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

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

Cape Cod Hospital Inc (NPI 1114984671)

Cape Cod Hospital Inc is a general acute care hospital provider located in Hyannis, Massachusetts. This profile covers 0 Medicare and 488 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	Cape Cod Hospital Inc
Address	27 Park St
City	Hyannis
State	MA
ZIP	02601
Taxonomy	General Acute Care Hospital
NPI Enumerated	April 28, 2006

Payer Source	Total Paid
Medicaid	$86.9M
Medicare	$0

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

488 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.	65,540	$170	$11.3M
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.	52,840	$150	$8M
96361	The provider administers intravenous, or IV, fluids with electrolytes through an already established intravenous route for each additional hour to treat more severe dehydration.	21,300	$360	$7.6M
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.	42,050	$150	$6.4M
G0378	Hospital observation service, per hour	26,100	$110	$2.9M
96365	The provider administers the initial intravenous infusion of a medication or other substance for a period up to one hour to prevent, treat, or diagnose a condition or disease.	24,970	$120	$2.9M
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…	43,010	$60	$2.4M
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…	15,800	$150	$2.3M
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	33,880	$60	$2.1M
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.	12,720	$160	$2M

Showing 1–10 of 488

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Massachusetts Distribution

Cape Cod Hospital Inc — 5 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Massachusetts

Full comparison — all codes billed, vs. Massachusetts median

488 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
96361	The provider administers intravenous, or IV, fluids with electrolytes through an already established intravenous route for each additional hour to treat more severe dehydration.	17	90	7,560	$350	$4.2M
S9485	Crisis intervention mental health services, per diem	33	110	1,250	$540	$3.2M
Q5103	Injection, infliximab-dyyb, biosimilar, (inflectra), 10 mg	8	10	1,200	$1,560	$2.1M
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…	14	50	1,870	$210	$1.4M
77386	Intensity modulated radiation treatment delivery (IMRT), includes guidance and tracking, when performed; complex	9	10	1,070	$220	$1.4M
G0378	Hospital observation service, per hour	12	70	7,250	$100	$1.3M
96365	The provider administers the initial intravenous infusion of a medication or other substance for a period up to one hour to prevent, treat, or diagnose a condition or disease.	7	80	4,380	$140	$1.1M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	35	110	5,660	$30	$1.1M
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.	20	520	120	$130	$1M
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…	11	130	1,830	$60	$974.3K

Showing 1–10 of 488

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Daniel Gorin	MA	Surgery Physician	$1.1M	$0
Mallory Hatfield	MA	Cardiovascular Disease Physician	$1M	$0
John Kalin	MA	Cardiovascular Disease Physician	$617.9K	$0
Peter Chiotellis	MA	Cardiovascular Disease Physician	$555.9K	$0
Mark Wolfe	MA	Cardiovascular Disease Physician	$515.7K	$0
Michael Mecley	MA	Cardiovascular Disease Physician	$479.3K	$0
Claude-laurent Sader	MA	Cardiovascular Disease Physician	$309K	$0
Jorge Alfonso	MA	Internal Medicine Physician	$297.5K	$0
Edward Caldwell	MA	Otolaryngology Physician	$243.5K	$0
Ann Gryboski	MA	Internal Medicine Physician	$238.5K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Relief Home Health Services Inc	MA	Home Health Agency	$0	$37.2M
Harbor Health Services, Inc.	MA	Community Health Clinic/Center	$0	$21.8M
Capeabilities	MA	Developmentally Disabled Services Day Training Agency	$0	$18M
Duffy Health Center, Inc	MA	Federally Qualified Health Center (FQHC)	$0	$16.8M
Coastal Medical Transportation Services LLC	MA	Land Ambulance	$5.2M	$10.2M
Coastal Ambulance LLC	MA	Land Ambulance	$5.1M	$8.2M
The Commonwealth Of Massachusetts	MA	Case Management Agency	$0	$9M
Advantage Home Health Care Services LLC	MA	Home Health Agency	$0	$8.5M
Habilitation Assistance Corportation	MA	Developmentally Disabled Services Day Training Agency	$0	$7.3M
Cape Cod Emergency Associates, LLC	MA	Emergency Medicine Physician	$0	$7.2M

Cape Cod Hospital Inc — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

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