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.

Legacy Mount Hood Medical Center (NPI 1255354700)

Key Findings

Field	Value
Entity Type	Organization
Organization	Legacy Mount Hood Medical Center
Address	24800 Se Stark St
City	Gresham
State	OR
ZIP	97030
Taxonomy	General Acute Care Hospital
NPI Enumerated	July 25, 2006

Payer Source	Total Paid
Medicaid	$43.2M
Medicare	$0

LEGACY MOUNT HOOD MEDICAL CENTER is effectively a Medicaid-focused hospital in the available data: there is no Medicare billing on file while total Medicaid revenue is $43.2M. This makes the provider functionally single‑payer in the dataset and indicates its measurable public revenue footprint is concentrated in state Medicaid payments rather than Medicare. The NPI has been enumerated since 2006-07-25, signaling roughly 20 years of active registration in the national provider directory.

Revenue concentration is high: the precomputed top three Medicaid codes account for 78.4% of the provider’s total Medicaid revenue. The three highest-revenue codes are all emergency department E/M services (99284, 99285, 99283), which together drive the majority of the hospital’s Medicaid receipts and imply that ED services are the core revenue center for this facility under Medicaid.

The hospital’s Medicaid activity is ED‑centric and weighted toward higher‑acuity care. The top three codes by revenue are 99284 ($12.2M, 28.4%), 99285 ($11.3M, 26.2%), and 99283 ($10.3M, 23.8%), reflecting large volumes of moderate- and high‑level emergency department evaluation and management visits. That mix suggests a service-line profile focused on acute unscheduled care rather than elective inpatient procedures or specialty outpatient clinics.

Competitive standing in-state for key ED codes is solid but not dominant: 99283 ranks #7 of 137 providers (96th percentile) and 99284 and 99285 rank in the 91st–93rd percentiles (#11 of 145 and #13 of 129 respectively). Those placements mean the hospital is a high-volume provider for ED E/M services relative to most Oregon peers, especially for 99283 where volume is notably above typical state levels.

Beyond ED visits, the provider shows unusually high relative volume for several infusion and medication administration services. Codes 96374, 96375, and 96361 rank in the 96th–97th percentiles (e.g., 96374 is #3 of 62 and labeled notably above typical state volume), indicating the facility delivers a large number of IV medication administrations and related infusion services compared with other in-state hospitals. This pattern is consistent with ED throughput and medical therapy delivered in the hospital outpatient setting.

There are a few extreme statistical outliers that warrant attention for network and operational planning. Code 0241U is ranked #1 of 47 providers in-state (100th percentile) and described as an extreme outlier with volume far above typical state levels, and 93005 (ECG recording only) is in the 95th percentile (#5 of 74). These outlier statuses suggest the hospital either specializes in certain point-of-care diagnostics or has billing patterns that concentrate these services relative to peers; either way, they materially affect revenue mix beyond the ED codes.

Procedure mix shows a blend of diagnostic imaging and endoscopy services at moderate volumes, supporting broader hospital capability beyond the ED. Examples include 71045/71046 chest x‑rays, 74177 abdominal CT with contrast, 70450 head CT, 93306 echocardiography, and endoscopy/colonoscopy codes 43239, 45385, and 45380, all of which appear in the top‑25 Medicaid list with typical to above‑typical state rankings. This indicates the hospital maintains imaging, cardiology echo, and GI procedural capacity that supplement its high ED throughput.

Given the NPI tenure (enumerated ~20 years ago) and the Medicaid revenue profile dominated by ED E/M and infusion codes, operational priorities for payers and network analysts should focus on emergency care capacity, ambulatory infusion services, and the implications of several state-level outlier volumes (notably 0241U and high ranks for IV administration codes). Those elements will most strongly influence contract negotiations, utilization management, and care‑coordination efforts tied to this provider.

Medicaid: Complete Services Breakdown

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

105 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.	48,310	$250	$12.2M
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.	34,140	$330	$11.3M
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.	58,330	$180	$10.3M
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	27,660	$130	$3.6M
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.	9,520	$100	$914.3K
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.	1,930	$390	$760K
0241U	N/A	7,390	$90	$672.9K
96375	Following the administration of a drug or other substance via intravenous, or IV, push, the provider sequentially infuses a different medication or medications, also via IV push. He administers the…	14,290	$40	$543.1K
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.	8,880	$60	$506.2K
71045	In this diagnostic procedure, the provider performs a single radiological view of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and nearby…	8,350	$40	$367.4K

Showing 1–10 of 105

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

Legacy Mount Hood Medical Center — 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

105 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.	11	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.	13	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.	7	140	10,160	$130	$2.3M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	17	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.	3	60	3,620	$90	$623.7K
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…	32	60	420	$60	$405.1K
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…	17	60	460	$40	$327.4K
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.	10	80	1,130	$90	$327.2K
99291	Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is…	40	40	380	$130	$326.9K
45385	The provider examines the colon and rectum using a colonoscope, a long, thin flexible tubular instrument with a light source and camera. He removes one or more tumors, polyps, or other lesions with a…	15	40	310	$420	$325.7K

Showing 1–10 of 105

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Legacy Emanuel Hospital & Health Center	OR	General Acute Care Hospital	$0	$64.2M
Legacy Emanuel Hospital & Health Center	OR	General Acute Care Hospital	$0	$50.8M
Legacy Clinics LLC	OR	Clinic/Center	$35.6K	$48.7M
Union Associated Physicians Clinic, LLC	IN	Family Medicine Physician	$0	$31.1M
Legacy Good Samaritan Hospital And Medical Center	OR	General Acute Care Hospital	$0	$18.3M
Legacy Emanuel Hospital & Health Center	OR	Clinic/Center	$0	$17M
Legacy Salmon Creek Hospital	WA	Clinic/Center	$0	$9.9M
Legacy Good Samaritan Hospital And Medical Center	OR	Clinic/Center	$0	$3.9M
Legacy Emanuel Hospital & Health Center	OR	Rural Health Clinic/Center	$0	$1.8M
Legacy Emanuel Hospital & Health Center	OR	Clinic/Center	$0	$1.5M

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Telecare Mental Health Services Of Oregon, Inc	OR	Mental Illness Community Based Residential Treatment Facility	$0	$12M
The Evangelical Lutheran Good Samaritan Society	OR	In Home Supportive Care Agency	$0	$5M
Calcagno Pediatrics PC	OR	Pediatrics Physician	$0	$5M
Mtn. View Family Practice, PC	OR	Family Medicine Physician	$0	$1.8M
Jiyoung E Lee Dmd PC	OR	Pediatric Dentistry	$0	$1.6M
Performance Modalities Inc	OR	Oxygen Equipment & Supplies (DME)	$0	$1.4M
Providence Health & Services - Oregon	OR	Family Medicine Physician	$0	$1.3M
Legacy Mount Hood Medical Center	OR	Clinic/Center	$0	$1.1M
Columbia Pain And Spine Institute	OR	Physical Medicine & Rehabilitation Physician	$0	$1M
Ana Squellati	OR	Naturopath	$0	$959K

Legacy Mount Hood Medical Center — 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