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

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

Arthur G James Cancer Hospital And Research Institute (NPI 1124127683)

Field	Value
Entity Type	Organization
Organization	Arthur G James Cancer Hospital And Research Institute
Address	460 W 10th Ave
City	Columbus
State	OH
ZIP	43210
Taxonomy	Special Hospital
NPI Enumerated	September 21, 2006

Payer Source	Total Paid
Medicaid	$140.7M
Medicare	$0

Key Findings

This provider has no Medicare billing on file and reports $140.7M in lifetime Medicaid revenue, making its public fee-for-service footprint effectively single-payer (Medicaid) in the available claims data. That concentration means observed activity and revenue patterns below reflect Medicaid utilization rather than a mixed Medicare/Medicaid business model.

Revenue is highly concentrated in a small set of high-cost oncology services: the top three Medicaid codes (J9271, 77386, J9299) account for 49.7% of this provider's total Medicaid revenue. Those three codes individually represent $27.3M (J9271, 26.1%), $15.5M (77386, 14.9%), and $9.1M (J9299, 8.7%) of the $140.7M Medicaid revenue, indicating the majority of dollars flow through a handful of immunotherapy and advanced radiation therapy services.

The code mix is characteristic of a high-volume comprehensive cancer center: large volumes and high average paid/claim for checkpoint inhibitors (J9271 pembrolizumab, J9299 nivolumab), high-complexity IMRT delivery (77386), along with chemotherapy administration (96413, 96417) and supportive biologics (J2506 pegfilgrastim). Additionally, substantial imaging and radiation planning codes (78815 PET/CT, 71260/74177 CTs, 77334 custom devices) point to integrated diagnostic, infusion, and radiation therapy operations rather than a primarily inpatient general hospital.

On statewide competitive standing for key oncology services, this provider is a dominant player: 77386 ranks #1 of 15 providers in-state (100th percentile) and is explicitly described as "notably above typical state volume," while J9299 ranks #1 of 7 providers (100th percentile) and J9271 ranks #2 of 22 (95th percentile) and is also "notably above typical state volume". Several other radiation and planning codes (e.g., 77334, 77300, 96417) are listed as "extreme outlier" or 100th percentile and rank #1 of their peer sets, reinforcing that this provider operates at much higher state-level volumes for specialized oncology procedures.

Operational throughput is substantial across both high-cost drugs and high-claim ancillary services: examples include 9.8K claims for 77386 ($15.5M), 17.4K claims for 96413 ($4.5M), 60.9K claims for 85025 ($1.8M), and 37.1K claims for 99211 ($1.8M). These claim counts indicate large outpatient infusion, lab, and clinic volumes consistent with a referral cancer center managing ongoing systemic therapy and follow-up visits.

Advanced radiation and imaging capabilities are supported by both volume and outlier status: 77386 (9.8K claims, $15.5M) and 77334 (1.5K claims, $1.8M, "extreme outlier, far above typical state volume") sit near the top of in-state rankings, and imaging codes such as 78815 (2K claims, $2.8M) and 70553 (2.8K claims, $1.7M) further show integrated PET/CT and MRI utilization to support complex radiation planning. This combination suggests in-house planning, device fabrication, and image-guided treatment delivery capability.

The provider’s dependence on Medicaid (no Medicare billing on file) creates concentrated payer exposure: $140.7M of publicly reported revenue is from Medicaid, and the heavy share of high-cost oncology agents and radiation services means a large portion of reimbursement is tied to a single public payer in these records. Analysts should treat negotiation leverage, reimbursement sensitivity, and utilization comparisons within the Medicaid context rather than across a mixed Medicare/Medicaid footprint.

This entity has an established presence in the market, with an NPI enumeration date of 2006-09-21 (~20 years ago) and a taxonomy of Special Hospital; combined with the code mix and state rankings, the data indicate a longstanding, specialized cancer hospital operating at scale within Ohio’s Medicaid environment.

Medicaid: Complete Services Breakdown

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

390 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J9271	Injection, pembrolizumab, 1 mg	1,860	$14,690	$27.3M
77386	Intensity modulated radiation treatment delivery (IMRT), includes guidance and tracking, when performed; complex	9,790	$1,590	$15.5M
J9299	Injection, nivolumab, 1 mg	730	$12,410	$9.1M
J2506	Injection, pegfilgrastim, excludes biosimilar, 0.5 mg	1,190	$4,670	$5.6M
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…	17,400	$260	$4.5M
J9358	Injection, fam-trastuzumab deruxtecan-nxki, 1 mg	740	$5,390	$4M
J9306	Injection, pertuzumab, 1 mg	450	$8,350	$3.7M
J9144	Injection, daratumumab, 10 mg and hyaluronidase‑fihj	480	$7,550	$3.6M
77301	Intensity modulated radiotherapy (IMRT) uses advanced computer technology to deliver very precise radiation beams that target and destroy the cancerous cells while avoiding the surrounding healthy…	750	$4,230	$3.2M
78815	PET and CT scans are both standard imaging tools that allow doctors to evaluate the location and metabolic actions of tumors or cancer inside the body before beginning an active treatment regimen.…	1,960	$1,440	$2.8M

Showing 1–10 of 390

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Ohio Distribution

Arthur G James Cancer Hospital And Research Institute — 14 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Ohio

Full comparison — all codes billed, vs. Ohio median

390 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	42	150	4,030	$100	$5.9M
J9271	Injection, pembrolizumab, 1 mg	2	20	360	$8,480	$5M
J9358	Injection, fam-trastuzumab deruxtecan-nxki, 1 mg	1	10	740	$5,390	$4M
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.	113	170	4,660	$300	$2.6M
J9355	Injection, trastuzumab, excludes biosimilar, 10 mg	1	10	840	$2,870	$2.4M
J9299	Injection, nivolumab, 1 mg	1	10	210	$6,940	$2.1M
J9144	Injection, daratumumab, 10 mg and hyaluronidase‑fihj	2	10	280	$5,660	$2M
77386	Intensity modulated radiation treatment delivery (IMRT), includes guidance and tracking, when performed; complex	1	20	480	$730	$1.6M
J9306	Injection, pertuzumab, 1 mg	1	10	30	$7,910	$1.3M
J2506	Injection, pegfilgrastim, excludes biosimilar, 0.5 mg	1	10	490	$2,060	$1.1M

Showing 1–10 of 390

Nearby Providers

Other providers in the same ZIP code as Arthur G James Cancer Hospital And Research Institute, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Ohio State University Hospitals	OH	General Acute Care Hospital	$0	$197.7M
Osu Internal Medicine, LLC	OH	Internal Medicine Physician	$0	$28M
Osu Emergency Medicine LLC	OH	Emergency Medical Services (Emergency Medicine) Physician	$0	$15.7M
Osu Radiology LLC	OH	Diagnostic Radiology Physician	$0	$13.9M
Dental Clinics College Of Dentistry	OH	Dentist	$0	$9.4M
Jonathan Rock	OH	Anatomic Pathology & Clinical Pathology Physician	$498.3K	$0
Amado Del Rosario	OH	Diagnostic Radiology Physician	$490.7K	$0
Albert Clairmont	OH	Physical Medicine & Rehabilitation Physician	$444.1K	$0
David Meier	OH	Interventional Cardiology Physician	$405.3K	$0
Evan Wuthrick	OH	Radiation Oncology Physician	$237.8K	$0

Arthur G James Cancer Hospital And Research Institute — Billing Profile & Reimbursement Data

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Arthur G James Cancer Hospital And Research Institute — 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

Nearby Providers

Frequently Asked Questions

References