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.

Peacehealth (NPI 1083888515)

Key Findings

Field	Value
Entity Type	Organization
Organization	Peacehealth
Address	3333 Riverbend Drive
City	Springfield
State	OR
ZIP	97477
Taxonomy	General Acute Care Hospital
NPI Enumerated	April 16, 2008

Payer Source	Total Paid
Medicaid	$30.7M
Medicare	$0

PEACEHEALTH reports no Medicare billing on file and $30.7M in lifetime Medicaid revenue, making its Medicaid activity effectively the sole documented public-payer footprint in our data. This single-payer profile means analyses of scale and competitive positioning should focus on Medicaid flows rather than a dual Medicare/Medicaid comparison.

Revenue is extremely concentrated in emergency-department E/M codes: the precomputed top-three codes account for 84.5% of the provider's Medicaid revenue, with 99285 alone contributing $15.4M (50.3% of Medicaid revenue), 99284 contributing $7.2M (23.5%), and 99283 contributing $3.3M (10.7%). That level of concentration indicates the ED is the dominant revenue engine for the facility.

The code-level mix—large counts for 99285 (42.3K claims, ranks #10 of 129 in-state, 93rd percentile, “typical, unremarkable volume” label applied in source) and 99284 (27.8K claims, ranks #28 of 145, 81st percentile)—signals a high-volume emergency department handling a substantial share of higher-acuity visits. The presence of frequent IV administration codes such as 96374 (12.2K claims, $1.3M) and 96361 (3.4K claims, $118K) supports an operational profile oriented to acute medical treatment and ED throughput.

Procedure and specialty ambulatory services are present but secondary: GI endoscopy codes (45385 $931.5K; 43239 $894.8K; 45380 $462.3K) together represent modest Medicaid revenue and rank in the upper half of state providers (e.g., 45385 ranks #8 of 38, 43239 ranks #8 of 60). These entries indicate an on-site endoscopy suite and procedural capability that supplement the ED-driven revenue mix but do not rival ED E/M codes in scale.

Ancillary diagnostics and high-claim, low-dollar services are a notable pattern: 93005 shows 28.1K claims generating $28.1K and is flagged as “notably above typical state volume,” while lab and imaging codes such as 87635 (4.8K claims, $124.2K, 92nd percentile) and 84484 (9.2K claims, $9.2K, 89th percentile) demonstrate high throughput with low per-claim payment. This combination is consistent with heavy ED and observation utilization generating many discrete, low-paid technical claims alongside higher-paid E/M encounters.

Competitive standing is mixed: for high-acuity ED care PEACEHEALTH is a major in-state participant (99285 at the 93rd percentile, rank #10 of 129), but for many other codes the provider ranks in typical ranges (many entries labeled “typical, unremarkable volume”), so its strength appears concentrated in emergency services rather than broad dominance across outpatient or specialty lines. Analysts should treat the provider as a regional ED leader with otherwise conventional market share on ancillary and procedural codes.

The provider has an established operating history with NPI enumeration dated 2008-04-16 (~18 years ago), indicating long-tenured presence in the market. That tenure, combined with an ED-centric Medicaid revenue base, suggests organizational experience in managing high ED volumes and the staffing/resource implications that accompany sustained emergency care demand.

Because 84.5% of Medicaid revenue is tied to the top three ED E/M codes, the facility’s financial performance is highly sensitive to changes in Medicaid ED utilization or reimbursement policy. This concentrated revenue profile implies limited Medicaid revenue diversification and potential vulnerability to shifts in ED visit patterns, payer policies, or care-site substitution initiatives that reduce ED reliance.

Medicaid: Complete Services Breakdown

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

71 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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.	42,270	$370	$15.4M
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.	27,810	$260	$7.2M
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.	17,690	$190	$3.3M
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	12,230	$110	$1.3M
45385	The provider examines the colon and rectum using a colonoscope, a long, thin flexible tubular instrument with a light source and camera. He removes one or more tumors, polyps, or other lesions with a…	1,530	$610	$931.5K
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.	2,400	$370	$894.8K
45380	The provider examines the rectum and colon using a flexible colonoscope, a tubular instrument with a light source and camera, to look for the cause of a patient's symptoms, which may include…	880	$520	$462.3K
11042	The provider uses surgical instruments to remove the dead tissue in skin down to the subcutaneous layer and including the epidermis and dermis, up to the first 20 cm2.	1,820	$120	$216.3K
G0463	Hospital outpatient clinic visit for assessment and management of a patient	3,110	$40	$136.7K
87635	Using an amplified nucleic acid probe technique, the lab analyst performs the necessary steps to identify the nucleic acids from the severe acute respiratory syndrome coronavirus 2 (SARS–COV–2) virus…	4,780	$30	$124.2K

Showing 1–10 of 71

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

Peacehealth — 1 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

71 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.	28	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.	10	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.	51	140	10,160	$130	$2.3M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	24	40	3,200	$60	$1.5M
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	12	60	3,620	$90	$623.7K
41899	Use this code to report a procedure on the teeth and adjoining alveolar structures for which there is no specific code available.	14	20	190	$1,070	$556K
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…	27	60	420	$60	$405.1K
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.	49	80	1,130	$90	$327.2K
45385	The provider examines the colon and rectum using a colonoscope, a long, thin flexible tubular instrument with a light source and camera. He removes one or more tumors, polyps, or other lesions with a…	8	40	310	$420	$325.7K
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.	64	80	1,210	$40	$294.3K

Showing 1–10 of 71

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mckenzie-willamette Regional Medical Center Associates LLC	OR	General Acute Care Hospital	$0	$44.6M
Lane County Oregon	OR	Federally Qualified Health Center (FQHC)	$0	$20.6M
Springfield Treatment Center	OR	Methadone Clinic	$0	$20.5M
Mental Health For Children, Inc	OR	Mental Health Counselor	$0	$12.7M
G Street Integrated Health	OR	Clinic/Center	$0	$9.3M
Radiology Associates PC	OR	Diagnostic Radiology Physician	$0	$7.8M
Oregon Endoscopy Center, LLC	OR	Ambulatory Surgical Clinic/Center	$919.2K	$5.6M
Pathology Consultants, PC	OR	Anatomic Pathology & Clinical Pathology Physician	$0	$5.5M
Peacehealth	OR	Hospitalist Physician	$0	$5.5M
Womens Care, PC	OR	Obstetrics & Gynecology Physician	$0	$5.3M

Peacehealth — 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

Nearby Providers

Frequently Asked Questions

References