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

Why is the Medicaid comparison limited to West Virginia 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. West Virginia (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.

Summersville Regional Medical Center (NPI 1104813740)

Field	Value
Entity Type	Organization
Organization	Summersville Regional Medical Center
Address	400 Fairview Heights Rd
City	Summersville
State	WV
ZIP	26651
Taxonomy	Critical Access Hospital
NPI Enumerated	September 29, 2005

Payer Source	Total Paid
Medicaid	$3.4M
Medicare	$0

Medicaid: Complete Services Breakdown

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

167 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.	3,630	$70	$261.1K
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.	3,430	$60	$192.3K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	8,660	$20	$181.8K
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.	5,720	$30	$177.4K
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…	5,930	$20	$142.3K
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.	740	$190	$138.2K
81001	Urinalysis is used to detect substances or cellular material in the urine associated with different metabolic and kidney disorders. It is used to detect urinary tract infections (UTI) and other…	3,340	$30	$86.8K
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	2,040	$40	$73.5K
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…	1,860	$40	$65.2K
96375	Following the administration of a drug or other substance via intravenous, or IV, push, the provider sequentially infuses a different medication or medications, also via IV push. He administers the…	1,880	$30	$64K

Showing 1–10 of 167

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. West Virginia Distribution

Summersville Regional Medical Center — 0 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — West Virginia

Full comparison — all codes billed, vs. West Virginia median

167 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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.	92	130	2,090	$210	$1.5M
87491	The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique.	35	40	820	$30	$1.2M
87591	The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique.	35	40	820	$30	$1.2M
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.	82	170	3,350	$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.	86	160	3,690	$80	$714.8K
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.	51	80	950	$140	$559.5K
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.	72	110	2,080	$50	$537.1K
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…	34	50	800	$70	$504.4K
G0378	Hospital observation service, per hour	45	50	940	$140	$363K
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.	54	110	5,530	$20	$344.8K

Showing 1–10 of 167

Related Providers

Other providers that share a Tax Identification Number (TIN) with Summersville Regional Medical Center, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
West Virginia Health Care Cooperative Inc	WV	Critical Access Hospital	$0	$19.2M
West Virginia Health Care Cooperative Inc	WV	Hospitalist Physician	$0	$3.1M
West Virginia Health Care Cooperative Inc	WV	Rural Health Clinic/Center	$0	$1.6M
Salman Osman	WV	Hematology & Oncology Physician	$146.1K	$0
Charles Moore	WV	Ophthalmology Physician	$145.3K	$0
Bethany Pellegrino	WV	Nephrology Physician	$126.5K	$0
Richard Trenbath	WV	Family Medicine Physician	$75.3K	$0
Jonathan Stanley	WV	Infectious Disease Physician	$73.7K	$0
Yaoxian Ding	RI	Anatomic Pathology & Clinical Pathology Physician	$36.9K	$22.7K
Howard Lafferty	WV	Family Medicine Physician	$57.2K	$0

Nearby Providers

Other providers in the same ZIP code as Summersville Regional Medical Center, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Summersville Pediatrics Inc.	WV	Specialist	$0	$12M
Nicholas Community Action Partnership, Inc.	WV	Point of Service	$0	$6.2M
Nicholas Pharmacy Inc	WV	Oxygen Equipment & Supplies (DME)	$0	$2.2M
Nicholas Community Action Partnership, Inc.	WV	Home Health Agency	$0	$2M
Nicholas Emergency Group, PLLC	WV	Emergency Medicine Physician	$0	$1.6M
New River Health Association, Inc.	WV	Federally Qualified Health Center (FQHC)	$0	$1.4M
New River Health Association, Inc.	WV	Federally Qualified Health Center (FQHC)	$0	$1.3M
Katherine Wooton	WV	Dentist	$0	$1.2M
Mountain Ridge Dialysis LLC	WV	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$845.4K
Stephen Young	WV	Physical Therapist	$71.1K	$0

Summersville Regional Medical Center — Billing Profile & Reimbursement Data

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Summersville Regional 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