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

Why is the Medicaid comparison limited to New Jersey 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. New Jersey (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.

Capital Health System Inc (NPI 1275583726)

Field	Value
Entity Type	Organization
Organization	Capital Health System Inc
Address	750 Brunswick Ave
City	Trenton
State	NJ
ZIP	08638
Taxonomy	General Acute Care Hospital
NPI Enumerated	May 12, 2006

Payer Source	Total Paid
Medicaid	$114.5M
Medicare	$0

Key Findings

CAPITAL HEALTH SYSTEM INC reports $114.5M in lifetime Medicaid revenue and has no Medicare billing on file, making its active reimbursement footprint effectively single-payer (Medicaid). That concentration in a single public payer increases sensitivity to state Medicaid rate changes, policy shifts, or utilization-management actions that affect Medicaid volumes or covered services.

Revenue is highly concentrated in a small number of Medicaid codes: the top three codes account for 59.8% of the provider’s total Medicaid revenue. Specifically, 99283 generates $25.1M (25.5%), 99284 generates $24.8M (25.2%), and S9480 generates $9M (9.1%), indicating a small set of services drives the majority of reported Medicaid income.

The code mix points to a dominant emergency/acute-care operational profile with a significant behavioral-health component. High-volume ED E/M codes (99282–99285) drive the largest shares—99283 (65.9K claims, $381 avg paid/claim, $25.1M) and 99284 (70K claims, $354 avg paid/claim, $24.8M)—while S9480 (10.7K claims, $843 avg paid/claim, $9M) and H0035/T2034 reflect substantial intensive outpatient psychiatric and crisis-intervention activity.

Operational throughput is supported by complementary acute-care services and transports: G0378 observation billing (6.5K claims, $775 avg paid/claim, $5M) and ambulance lines such as A0427 (15.6K claims, $212 avg paid/claim, $3.3M) and A0429 (6.1K claims, $140 avg paid/claim, $853.2K) indicate frequent ED-to-observation workflows and emergency transport utilization. These ancillary revenue streams reinforce the impression of a busy emergency department with associated observation and transport activity.

Competitive standing across in-state peers is strong for several high-impact codes. 99283 ranks #22 of 262 providers and is characterized as notably above typical state volume, while 99284 ranks #20 of 319 (described as typical, unremarkable volume). S9480 ranks #2 of 29 providers (96th percentile) and is also described as notably above typical state volume, signaling that the provider is a leading in-state deliverer of intensive outpatient psychiatric services.

There are several statistical outliers in the provider’s Medicaid mix that are worth noting for network analysts: 99241 (office consultation) is an extreme outlier, ranking #1 of 26 providers with 10.3K claims and $761.9K revenue (0.8%); high-volume low-dollar ancillary lines such as 36415 (72.2K claims, $10 avg paid/claim, $722.3K) rank in the 98th percentile, indicating unusually large specimen-collection throughput relative to peers.

Imaging and diagnostic services are meaningfully represented and support the acute-care profile: 70450 (13.7K claims, $104 avg paid/claim, $1.4M) and 74177 (7.4K claims, $273 avg paid/claim, $2M) indicate sizable CT volumes, while 93306 echocardiography (2.6K claims, $470 avg paid/claim, $1.2M) and 77067 mammography (2.2K claims, $329 avg paid/claim, $733K) show a broad set of diagnostic capabilities billed to Medicaid.

The provider has an established presence in the market with NPI enumeration dated 2006-05-12 (~20 years ago), suggesting long-tenure operations. That longevity, combined with concentrated Medicaid exposure and leading in-state positions on several ED and behavioral-health codes, frames CAPITAL HEALTH SYSTEM INC as a mature Medicaid-focused acute-care hospital whose financial and contracting outlook will be especially sensitive to Medicaid policy and utilization trends.

Medicaid: Complete Services Breakdown

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

330 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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.	65,890	$380	$25.1M
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.	70,010	$350	$24.8M
S9480	Intensive outpatient psychiatric services, per diem	10,650	$840	$9M
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.	20,720	$340	$7.1M
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.	20,180	$300	$6.1M
G0378	Hospital observation service, per hour	6,480	$780	$5M
A0427	Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency)	15,580	$210	$3.3M
T2034	Crisis intervention, waiver; per diem	3,410	$840	$2.9M
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.	7,380	$270	$2M
99213	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…	25,620	$70	$1.7M

Showing 1–10 of 330

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. New Jersey Distribution

Capital Health System Inc — 5 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — New Jersey

Full comparison — all codes billed, vs. New Jersey median

330 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
G0378	Hospital observation service, per hour	38	80	6,290	$690	$6.6M
H0035	Mental health partial hospitalization, treatment, less than 24 hours	142	170	21,080	$100	$4.2M
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…	69	130	3,180	$60	$4.2M
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.	22	260	4,240	$220	$4.1M
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.	20	320	580	$230	$4M
A0427	Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency)	7	30	9,660	$310	$3.4M
S9480	Intensive outpatient psychiatric services, per diem	2	30	3,840	$770	$3.3M
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.	50	280	920	$200	$2.6M
T2034	Crisis intervention, waiver; per diem	8	20	2,220	$860	$2.3M
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.	38	150	3,680	$30	$1.5M

Showing 1–10 of 330

Related Providers

Other providers that share a Tax Identification Number (TIN) with Capital Health System Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Capital Health System, Inc.	NJ	General Acute Care Hospital	$0	$132.1M
St. Francis Medical Center	NJ	General Acute Care Hospital	$0	$30.6M

Nearby Providers

Other providers in the same ZIP code as Capital Health System Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Arc Mercer, Inc	NJ	Developmentally Disabled Services Day Training Agency	$0	$87.5M
Capital Health Medical Group	NJ	Internal Medicine Physician	$0	$19.3M
Senior Star Corp. Medical Day	NJ	Adult Day Care Clinic/Center	$0	$15.3M
Phoenix Behavioral Health LLC	NJ	In Home Supportive Care Agency	$0	$9.7M
Emergency Medical Associates Chs LLC	NJ	Emergency Medicine Physician	$0	$8.3M
Trenton Healthcare, LLC	NJ	Methadone Clinic	$39.9K	$7.5M
Hadia Ata	NJ	Anatomic Pathology & Clinical Pathology Physician	$1.8M	$0
Anusuya Jeyakumar	NJ	Geriatric Medicine (Internal Medicine) Physician	$276.2K	$6K
Biagio Manna	NJ	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	$236.8K	$0
Nilesh Rana	NJ	Internal Medicine Physician	$144.2K	$50

Capital Health System Inc — Billing Profile & Reimbursement Data

Sign up for Capital Health System Inc — Billing Profile & Reimbursement Data policy alerts

Capital Health System Inc — Billing Profile & Reimbursement Data

Sign up for Capital Health System Inc — Billing Profile & Reimbursement Data policy alerts

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