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

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

Presbyterian Medical Center Of The University Of Pennsylvania Health S (NPI 1245207521)

Field	Value
Entity Type	Organization
Organization	Presbyterian Medical Center Of The University Of Pennsylvania Health S
Address	51 N 39th St
City	Philadelphia
State	PA
ZIP	19104
Taxonomy	General Acute Care Hospital
NPI Enumerated	March 4, 2006

Payer Source	Total Paid
Medicaid	$23.3M
Medicare	$0

Medicaid: Complete Services Breakdown

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

343 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.	20,020	$200	$3.9M
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.	18,810	$200	$3.7M
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.	18,670	$190	$3.5M
G0378	Hospital observation service, per hour	1,940	$1,260	$2.4M
J1745	Injection, infliximab, excludes biosimilar, 10 mg	610	$1,900	$1.2M
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…	7,930	$70	$523K
G9012	Other specified case management service not elsewhere classified	2,020	$240	$486.6K
T1015	Clinic visit/encounter, all-inclusive	3,370	$140	$478.1K
G0483	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…	3,700	$100	$365.9K
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.	440	$800	$350.4K

Showing 1–10 of 343

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Pennsylvania Distribution

Presbyterian Medical Center Of The University Of Pennsylvania Health S — 5 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Pennsylvania

Full comparison — all codes billed, vs. Pennsylvania median

343 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J1745	Injection, infliximab, excludes biosimilar, 10 mg	7	20	350	$1,720	$1.6M
G0378	Hospital observation service, per hour	40	150	510	$870	$1.4M
T1015	Clinic visit/encounter, all-inclusive	436	1,690	760	$170	$1.2M
J9271	Injection, pembrolizumab, 1 mg	21	20	420	$1,230	$827.7K
G9012	Other specified case management service not elsewhere classified	98	320	770	$260	$758K
H0015	Alcohol and/or drug services; intensive outpatient (treatment program that operates at least 3 hours/day and at least 3 days/week and is based on an individualized treatment plan), including…	73	150	2,970	$100	$699.4K
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.	52	210	730	$40	$689.7K
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…	30	200	990	$70	$517.5K
G0483	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…	8	20	3,040	$60	$483.4K
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.	68	1,600	270	$120	$409.7K

Showing 1–10 of 343

Related Providers

Other providers that share a Tax Identification Number (TIN) with Presbyterian Medical Center Of The University Of Pennsylvania Health S, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Presbyterian Medical Center Of The University Of Pennsylvania Health S	PA	Home Health Agency	$0	$6.5M

Nearby Providers

Other providers in the same ZIP code as Presbyterian Medical Center Of The University Of Pennsylvania Health S, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Childrens Hospital Of Philadelphia	PA	Children's Hospital	$0	$286.9M
Trustees Of The University Of Pennsylvania	PA	General Acute Care Hospital	$0	$84M
House House Rehabilitation Services	PA	Community/Behavioral Health Agency	$0	$32.8M
Childrens Health Care Associates, Inc	PA	Pediatric Emergency Medicine (Emergency Medicine) Physician	$0	$24.2M
University Of Penn-medical Group	PA	Emergency Medicine Physician	$0	$21.5M
University Of Penn-medical Group	PA	Diagnostic Radiology Physician	$0	$17.7M
Horizon House, Inc.	PA	Community/Behavioral Health Agency	$0	$13.9M
Tricounty Medical Equipment And Supply, LLC	PA	Durable Medical Equipment & Medical Supplies	$0	$13.1M
Dunbar Strategic Consulting Group	PA	Community/Behavioral Health Agency	$0	$10.8M
Intercultural Family Services, Inc.	PA	Health Service Psychologist	$0	$10.7M

Presbyterian Medical Center Of The University Of Pennsylvania Health S — Billing Profile & Reimbursement Data

Sign up for Presbyterian Medical Center Of The University Of Pennsylvania Health S — Billing Profile & Reimbursement Data policy alerts

Presbyterian Medical Center Of The University Of Pennsylvania Health S — Billing Profile & Reimbursement Data

Sign up for Presbyterian Medical Center Of The University Of Pennsylvania Health S — Billing Profile & Reimbursement Data policy alerts

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References