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

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

Baptist Healthcare System Inc. (NPI 1265539498)

Key Findings

Field	Value
Entity Type	Organization
Organization	Baptist Healthcare System Inc.
Address	4000 Kresge Way
City	Louisville
State	KY
ZIP	40207
Taxonomy	General Acute Care Hospital
NPI Enumerated	September 20, 2006

Payer Source	Total Paid
Medicaid	$62.4M
Medicare	$0

BAPTIST HEALTHCARE SYSTEM INC. is effectively a Medicaid-centered provider: there is no Medicare billing on file while total Medicaid revenue is $62.4M, so Medicaid drives the entirety of the observed payer revenue and the facility should be treated as single-payer dominant in this dataset. This concentration implies strategic focus on services and patient populations that are reimbursed through Kentucky Medicaid rather than Medicare.

Revenue concentration is moderately focused: the precomputed top 3 Medicaid codes by revenue account for 36.4% of the provider's total Medicaid revenue, indicating that a little over one-third of Medicaid revenue derives from a small group of high-value services. This level of concentration suggests management should monitor those top codes closely for operational capacity and margin impacts.

Emergency department E/M services are major revenue drivers. Codes 99284 ($6.5M, 14.6%) and 99283 ($5.4M, 12.2%) together account for $11.9M and 26.8% of Medicaid revenue, showing the hospital handles high-volume moderate- and low-complexity ED visits; 99285 also contributes $2.9M (6.5%). The code mix points to a busy emergency department and acute care throughput as a key service line for Medicaid patients.

Observation and advanced imaging form another important service-line cluster: G0378 (hospital observation per hour) generates $4.2M (9.5%), and CT abdomen/pelvis with contrast 74177 ($3.8M, 8.6%) and without contrast 74176 ($1.3M, 3.0%) are material contributors. This pattern is consistent with ED-driven observation stays and associated diagnostic imaging workflows, indicating resource needs in radiology and short-stay inpatient/observation capacity.

The provider shows notable procedural and cardiac service volumes: trans-thoracic echocardiography 93306 is $2.7M (6.1%) and myocardial perfusion imaging 78452 is $1.8M (4.0%), both ranking in high state percentiles (86th and 93th respectively). These ranks suggest the hospital is a regional player for cardiac diagnostic services within Kentucky, with above-typical state volumes for some cardiac imaging.

Competitive standing across Medicaid codes is generally modest-to-strong but not dominant: many top codes sit in state percentiles in the 60s–90s but often around the 80s, and rank positions are typically mid-range among providers (for example, 99284 ranks #50/282, 99283 #39/284). This indicates the hospital provides typical, unremarkable volumes for most codes statewide but has pockets of above-typical activity (e.g., 97110 at the 96th percentile and 78452 at the 93th percentile).

Specific outlier note: physical therapy therapeutic exercise 97110 is listed at the 96th percentile statewide with $990.5K revenue, characterized as notably above typical state volume. This suggests an unusually large ambulatory or rehabilitation PT volume relative to peers, which may reflect a strong outpatient therapy program or system-level referral patterns.

Tenure is long-standing: the NPI was enumerated around 2006-09-20 (~20 years ago), indicating the hospital has had a steady presence in the market for two decades, which supports its observed breadth of ED, imaging, cardiac, and procedural services. This longevity lends context to the mix of established service lines rather than a newly developed specialty focus.

Medicaid: Complete Services Breakdown

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

351 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.	26,310	$250	$6.5M
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.	31,710	$170	$5.4M
G0378	Hospital observation service, per hour	9,380	$450	$4.2M
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.	9,470	$400	$3.8M
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.	9,460	$300	$2.9M
93306	The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent…	6,450	$420	$2.7M
78452	In this procedure, the provider performs multiple SPECT studies of the heart to determine the areas of deficient blood flow. The goal of the procedure is to determine areas that have deficient blood…	4,680	$380	$1.8M
C1713	Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable)	1,300	$1,220	$1.6M
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.	8,260	$170	$1.4M
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.	3,400	$410	$1.4M

Showing 1–10 of 351

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Kentucky Distribution

Baptist Healthcare System Inc. — 1 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Kentucky

Full comparison — all codes billed, vs. Kentucky median

351 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
97535	A healthcare provider is required to give proper instruction to a person especially in cases of recovery from acute disease.	177	310	830	$120	$3.7M
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.	50	280	7,150	$150	$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.	79	240	4,710	$150	$2.6M
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.	39	280	5,700	$120	$2M
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.	32	180	1,870	$280	$1.5M
G0378	Hospital observation service, per hour	17	90	2,770	$190	$1.3M
0202U	This is a Proprietary Laboratory Analyses (PLA) code, meaning that the code applies to only one unique lab test made by a specific manufacturer or performed by a specific lab. Report 0202U for the…	13	30	2,320	$290	$1.2M
C1776	Joint device (implantable)	9	20	130	$2,890	$1.1M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	31	80	7,740	$30	$1.1M
C1713	Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable)	13	40	550	$910	$1.1M

Showing 1–10 of 351

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Access Adult Health Day Care Center	KY	Adult Day Care Clinic/Center	$0	$71M
Commonwealth Pain Associates, PLLC	KY	Interventional Pain Medicine Physician	$0	$42.2M
Access Adult Health Day Care Center	KY	Adult Day Care Clinic/Center	$0	$32.6M
Gould's Discount Medical LLC	KY	Durable Medical Equipment & Medical Supplies	$0	$32.1M
Path Forward Of Kentucky Inc.	KY	Community/Behavioral Health Agency	$0	$22.1M
Tatyanas Case Management, LLC	KY	Adult Day Care Clinic/Center	$0	$14.2M
Center For Behavioral Health Kentucky LLC	KY	Methadone Clinic	$299.5K	$13.2M
Pediatric And Neonatal Specialists	KY	Pediatrics Physician	$0	$8.8M
Emergency Medical Associates, Psc	KY	Emergency Medicine Physician	$0	$8M
Hmr Acquisition, Lca	KY	Case Manager/Care Coordinator	$0	$7M

Baptist Healthcare System Inc. — Billing Profile & Reimbursement Data

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Baptist Healthcare System 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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Baptist Healthcare System, Inc	KY	General Acute Care Hospital	$0	$121.5M
Baptist Healthcare System, Inc	KY	General Acute Care Hospital	$0	$98.1M
Baptist Healthcare System Inc	KY	General Acute Care Hospital	$0	$95.7M
Baptist Healthcare System, Inc	KY	General Acute Care Hospital	$0	$72.6M
Baptist Healthcare System, Inc.	KY	General Acute Care Hospital	$0	$58.5M
Hardin Memorial Hospital	KY	General Acute Care Hospital	$0	$37.2M
Baptist Healthcare System, Inc.	IN	General Acute Care Hospital	$0	$34.6M
Baptist Healthcare System, Inc.	KY	General Acute Care Hospital	$0	$16.1M
Baptist Healthcare System, Inc.	KY	Ambulatory Surgical Clinic/Center	$1.2M	$183.5K
Baptist Healthcare System Inc	KY	Land Ambulance	$424.7K	$47.4K