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.

South Shore Hospital Inc. (NPI 1134227606)

Field	Value
Entity Type	Organization
Organization	South Shore Hospital Inc.
Address	55 Fogg Road
City	South Weymouth
State	MA
ZIP	02190
Taxonomy	General Acute Care Hospital
NPI Enumerated	September 20, 2006

Payer Source	Total Paid
Medicaid	$95.1M
Medicare	$0

Key Findings

This provider is effectively single-payer in the available data: Medicare billing is absent (no Medicare billing on file) while Total Medicaid revenue is $95.1M, indicating that Medicaid dominates the observed reimbursement profile for SOUTH SHORE HOSPITAL INC.. Analysts should treat Medicaid flows as the primary financial lens when assessing this hospital's payer exposure and service economics.

Revenue concentration is high at the code level: the precomputed top 3 Medicaid codes account for 47.9% of this provider's total Medicaid revenue. These top three contributors are 99283 (87.9K claims, $162 avg paid/claim, $14.2M revenue — 19.1%), 96361 (36K claims, $366 avg paid/claim, $13.2M revenue — 17.7%), and 99284 (53.5K claims, $153 avg paid/claim, $8.2M revenue — 11.0%), together creating nearly half of Medicaid revenue and highlighting concentrated risk around a small set of ED and infusion services.

The code mix points to an emergency-department–centric acute care operation with substantial infusion activity: high-volume ED E/M codes 99283, 99284, 99285 and 99282 dominate revenue and claims, while infusion codes 96361, 96360, 96365 and 96366 also contribute materially (96361 alone is $13.2M). Combined with notable observation-hours billing via G0378 (32K claims, $2M), the pattern is consistent with heavy ED throughput plus significant short-stay/observation management and IV therapy services.

On competitive standing within the state, SOUTH SHORE HOSPITAL is a major outlier for several high-revenue codes: 99283 ranks #11 of 547 providers in-state (98th percentile; extreme outlier), 99284 ranks #28 of 827 (97th percentile; notably above typical state volume), and 96361 ranks #7 of 87 (93rd percentile; notably above typical state volume). These ranks indicate the hospital is a leading state provider for low- and moderate-level ED E/M visits and IV-fluid infusion services, suggesting outsized market share or unusually high ED utilization relative to peers.

Laboratory and testing volumes are also elevated: SARS–CoV–2 PCR testing code 87635 shows 31.9K claims and $1.2M revenue and ranks #5 of 717 providers in-state (99th percentile; extreme outlier), and definitive drug testing G0480 has 23.6K claims and $732.9K revenue (92nd percentile). These extreme and high-percentile lab testing volumes imply robust on-site lab capacity supporting high ED and inpatient throughput as well as frequent toxicology and infectious-disease testing.

Ambulance and observation-related codes indicate strong EMS intake and short-stay care: ground mileage A0425 appears with 41.1K claims ($1.2M), basic life support emergency A0429 has 11.2K claims ($1.8M), and G0378 observation (32K claims, $2M) is sizable. Together these codes suggest the hospital receives substantial transported emergency volumes and converts a meaningful share into observation hours, reinforcing the characterization of high acute-care and ED demand.

Service breadth beyond the ED is visible in imaging and procedural codes: head CT 70450 (19.1K claims, $2.3M), abdomen/pelvis CT 74177 (17.2K claims, $2.1M), and surgical debridement 11042 (10.7K claims, $1.9M) all rank in high state percentiles (around the 92nd–97th percentiles). This mix supports the interpretation that the facility operates full diagnostic imaging and procedural capabilities typical of a general acute care hospital handling trauma, surgical wound care, and acute diagnostic workups.

The provider has an established enrollment history with NPI enumeration on 2006-09-20 (~20 years ago), indicating long-standing operation in the market. That tenure, combined with the high-percentile rankings on numerous ED, infusion, transport, and lab codes, suggests entrenched referral and EMS relationships that likely contribute to the observed high Medicaid volumes and code concentration.

Medicaid: Complete Services Breakdown

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

363 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.	87,850	$160	$14.2M
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.	36,020	$370	$13.2M
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.	53,530	$150	$8.2M
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.	34,350	$170	$5.7M
S9485	Crisis intervention mental health services, per diem	6,580	$440	$2.9M
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.	15,230	$160	$2.4M
70450	The provider performed computed tomography, or CT scanning, of the head or brain, without contrast. He performs the procedure to diagnose any brain or intracranial abnormalities.	19,070	$120	$2.3M
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.	17,190	$120	$2.1M
G0378	Hospital observation service, per hour	31,980	$60	$2M
11042	The provider uses surgical instruments to remove the dead tissue in skin down to the subcutaneous layer and including the epidermis and dermis, up to the first 20 cm2.	10,680	$180	$1.9M

Showing 1–10 of 363

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

South Shore Hospital Inc. — 7 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

363 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.	7	90	7,560	$350	$4.2M
S9485	Crisis intervention mental health services, per diem	22	110	1,250	$540	$3.2M
A0428	Ambulance service, basic life support, non-emergency transport, (bls)	17	60	9,300	$90	$2.1M
G0378	Hospital observation service, per hour	9	70	7,250	$100	$1.3M
A0429	Ambulance service, basic life support, emergency transport (bls-emergency)	21	240	980	$180	$1.2M
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.	22	80	4,380	$140	$1.1M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	36	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.	42	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…	37	130	1,830	$60	$974.3K
96366	The provider administers an intravenous infusion or infusions of a medication for an additional hour or subsequent hours after the first hour to prevent, treat, or diagnose a condition or disease.	17	60	1,750	$260	$907.4K

Showing 1–10 of 363

Related Providers

Other providers that share a Tax Identification Number (TIN) with South Shore Hospital Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
South Shore Hospital Inc.	MA	Home Health Agency	$0	$7.9M
James Giddings	RI	Emergency Medicine Physician	$78.4K	$889.8K
Brian Dolan	MA	Internal Medicine Physician	$338.2K	$0
Anthony Marks	MA	Interventional Cardiology Physician	$331.7K	$200
James Mensching	MA	Emergency Medicine Physician	$88K	$139.9K
Kenneth Mclaughlin	MA	Emergency Medicine Physician	$153.3K	$0
Kelly Mcdonough	RI	Emergency Medicine Physician	$96.9K	$20.5K
Gerry Campos	MA	Obstetrics & Gynecology Physician	$109.1K	$0
Scott Fairfield	MA	Emergency Medicine Physician	$101.9K	$0
Suniti Nimbkar	MA	Surgery Physician	$71.7K	$0

Nearby Providers

Other providers in the same ZIP code as South Shore Hospital Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Coastal Medical Associates	MA	Anesthesiology Physician	$0	$10M
Jennifer Byer	MA	Medical Oncology Physician	$3.5M	$0
Shields Imaging Of Eastern Massachusetts LLC	MA	Mobile Radiology Clinic/Center	$2.7M	$774.1K
Harbor Medical Associates, Inc.	MA	Clinical Medical Laboratory	$1.8M	$420.7K
New England Eye Surgical Center Inc	MA	Ophthalmologic Surgery Clinic/Center	$1.8M	$271.1K
Harbor Medical Associates, Inc.	MA	Diagnostic Radiology Physician	$753K	$191K
Weymouth Endoscopy, LLC	MA	Endoscopy Clinic/Center	$844.3K	$4.7K
Patricia Hopkins	MA	Internal Medicine Physician	$733.6K	$0
George Kroumpouzos	MA	Dermatology Physician	$721.7K	$0
Harbor Medical Associates, Inc.	MA	Diagnostic Radiology Physician	$620.5K	$0

South Shore Hospital Inc. — 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