	$60	$52.5K
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…	4	50	50	$80	$50K
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…	46	110	170	$70	$38.6K
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…	4	70	70	$50	$36K
92015	The provider determines the process of determining if a patient's vision is less than 20/20 and by what amount so that corrective lenses or contact lenses can be prescribed and produced.	48	70	850	$10	$26.9K
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	10	180	$90	$17.8K
99222	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	5	10	40	$60	$14.4K

Showing 1–10 of 43

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Rutland Hospital, Inc.	VT	Psychiatric Hospital Unit	$396.2K	$13.3M
Rutland Hospital, Inc	VT	Emergency Medicine Physician	$0	$1.8M
Rutland Hospital, Inc.	VT	General Acute Care Hospital	$0	$948.8K
Jennifer Fauntleroy	VT	Psychiatry Physician	$65.4K	$712.9K
Rutland Hospital, Inc.	VT	Specialist	$0	$653.6K
Philip Ginsburg	VT	Gastroenterology Physician	$628K	$0
James Fitts	CA	Cardiovascular Disease Physician	$389.7K	$0
Rutland Hospital, Inc.	VT	Specialist	$0	$345K
William Lighthart	WY	Adult Reconstructive Orthopaedic Surgery Physician	$293.1K	$0
Eric Marsh	VT	Surgery Physician	$273.7K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Rutland Mental Health Services	VT	Developmental Disabilities Clinic/Center	$0	$122.1M
Community Health Centers Of The Rutland Region Inc	VT	Federally Qualified Health Center (FQHC)	$0	$20.6M
Rutland Mental Health Services, Inc.	VT	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$17.7M
Community Health Centers Of The Rutland Region, Inc.	VT	Pediatrics Physician	$0	$13.6M
Regional Ambulance Service, Inc	VT	Land Ambulance	$1.4M	$5.3M
Vna & Hospice Of The Southwest Region, Inc	VT	Home Health Agency	$0	$4.8M
Bradford Psychiatric Associates. LLC	VT	Addiction Medicine (Internal Medicine) Physician	$0	$4.7M
Community Health Centers Of The Rutland Region, Inc.	VT	Dentist	$0	$4.4M
Community Health Centers Of The Rutland Region, Inc.	VT	Federally Qualified Health Center (FQHC)	$0	$4.3M
Community Health Centers Of The Rutland Region Inc	VT	Federally Qualified Health Center (FQHC)	$0	$3.2M

Rutland Hospital, Inc. — 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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