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

Why is the Medicaid comparison limited to South Carolina 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. South Carolina (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.

Spartanburg Medical Center (NPI 1093819492)

Spartanburg Medical Center is a maternal & fetal medicine physician provider located in Spartanburg, South Carolina. This profile covers 0 Medicare and 26 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	Spartanburg Medical Center
Address	853 N Church St
City	Spartanburg
State	SC
ZIP	29303
Taxonomy	Maternal & Fetal Medicine Physician
NPI Enumerated	September 7, 2006

Payer Source	Total Paid
Medicaid	$11.5M
Medicare	$0

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

26 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	24,750	$90	$2.2M
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…	33,770	$60	$2M
76811	The provider performs an ultrasound study using a transabdominal approach to examine the fetus and mother, along with additional examination of the fetal anatomy, such as the heart rate, amniotic…	10,700	$150	$1.6M
76819	The provider performs a biophysical profile test to measure the health of the baby during pregnancy using only ultrasound and not a nonstress test.	21,040	$70	$1.5M
76825	The provider performs real–time fetal echocardiography, with or without M–mode recording, for complete evaluation of a fetal cardiovascular system.	5,100	$200	$1M
76820	The provider performs Doppler ultrasonography for fetal surveillance to determine the velocity of blood flow through the umbilical artery. This test determines the timing of labor induction and when…	20,970	$40	$796.9K
76817	The provider performs an ultrasound of the pregnant uterus to examine the fetus and the mother's organs using a transvaginal approach.	7,780	$70	$568.2K
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…	6,170	$90	$530.2K
76821	The provider performs Doppler ultrasonography for fetal surveillance to determine the velocity of blood flow through the middle cerebral artery. This test determines the timing of labor induction and…	3,590	$70	$262.1K
93325	The provider performs Doppler echocardiography, a diagnostic procedure based on the Doppler effect of sound, color flow velocity mapping, a two–dimensional image representation of blood flow in the…	11,050	$20	$254.1K

Showing 1–10 of 26

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. South Carolina Distribution

Spartanburg Medical Center — 12 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — South Carolina

Full comparison — all codes billed, vs. South Carolina median

26 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
76811	The provider performs an ultrasound study using a transabdominal approach to examine the fetus and mother, along with additional examination of the fetal anatomy, such as the heart rate, amniotic…	2	40	510	$170	$302.7K
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…	66	2,770	210	$60	$254.5K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	187	710	350	$60	$247.2K
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…	255	2,480	350	$80	$246K
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	2	100	240	$100	$187.3K
99244	The provider sees a patient for an office or other outpatient consultation involving evaluation and management (E/M). The E/M involves a moderate level of medical decision making or the provider…	95	110	70	$150	$157.3K
76819	The provider performs a biophysical profile test to measure the health of the baby during pregnancy using only ultrasound and not a nonstress test.	2	70	150	$70	$156.2K
96372	A therapeutic, prophylactic, or diagnostic substance (a fluid, a drug, etc.) is injected via intramuscular or subcutaneous route into the patient's body. The procedure is performed by the physician…	128	410	330	$50	$152.6K
76825	The provider performs real–time fetal echocardiography, with or without M–mode recording, for complete evaluation of a fetal cardiovascular system.	1	10	220	$180	$136.9K
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,…	124	610	190	$50	$98.4K

Showing 1–10 of 26

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Axcess Healthcare Services, LLC	SC	Nursing Care Agency	$0	$98.5M
South Carolina Dept Of Mental Health Accounting Office	SC	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$40M
Better Beginnings, Inc	SC	Pediatric Occupational Therapist	$0	$6.9M
Whitney Road Dental Health Center, P.C.	SC	General Practice Dentistry	$0	$6.3M
Foothills Pediatric Dentistry, PA	SC	Pediatric Dentistry	$0	$4.9M
Bhg Xxxviii, LLC	SC	Substance Use Disorder Rehabilitation Clinic/Center	$264.8K	$3.5M
Upstate Carolina Radiology PA	SC	Diagnostic Radiology Physician	$0	$3.2M
Jonathan Mims	SC	General Practice Dentistry	$0	$3.2M
Spartanburg Medical Center	SC	Pediatrics Physician	$0	$2.5M
Spartanburg & Pelham Ob-gyn,p.a.	SC	Obstetrics Physician	$0	$2M

Spartanburg Medical Center — Billing Profile & Reimbursement Data

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Spartanburg Medical Center — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Spartanburg Medical Center	SC	General Acute Care Hospital	$0	$187.7M
Spartanburg Medical Center	SC	Emergency Medicine Physician	$0	$17.2M
Spartanburg Medical Center	SC	Family Medicine Physician	$0	$17M
Cherokee Medical Center	SC	General Acute Care Hospital	$0	$15.4M
Pelham Medical Center	SC	General Acute Care Hospital	$0	$13.8M
Union Medical Center	SC	General Acute Care Hospital	$0	$10.7M
Spartanburg Medical Center	SC	Community Based Hospice Care Agency	$0	$8.9M
Spartanburg Medical Center	SC	Urgent Care Clinic/Center	$0	$6.3M
Spartanburg Medical Center	SC	Pediatrics Physician	$0	$4.8M
Spartanburg Medical Center	SC	Urgent Care Clinic/Center	$0	$4.2M