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

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

West Penn Allegheny Health System Inc. (NPI 1285667493)

Field	Value
Entity Type	Organization
Organization	West Penn Allegheny Health System Inc.
Address	320 E North Ave
City	Pittsburgh
State	PA
ZIP	15212
Taxonomy	General Acute Care Hospital
NPI Enumerated	July 9, 2006

Payer Source	Total Paid
Medicaid	$10.8M
Medicare	$0

Medicaid: Complete Services Breakdown

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

306 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.	14,550	$150	$2.2M
G0378	Hospital observation service, per hour	1,700	$880	$1.5M
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.	9,740	$150	$1.5M
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.	8,970	$140	$1.2M
A0431	Ambulance service, conventional air services, transport, one way (rotary wing)	130	$2,970	$373.8K
T1015	Clinic visit/encounter, all-inclusive	7,150	$50	$321.7K
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…	3,860	$80	$308.4K
87536	A lab tests a patient’s specimen to measure the amount of HIV–1 present. This may be referred to as viral load.	1,260	$130	$168.4K
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.	1,570	$100	$157.1K
0002A	N/A	3,090	$40	$129.8K

Showing 1–10 of 306

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Pennsylvania Distribution

West Penn Allegheny Health System Inc. — 3 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Pennsylvania

Full comparison — all codes billed, vs. Pennsylvania median

306 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
A0431	Ambulance service, conventional air services, transport, one way (rotary wing)	8	10	280	$2,940	$5.9M
G0378	Hospital observation service, per hour	44	150	510	$870	$1.4M
T1015	Clinic visit/encounter, all-inclusive	273	1,690	760	$170	$1.2M
A0436	Rotary wing air mileage, per statute mile	8	10	240	$690	$1.2M
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…	130	130	310	$60	$769.3K
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.	81	210	730	$40	$689.7K
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…	48	200	990	$70	$517.5K
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.	131	1,600	270	$120	$409.7K
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.	106	1,060	150	$130	$405.4K
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…	48	60	430	$200	$354.2K

Showing 1–10 of 306

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
West Penn Allegheny Health System Inc	PA	General Acute Care Hospital	$0	$12.7M
West Penn Allegheny Health System Inc.	PA	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$8.6M
West Penn Allegheny Health System Inc.	PA	General Acute Care Hospital	$0	$8.2M
Puvalai Vijaykumar	GA	Clinical Cardiac Electrophysiology Physician	$152.9K	$0
Ali Amjad	PA	Hematology & Oncology Physician	$98K	$2.5K
Jason Lamb	WV	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	$74.1K	$0
Carlos Bedetti	FL	Anatomic Pathology & Clinical Pathology Physician	$67.7K	$0
Mark Bunker	PA	Immunopathology Physician	$52.6K	$0
Ariel Aballay	PA	Surgery Physician	$4.8K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Cernostics, Inc.	PA	Clinical Medical Laboratory	$44.5M	$83.5K
Christian Home Healthcare	PA	In Home Supportive Care Agency	$0	$13.7M
Thierry Verstraeten	PA	Ophthalmology Physician	$894.3K	$45K
Robert Lewen	PA	Ophthalmology Physician	$383.8K	$1.1K
Athanasios Colonias	PA	Radiation Oncology Physician	$324.7K	$0
Paul Klepchick	PA	Diagnostic Radiology Physician	$146.7K	$95.6K
Mikhail Chilingaryan	PA	Internal Medicine Physician	$240.2K	$0
Sameer Jain	PA	Orthopaedic Surgery Physician	$198.5K	$0
Brett Nielson	PA	Diagnostic Radiology Physician	$180.4K	$760
Nicholas Sotereanos	PA	Orthopaedic Surgery Physician	$175.9K	$0

West Penn Allegheny Health System Inc. — Billing Profile & Reimbursement Data

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West Penn Allegheny Health System Inc. — 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