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

Why is the Medicaid comparison limited to North Carolina 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. North Carolina (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.

Dlp Rutherford Regional Health System, LLC (NPI 1245321181)

Dlp Rutherford Regional Health System, LLC is a general acute care hospital provider located in Rutherfordton, North Carolina. This profile covers 0 Medicare and 125 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	Dlp Rutherford Regional Health System, LLC
Address	288 S Ridgecrest Ave
City	Rutherfordton
State	NC
ZIP	28139
Taxonomy	General Acute Care Hospital
NPI Enumerated	September 27, 2006

Payer Source	Total Paid
Medicaid	$14.4M
Medicare	$0

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

125 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.	17,080	$170	$2.9M
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.	28,750	$100	$2.7M
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.	20,450	$120	$2.5M
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.	1,420	$660	$934.6K
87637	The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, influenza B, and respiratory syncytial virus (RSV)…	3,310	$150	$505.7K
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	11,330	$30	$351.4K
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.	2,380	$150	$347.9K
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.	6,820	$50	$320.5K
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.	3,810	$60	$232.5K
80053	The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel.	28,910	$10	$231.3K

Showing 1–10 of 125

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. North Carolina Distribution

Dlp Rutherford Regional Health System, LLC — 3 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — North Carolina

Full comparison — all codes billed, vs. North Carolina median

125 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.	91	330	6,130	$130	$2.7M
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	160	840	$70	$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.	59	320	6,160	$120	$2.1M
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.	56	280	2,690	$130	$1.6M
87661	The lab analyst performs a test for Trichomonas vaginalis using nucleic acid amplified probe technique.	28	70	280	$20	$896.7K
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.	104	360	1,830	$40	$819.8K
87491	The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique.	81	190	530	$20	$635.1K
87591	The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique.	82	190	560	$20	$609.8K
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…	92	150	860	$50	$586.6K
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.	46	160	490	$100	$435.6K

Showing 1–10 of 125

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Hong Li	NC	Anatomic Pathology & Clinical Pathology Physician	$493.2K	$0
Michael Roberts	NC	Orthopaedic Surgery Physician	$220.1K	$0
Terry Kersey	NC	Cardiovascular Disease Physician	$183.2K	$0
Luther Person	NC	Diagnostic Radiology Physician	$145.8K	$0
Troy Tevis	NC	Optometrist	$139K	$0
Jason Glover	NC	Foot & Ankle Surgery Podiatrist	$102.5K	$0
Keith Hill	NC	Medical Physician Assistant	$68.9K	$0
Willie Hester	NC	Nephrology Physician	$55.6K	$0
Mary Duran	NC	Family Medicine Physician	$51.8K	$0
Alfred Pirro	NC	Hospitalist Physician	$7.2K	$0

Dlp Rutherford Regional Health System, LLC — Billing Profile & Reimbursement Data

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Dlp Rutherford Regional Health System, LLC — 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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