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

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

Albany General Hospital (NPI 1154372340)

Key Findings

Field	Value
Entity Type	Organization
Organization	Albany General Hospital
Address	1046 6th Avenue Sw
City	Albany
State	OR
ZIP	97321
Taxonomy	General Acute Care Hospital
NPI Enumerated	May 13, 2006

Payer Source	Total Paid
Medicaid	$25.5M
Medicare	$0

ALBANY GENERAL HOSPITAL has no Medicare billing on file and $25.5M in lifetime Medicaid revenue, making its public billing footprint effectively single‑payer (Medicaid) in the available data. Analysts should treat Medicaid as the operative revenue stream when assessing this facility’s service mix, market role, and contracting leverage.

Revenue concentration is highly focused: the precomputed top three Medicaid codes account for 68.3% of the provider’s total Medicaid revenue, driven primarily by 99284 ($7.6M, 30.9%) and 99283 ($7.4M, 30.1%), with polysomnography 95810 contributing $1.8M (7.3%). This concentration indicates that a small set of services—two emergency department E/M levels and sleep studies—generate the majority of billed Medicaid dollars.

The code mix indicates a core acute care and emergency operations profile. High claim counts and revenue for 99284 (29K claims, $262 avg paid, $7.6M) and 99283 (40.4K claims, $183 avg paid, $7.4M) point to heavy ED throughput and reliance on emergent/urgent evaluation-and-management services as primary revenue drivers.

ALBANY GENERAL HOSPITAL operates a regionally significant sleep program: 95810 is $1.8M (7.3% of Medicaid revenue) and ranks #1 of 34 providers in-state (100th percentile, labeled an "extreme outlier"), while 95811 contributes $1.3M (5.5%) and ranks #2 of 24 (96th percentile). These rankings and dollar amounts suggest a major ambulatory or hospital-based sleep lab capacity that far exceeds typical state volume and likely differentiates the hospital’s service offering.

Despite large absolute Medicaid dollars from ED E/M codes, the hospital’s competitive standing on those codes is solid but not dominant statewide: 99284 ranks #24 of 145 (84th percentile) and 99283 ranks #18 of 137 (88th percentile), both described as "typical, unremarkable volume for this code." That pattern implies high ED volume in absolute terms but within the expected distribution of in‑state acute care providers rather than outlier dominance.

Beyond ED and sleep services, the hospital reports notable volumes in ancillary outpatient and testing codes that reflect typical hospital outpatient activity: 87635 (SARS–CoV‑2 testing) is 11.4K claims and $490.5K (2.0% of Medicaid revenue), ranking #4 of 143 providers (98th percentile), and G0463 (hospital outpatient clinic visit) is 10.3K claims and $452.2K (1.8%), ranking at the 70th percentile. These items support the view of a broad outpatient operational footprint tied to the ED and clinic settings.

There are additional state-level specialty outliers that suggest unique service lines: 81514 (BV nucleic acid testing) is $110.2K and ranks #1 of 8 providers in-state (100th percentile; "notably above typical"), and G0330 (dental rehabilitation with monitored anesthesia) appears ($164.5K) and ranks #2 of 3 providers. These codes indicate the hospital provides some higher-concentration diagnostic and procedural services that are uncommon among peers.

The NPI was enumerated on 2006-05-13 ("~20 years ago"), indicating an established presence in the market. For payers and network analysts, this tenure combined with the concentrated Medicaid revenue base suggests a mature facility with entrenched ED and sleep lab operations that should be evaluated as a long-standing Medicaid provider when considering network participation or utilization management strategies.

Medicaid: Complete Services Breakdown

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

111 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.	29,030	$260	$7.6M
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.	40,420	$180	$7.4M
95810	Polysomnography refers to the continuous and simultaneous monitoring and recording of various physiological and pathophysiological parameters of sleep for six or more hours with physician review,…	2,500	$720	$1.8M
95811	During the study, the physician monitors the sleep pattern of the patient, along with different bodily functions during the sleep cycle extending over a period of six hours or more.	2,010	$670	$1.3M
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.	3,710	$340	$1.3M
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	6,120	$140	$844.8K
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.	7,300	$110	$766.1K
87635	Using an amplified nucleic acid probe technique, the lab analyst performs the necessary steps to identify the nucleic acids from the severe acute respiratory syndrome coronavirus 2 (SARS–COV–2) virus…	11,410	$40	$490.5K
G0463	Hospital outpatient clinic visit for assessment and management of a patient	10,280	$40	$452.2K
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.	3,040	$130	$398.4K

Showing 1–10 of 111

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Oregon Distribution

Albany General Hospital — 5 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Oregon

Full comparison — all codes billed, vs. Oregon median

111 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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.	24	150	7,400	$170	$2.8M
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.	60	130	2,610	$200	$2.3M
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.	18	140	10,160	$130	$2.3M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	14	40	3,200	$60	$1.5M
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	26	60	3,620	$90	$623.7K
41899	Use this code to report a procedure on the teeth and adjoining alveolar structures for which there is no specific code available.	6	20	190	$1,070	$556K
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…	20	60	420	$60	$405.1K
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	80	1,130	$90	$327.2K
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…	486	1,500	650	$70	$312.4K
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.	35	80	1,210	$40	$294.3K

Showing 1–10 of 111

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mid-valley Healthcare Inc	OR	Critical Access Hospital	$0	$34.5M
Samaritan Pacific Health Services, Inc	OR	Critical Access Hospital	$0	$20.6M
Good Samaritan Hospital Corvallis	OR	General Acute Care Hospital	$0	$14.6M
Samaritan North Lincoln Hospital	OR	Critical Access Hospital	$0	$12.3M
Samaritan Pacific Health Services, Inc.	OR	Oxygen Equipment & Supplies (DME)	$0	$7.2M
Albany General Hospital	OR	Pediatrics Physician	$0	$4.9M
Albany General Hospital	OR	Family Medicine Physician	$0	$4.5M
Samaritan Endoscopy LLC	OR	Ambulatory Surgical Clinic/Center	$474.4K	$3.8M
Mid-valley Healthcare, Inc.	OR	Rural Health Clinic/Center	$0	$4.2M
Samaritan Pacific Health Services Inc	OR	Rural Health Clinic/Center	$0	$2.7M

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
County Of Linn	OR	Community/Behavioral Health Agency	$0	$4.8M
City Of Albany	OR	Ambulance	$541.6K	$3.6M
Albany Emergency Physicians Services, PC	OR	Emergency Medicine Physician	$0	$3M
Eyecare Associates PC	OR	Ophthalmology Physician	$0	$2.7M
Sarah Soric Therapy LLC	OR	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$2.3M
Qualicenters Albany, Ltd.	OR	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$2.2M
Crc Health Oregon, LLC	OR	Methadone Clinic	$161.7K	$2M
Albany General Hospital	OR	Family Medicine Physician	$0	$2M
Linn County	OR	Case Management Agency	$0	$1.8M
F & G Investments, LLC	OR	Pediatric Dentistry	$0	$1.7M

Albany General Hospital — Billing Profile & Reimbursement Data

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Albany General 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