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

Why is the Medicaid comparison limited to New Jersey 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. New Jersey (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.

Saint Peter's University Hospital (NPI 1114924834)

Field	Value
Entity Type	Organization
Organization	Saint Peter's University Hospital
Address	254 Easton Ave
City	New Brunswick
State	NJ
ZIP	08901
Taxonomy	General Acute Care Hospital
NPI Enumerated	July 7, 2005

Payer Source	Total Paid
Medicaid	$185.5M
Medicare	$0

Key Findings

SAINT PETER'S UNIVERSITY HOSPITAL reports no Medicare billing on file and $185.5M in lifetime Medicaid revenue, making its publicly available billed activity effectively single‑payer (Medicaid) in scale. Analysts should treat Medicaid as the primary source of fee‑for‑service activity for this entity rather than a dual Medicare/Medicaid mix.

Revenue is highly concentrated in emergency department evaluation & management codes: 99283, 99282, and 99284 are the top three Medicaid codes and together account for 41.1% of the provider's total Medicaid revenue. This concentration indicates the ED (and related acute evaluation services) are the dominant revenue drivers for the hospital under Medicaid.

The provider is a statewide outlier on several ED and outpatient E/M measures: 99282 ranks #3 of 141 providers in‑state (99th percentile, labeled an "extreme outlier") and 99283 ranks #21 of 262 (92nd percentile). High rank positions for these codes suggest SAINT PETER'S is a major regional ED volume center for Medicaid patients, particularly at lower‑acuity ED visit levels.

Observation and short‑stay services are a material revenue stream: G0378 (hospital observation service, per hour) generates $12.2M (9.6% of Medicaid revenue) and ranks #19 of 78 providers (77th percentile). Paired with high ED volumes, this pattern points to a care model focused on ED throughput plus observation unit activity rather than inpatient/Medicare DRG billing.

Ambulatory and outpatient visits are also large volume contributors: 99213 (142K claims, $6M revenue) and 99214 (80.3K claims, $5.3M revenue) both rank at or near the top percentiles in‑state (99213 at 100th percentile; 99214 at 100th percentile) and are described as "extreme outliers" for volume. These counts indicate an extensive outpatient clinic footprint under Medicaid that supplements the ED as a revenue base.

Maternal/fetal and prenatal imaging services are prominent: 76816 ($4.4M, ranks #1 of 136, 100th percentile), 76819 ($2.3M, ranks #1 of 103, 100th percentile), and fetal monitoring codes 59025 and 59050 rank in top state positions (59025 rank #3 of 96, 98th percentile; 59050 rank #1 of 6, 100th percentile). This code mix signals a high-volume obstetrics program driving meaningful Medicaid revenue.

Behavioral health and specialized testing show notable positions: 90853 (group psychotherapy) accounts for $9.5M and ranks #9 of 332 (98th percentile), while proprietary lab code 0202U ($2.1M) ranks #1 of 47 providers in‑state (100th percentile). Together these findings indicate significant Medicaid activity in both mental health group services and in-state leadership for a specific respiratory PLA test.

Tenure and provider identity: the NPI was enumerated on 2005-07-07 (~21 years ago), establishing two decades of billing history. Given the combination of very high ED/observation throughput, extensive outpatient clinic volumes, and leading state ranks on several maternal, behavioral health, and specialized lab codes, the hospital functions as a large, Medicaid‑centric acute care and ambulatory provider in New Jersey with concentrated reliance on a few high‑volume ED codes (41.1% of Medicaid revenue).

Medicaid: Complete Services Breakdown

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

536 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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.	68,080	$350	$23.5M
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.	45,350	$320	$14.6M
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.	39,710	$350	$14.1M
G0378	Hospital observation service, per hour	12,420	$980	$12.2M
90853	Group psychotherapy is provided to a group of people who are normally not acquainted with each other but might be sharing similar kinds of psychological issues. The psychotherapist selects a group of…	26,480	$360	$9.5M
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…	142,030	$40	$6M
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…	80,310	$70	$5.3M
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	30,950	$140	$4.4M
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.	4,530	$750	$3.4M
59025	In this procedure, the provider measures the fetal heart rate of the fetus in response to its own movements.	12,770	$260	$3.3M

Showing 1–10 of 536

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. New Jersey Distribution

Saint Peter's University Hospital — 14 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — New Jersey

Full comparison — all codes billed, vs. New Jersey median

536 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
G0378	Hospital observation service, per hour	19	80	6,290	$690	$6.6M
U0003	Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high…	120	130	3,180	$60	$4.2M
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.	21	260	4,240	$220	$4.1M
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.	43	320	580	$230	$4M
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.	83	280	920	$200	$2.6M
41899	Use this code to report a procedure on the teeth and adjoining alveolar structures for which there is no specific code available.	26	30	860	$1,530	$2.1M
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.	48	150	3,680	$30	$1.5M
86480	The lab analyst performs a test to evaluate a cell mediated immunity gamma interferon antigen response to certain tuberculosis, or TB, antibodies.	21	40	810	$30	$1.4M
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.	3	140	1,410	$180	$1.3M
81220	The lab analyst performs the technical lab test to detect the presence of changes in the gene for cystic fibrosis transmembrane conductance regulator, also known as CFTR. The test evaluates the CFTR…	9	30	210	$200	$1.3M

Showing 1–10 of 536

Related Providers

Other providers that share a Tax Identification Number (TIN) with Saint Peter's University Hospital, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Archna Parmar	NJ	Internal Medicine Physician	$1M	$0
Sheema Jalil	NJ	Internal Medicine Physician	$408K	$0
William Baione	NJ	Orthopaedic Surgery Physician	$401.1K	$0
Samer Kassar	IN	Neurology Physician	$324K	$46.7K
Stephen Kayiaros	NJ	Orthopaedic Surgery Physician	$354.8K	$0
David Harwood	NJ	Orthopaedic Surgery Physician	$276.3K	$0
Rohini Mahajan	NJ	Physical Medicine & Rehabilitation Physician	$247.3K	$0
Tariq Alam	MO	Neurology Physician	$223.8K	$3.2K
Ayesha Ahmed	NJ	Internal Medicine Physician	$223.2K	$0
Michael Vardy	NJ	Gynecology Physician	$214.2K	$0

Nearby Providers

Other providers in the same ZIP code as Saint Peter's University Hospital, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Children's Specialized Hospital	NJ	Children's Rehabilitation Hospital	$0	$200M
Robert Wood Johnson University Hospital, Inc	NJ	General Acute Care Hospital	$0	$198.3M
Diya Care Inc	NJ	Home Health Agency	$0	$139.8M
Golden Path Adult Day Health Care Inc.	NJ	Adult Day Care Clinic/Center	$0	$17.7M
New Brunswick Board Of Education	NJ	Local Education Agency (LEA)	$0	$12.7M
Care We Love, LLC	NJ	Home Health Agency	$0	$11.2M
Damon House Inc.	NJ	Substance Abuse Rehabilitation Facility	$0	$9.8M
Southern Bank Emergency Physicians LLC	NJ	Emergency Medicine Physician	$0	$9.2M
New Brunswick Counseling Center	NJ	Substance Use Disorder Rehabilitation Clinic/Center	$174.7K	$9M
Rutgers Rwj Eric B. Chandler Health Center	NJ	Federally Qualified Health Center (FQHC)	$0	$7.3M

Saint Peter's University 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