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.

Georgetown Community Hospital LLC (NPI 1326107319)

Key Findings

Field	Value
Entity Type	Organization
Organization	Georgetown Community Hospital LLC
Address	1140 Lexington Rd
City	Georgetown
State	KY
ZIP	40324
Taxonomy	Rural Acute Care Hospital
NPI Enumerated	December 6, 2006

Payer Source	Total Paid
Medicaid	$44M
Medicare	$0

This provider is effectively a single‑payer Medicaid operator: Total Medicare revenue is listed as none (no Medicare billing on file), while Total Medicaid revenue is $44M. The lack of Medicare billing on file implies reimbursement exposure and utilization analyses should focus on Medicaid flows and contract negotiations rather than dual‑payer comparisons.

Revenue is concentrated: the top 3 Medicaid codes (99284, 99283, 74177) account for 44.2% of this provider's total Medicaid revenue. Individually, 99284 represents $6.7M (18.7% of Medicaid revenue), 99283 represents $4.7M (13.3%), and 74177 represents $4.4M (12.2%), highlighting a small set of services driving nearly half the Medicaid dollars.

The service mix points to a high‑volume emergency department and acute imaging capability: 99284 has 27.4K claims, 99283 has 30.8K claims, 99285 has 8K claims, and 99282 has 15.2K claims, all E/M ED codes. These claim volumes, together with the Rural Acute Care Hospital taxonomy, indicate the hospital functions as a regional ED hub with substantial patient throughput and case acuity variation.

Imaging is a major revenue driver and appears to be delivered on‑site: 74177 (CT abdomen/pelvis with contrast) shows 6.9K claims and $4.4M revenue (12.2%), 70450 (CT head without contrast) shows 5.5K claims and $1.1M revenue (3.0%), and 71275 (CTA chest) contributes $387.8K (1.1%). The prominence of high‑cost CT codes suggests investment in cross‑sectional imaging capacity that supports ED and acute diagnostic workflows.

Laboratory respiratory testing is a notable outlier versus in‑state peers: 87633 has 7K claims, $329 avg paid/claim, and $2.3M revenue (6.4% of Medicaid revenue) and ranks #5 of 81 providers in-state (95th percentile; notably above typical state volume). This elevated position for multiplex respiratory NAAT testing signals either a sustained high respiratory testing volume or centralized testing role for the facility.

Competitive standing is mixed across top services: ED E/M codes 99284 (ranks #48 of 282, 83th percentile) and 99283 (ranks #40 of 284, 86th percentile) sit at solid but not dominant in‑state positions described as typical or unremarkable volume, while 74177 (ranks #48 of 177, 73th percentile) is similarly in the mid to upper range. In contrast, 87633’s 95th percentile ranking makes the provider a leading state participant for that specific lab service, indicating pockets of relative strength amid otherwise typical market share.

The hospital generates meaningful ancillary and observation volumes that diversify Medicaid revenue beyond ED and imaging: G0378 (hospital observation service) has 2.5K claims and $934K revenue (2.6%), 43239 (EGD with biopsy) contributes $933.7K (2.6%), and infusion/IV administration codes 96374 and 96365 together represent routine procedural revenue streams ($1.2M and $676.3K respectively). These line items indicate integrated acute care, endoscopy, and infusion services alongside the ED and imaging footprint.

The provider shows long operational tenure: NPI enumerated (registered) 2006-12-06 (~20 years ago), consistent with an established rural acute care facility. Longevity combined with the concentrated Medicaid revenue base suggests stability in local service demand but also dependence on Medicaid payer dynamics for financial performance.

Medicaid: Complete Services Breakdown

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

267 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.	27,360	$250	$6.7M
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.	30,810	$150	$4.7M
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.	6,940	$630	$4.4M
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.	7,960	$330	$2.6M
87633	The lab analyst performs a test to identify a respiratory virus using amplified nucleic acid probe technique. He may also use a multiplex reverse transcription technique. The provider does this for…	7,010	$330	$2.3M
74176	The provider performs computed tomography of the abdomen and pelvis without contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	3,320	$570	$1.9M
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.	15,160	$100	$1.5M
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	13,400	$90	$1.2M
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.	5,490	$200	$1.1M
G0378	Hospital observation service, per hour	2,460	$380	$934K

Showing 1–10 of 267

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

Georgetown Community Hospital LLC — 0 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

267 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.	117	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.	48	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.	91	240	4,710	$150	$2.6M
G0483	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…	58	70	1,650	$100	$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.	40	280	5,700	$120	$2M
41899	Use this code to report a procedure on the teeth and adjoining alveolar structures for which there is no specific code available.	36	40	740	$1,170	$1.7M
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.	48	180	1,870	$280	$1.5M
G0378	Hospital observation service, per hour	47	90	2,770	$190	$1.3M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	46	80	7,740	$30	$1.1M
C1713	Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable)	26	40	550	$910	$1.1M

Showing 1–10 of 267

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Pinnacle Treatment Centers Ky-i, LLC	KY	Substance Abuse Rehabilitation Facility	$0	$30.8M
Pinnacle Treatment Centers Ky-i, LLC	KY	Substance Abuse Rehabilitation Facility	$0	$23.4M
Center For Comprehensive Services, Inc	KY	Rehabilitation Hospital	$0	$12.2M
Deaton & Deaton Counseling & Consulting	KY	Mental Health Counselor	$0	$8.6M
Kentucky Mso, LLC	KY	Cardiovascular Disease Physician	$0	$6.6M
Georgetown Pediatrics, Psc	KY	Pediatrics Physician	$0	$5.2M
Georgetown Urgent Care PLLC	KY	Urgent Care Clinic/Center	$0	$5M
The Implant And Oral Surgery Center, LLC	KY	Oral and Maxillofacial Surgery (Dentist)	$0	$4.9M
New Vista Of The Bluegrass Inc	KY	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$4.4M
Georgetown Medical, LLC	KY	Methadone Clinic	$0	$3.9M

Georgetown Community Hospital LLC — 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

Nearby Providers

Frequently Asked Questions

References