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

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

Cookeville Regional Medical Center (NPI 1275531956)

Field	Value
Entity Type	Organization
Organization	Cookeville Regional Medical Center
Address	1 Medical Center Blvd
City	Cookeville
State	TN
ZIP	38501
Taxonomy	General Acute Care Hospital
NPI Enumerated	July 7, 2005

Payer Source	Total Paid
Medicaid	$17.1M
Medicare	$0

Medicaid: Complete Services Breakdown

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

138 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.	32,680	$160	$5.1M
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.	35,300	$120	$4.1M
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.	9,300	$180	$1.6M
G0378	Hospital observation service, per hour	5,530	$170	$961.5K
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.	8,710	$80	$705.8K
41899	Use this code to report a procedure on the teeth and adjoining alveolar structures for which there is no specific code available.	1,270	$420	$539.8K
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.	960	$460	$443K
G0463	Hospital outpatient clinic visit for assessment and management of a patient	14,590	$20	$350.1K
97530	The provider uses various activities during direct contact with the patient to improve the patient’s functional performance. Use this code for each 15 minutes of activity.	4,140	$60	$265K
G0379	Direct admission of patient for hospital observation care	2,310	$110	$260.9K

Showing 1–10 of 138

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Tennessee Distribution

Cookeville Regional Medical Center — 8 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Tennessee

Full comparison — all codes billed, vs. Tennessee median

138 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
G0463	Hospital outpatient clinic visit for assessment and management of a patient	12	60	1,340	$50	$1.1M
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.	43	630	510	$120	$1.1M
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.	36	610	570	$110	$884.4K
41899	Use this code to report a procedure on the teeth and adjoining alveolar structures for which there is no specific code available.	7	30	410	$520	$719.2K
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.	62	570	640	$100	$637.8K
92507	The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with…	99	230	2,130	$40	$616.8K
97530	The provider uses various activities during direct contact with the patient to improve the patient’s functional performance. Use this code for each 15 minutes of activity.	107	340	1,400	$40	$354.2K
96413	Chemotherapy is a therapeutic procedure used for the treatment of cancer via the use of chemical agents. These chemical agents (drugs) work on the cancerous cells of the body to destroy them. These…	16	40	1,860	$70	$294.9K
G0378	Hospital observation service, per hour	6	100	410	$210	$264K
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.	214	240	840	$20	$259.2K

Showing 1–10 of 138

Related Providers

Other providers that share a Tax Identification Number (TIN) with Cookeville Regional Medical Center, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Somc Medical Care Foundation, Inc.	OH	Family Medicine Physician	$0	$25.3M
The Cookeville Surgery Center	TN	Ambulatory Surgical Clinic/Center	$24.7K	$1.6M
Joseph Jones	AL	Hematology & Oncology Physician	$1.6M	$0
Kenneth Niermann	TN	Radiation Oncology Physician	$625.8K	$0
Corbin Johnson	TN	Radiation Oncology Physician	$577.1K	$0
Dong Kim	TN	Radiation Oncology Physician	$469.4K	$0
Anthony Cmelak	TN	Radiation Oncology Physician	$391.9K	$0
Rufus Mark	FL	Radiation Oncology Physician	$319.4K	$0
Robert Jones	MS	Radiation Oncology Physician	$295.5K	$0
Jeramie Rosales Rodriguez	MO	Psychiatry Physician	$2.1K	$289.9K

Nearby Providers

Other providers in the same ZIP code as Cookeville Regional Medical Center, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Home Caregivers Of Cookeville	TN	Home Health Agency	$0	$49.6M
Senior Life Management LLC	TN	In Home Supportive Care Agency	$0	$13.3M
Putnam County Pediatrics	TN	Pediatrics Physician	$0	$8.4M
Cavity Commando's Dentistry For Kids PLLC	TN	Pediatric Dentistry	$0	$7.6M
Tennessee Pediatric & Adolescent Center	TN	Legal Medicine	$0	$7M
County Of Putnam	TN	Land Ambulance	$1.7M	$4M
Womens Health Services Of The Cumberlands, PLLC	TN	Obstetrics & Gynecology Physician	$0	$5.6M
Cookeville Regional Dental Inc	TN	Dentist	$0	$5.4M
Cookeville Pediatric Associates, PLLC	TN	Pediatrics Physician	$0	$5M
Upper Cumberland Rural Health Clinic PLLC	TN	Rural Health Clinic/Center	$0	$3.6M

Cookeville Regional Medical Center — Billing Profile & Reimbursement Data

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Cookeville Regional Medical Center — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References