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

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

Jackson Madison County General Hospital (NPI 1093705428)

Field	Value
Entity Type	Organization
Organization	Jackson Madison County General Hospital
Address	620 Skyline Dr
City	Jackson
State	TN
ZIP	38301
Taxonomy	General Acute Care Hospital
NPI Enumerated	October 26, 2005

Payer Source	Total Paid
Medicaid	$46.6M
Medicare	$0

Key Findings

This facility has no Medicare billing on file and reports $46.6M in lifetime Medicaid revenue, making its measurable payer footprint effectively single-payer Medicaid in the available data. The absence of Medicare activity suggests the provider’s present claims profile and competitive comparisons should be interpreted primarily through a Medicaid lens rather than a dual‑payer view.

Revenue is highly concentrated in emergency department E/M codes: the top three Medicaid codes (99284, 99283, 99285) together account for 73.2% of this provider’s total Medicaid revenue. Individually those codes are reported as $15.5M (35.6%) for 99284, $11.2M (25.6%) for 99283, and $5.3M (12.1%) for 99285, which indicates that ED visits are the dominant revenue driver for this hospital.

The code mix strongly points to an ED-anchored acute-care operation: 99284, 99283, and 99285 are the top revenue generators, and each ranks in very high state percentiles (99284 at 98th, 99283 at 97th, 99285 at 96th), signaling that the facility handles high volumes of moderate-to-high complexity emergency visits compared with in-state peers. This pattern is consistent with a general acute care hospital that serves as a primary regional emergency access point.

Beyond emergency services, the provider shows substantial on-site laboratory and specimen throughput. Proprietary respiratory testing 0202U ($2M, 4.6%, rank #2 of 15, 93th percentile) and high-volume routine lab codes such as 80048 (90.5K claims, rank #1 of 174, 100th percentile) and 85025 (169.5K claims, rank #6 of 554, 99th percentile) indicate a robust diagnostic capacity and high testing volume supporting ED and inpatient workflows.

The hospital also maintains notable oncology and infusion services: chemotherapy administration 96413 (15.4K claims, $984.5K, 2.3% of Medicaid revenue) ranks #3 of 37 in-state (94th percentile), while radiation therapy delivery codes 77412 (16.2K claims, $518.8K, rank #1 of 6, 100th percentile), 77336 (6.1K claims, $170.3K, rank #1 of 23, 100th percentile), and 77334 (1.7K claims, $168.6K, rank #1 of 29, 100th percentile) point to an active radiation oncology program and concentrated specialty treatments. These service-line signals suggest the hospital provides comprehensive oncology care beyond basic infusion.

Several procedure and supply codes are statistical outliers for in-state volume, highlighting specific high-throughput clinical operations: 36415 (151.5K claims, rank #6 of 1475, 100th percentile), 11042 (12.6K claims, rank #2 of 121, 99th percentile), 80048 (rank #1 of 174, 100th percentile), and 77336/77334 (both rank #1 of their peer groups at 100th percentile). Such extreme outlier status implies unusually large volumes in phlebotomy, wound debridement, basic metabolic testing, and radiation physics services relative to peers.

The provider performs pediatric ENT and ambulatory surgical procedures at measurable scale: 42820 (tonsil/adenoid removal in children) generates $808.1K (1.9% of Medicaid revenue, rank #10 of 51, 82th percentile) and 69436 (tympanostomy with tube insertion) generates $698.3K (1.6%, rank #18 of 65, 73th percentile), indicating maintained OR capacity for common pediatric procedures. These codes, together with cataract surgery 66984 and endoscopic biopsies 43239, point to an ongoing general surgical and specialty outpatient surgery capability.

The provider’s tenure (NPI enumerated 2005-10-26, ~21 years ago) combined with consistently high state percentiles across core ED and diagnostic codes suggests it is an established regional hospital with dominant Medicaid ED volumes. Given that the top three ED codes alone represent 73.2% of Medicaid revenue, the hospital’s financial performance and competitive position within the state are tightly linked to emergency-care volume and associated ancillary services, exposing it to utilization shifts or Medicaid policy changes that affect ED reimbursement or access patterns.

Medicaid: Complete Services Breakdown

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

187 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.	66,850	$230	$15.5M
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.	71,080	$160	$11.2M
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.	24,690	$210	$5.3M
0202U	This is a Proprietary Laboratory Analyses (PLA) code, meaning that the code applies to only one unique lab test made by a specific manufacturer or performed by a specific lab. Report 0202U for the…	7,860	$260	$2M
G0378	Hospital observation service, per hour	5,060	$230	$1.1M
96413	Chemotherapy is a therapeutic procedure used for the treatment of cancer via the use of chemical agents. These chemical agents (drugs) work on the cancerous cells of the body to destroy them. These…	15,380	$60	$984.5K
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…	169,480	$10	$847.4K
42820	The provider removes the tonsils and adenoids in a patient younger than 12 years old.	520	$1,560	$808.1K
69436	This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia.	560	$1,250	$698.3K
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.	1,410	$420	$583.9K

Showing 1–10 of 187

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Tennessee Distribution

Jackson Madison County General Hospital — 12 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Tennessee

Full comparison — all codes billed, vs. Tennessee median

187 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
G0463	Hospital outpatient clinic visit for assessment and management of a patient	9	60	1,340	$50	$1.1M
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.	16	630	510	$120	$1.1M
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	610	570	$110	$884.4K
41899	Use this code to report a procedure on the teeth and adjoining alveolar structures for which there is no specific code available.	19	30	410	$520	$719.2K
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.	25	570	640	$100	$637.8K
42820	The provider removes the tonsils and adenoids in a patient younger than 12 years old.	10	50	140	$850	$541.1K
0202U	This is a Proprietary Laboratory Analyses (PLA) code, meaning that the code applies to only one unique lab test made by a specific manufacturer or performed by a specific lab. Report 0202U for the…	2	20	1,060	$210	$535.6K
69436	This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia.	18	70	160	$500	$421.5K
96413	Chemotherapy is a therapeutic procedure used for the treatment of cancer via the use of chemical agents. These chemical agents (drugs) work on the cancerous cells of the body to destroy them. These…	3	40	1,860	$70	$294.9K
A0425	Ground mileage, per statute mile	156	340	6,120	$10	$280.5K

Showing 1–10 of 187

Related Providers

Other providers that share a Tax Identification Number (TIN) with Jackson Madison County General Hospital, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Jackson-madison County General Hospital	TN	Land Ambulance	$5.1M	$13M
West Tennessee Medical Group Inc	TN	Internal Medicine Physician	$0	$8.2M
Jackson-madison County General Hospital	TN	Community/Retail Pharmacy	$0	$7.4M
Stephen Huddleston	TN	Retina Specialist (Ophthalmology) Physician	$5.7M	$0
Wt Medical Associates	TN	Rural Health Clinic/Center	$0	$5.5M
Wt Medical Associates	TN	Internal Medicine Physician	$0	$4.9M
Scott Sullivan	TN	Retina Specialist (Ophthalmology) Physician	$3M	$0
Wt Medical Associates	TN	Rural Health Clinic/Center	$0	$2.5M
Salar Rafieetary	TN	Retina Specialist (Ophthalmology) Physician	$2.1M	$0
Rachel Robinson	TN	Family Nurse Practitioner	$2.1M	$0

Nearby Providers

Other providers in the same ZIP code as Jackson Madison County General Hospital, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Pathways Of Tennessee, Inc.	TN	Clinic/Center	$0	$30.6M
Emergency Medical Care Facilities PC	TN	Emergency Medicine Physician	$0	$19.7M
A Plus Care Solutions Incorporated	TN	In Home Supportive Care Agency	$0	$18.4M
Mid-south Perinatal Associates PC	TN	Maternal & Fetal Medicine Physician	$0	$11.6M
Wt University Medical Associates Inc	TN	Family Medicine Physician	$0	$7.5M
Shavetta Conner	TN	Public Health & General Preventive Medicine Physician	$8.1K	$4.9M
West Tennessee Healthcare Hospitalists Inc	TN	Hospitalist Physician	$0	$4.3M
Home Medical Products, Inc.	TN	Oxygen Equipment & Supplies (DME)	$0	$3.6M
Pathways Of Tennessee, Inc.	TN	Psychiatric Hospital	$0	$3.3M
William Priester	TN	Ophthalmology Physician	$3.2M	$0

Jackson Madison County General Hospital — Billing Profile & Reimbursement Data

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Jackson Madison County General Hospital — 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

Related Providers

Nearby Providers

Frequently Asked Questions

References