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

Why is the Medicaid comparison limited to South Carolina 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. South Carolina (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.

Shriners Hospitals For Children (NPI 1326187097)

Field	Value
Entity Type	Organization
Organization	Shriners Hospitals For Children
Address	950 W Faris Rd
City	Greenville
State	SC
ZIP	29605
Taxonomy	Children's Hospital
NPI Enumerated	February 6, 2007

Payer Source	Total Paid
Medicaid	$4.3M
Medicare	$0

Medicaid: Complete Services Breakdown

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

49 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J3490	Unclassified drugs	4,730	$350	$1.6M
99211	An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.	23,470	$30	$633.7K
77073	The provider images the lower extremity from hips to ankle to measure the difference in the length of the legs.	5,560	$60	$356.1K
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.	7,690	$30	$223.1K
72082	In this diagnostic procedure, the provider takes X–ray images from two or three projections (directions or angles) of the entire thoracic (upper and middle) and lumbar (lower) spine to evaluate the…	3,730	$50	$178.8K
72081	In this diagnostic procedure, the provider captures the entire thoracic (upper and middle) and lumbar (lower) spine in an X–ray image from a single projection (direction or angle) to evaluate the…	3,170	$50	$171K
73620	In this diagnostic procedure, the provider takes two X–ray views of a patient’s foot to assess an injury, fracture, arthritis, tumor, or congenital abnormality.	5,230	$30	$162.2K
72170	In this procedure, the provider takes one or two X–ray images of the pelvic bone to check for any fracture, swelling, or reason of pain in the pelvis.	2,860	$50	$134.5K
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	4,750	$20	$114K
73600	In this procedure, the provider takes two X–ray views of the ankle joint to check for any fracture, swelling, or reason for pain in the ankle.	3,150	$30	$97.5K

Showing 1–10 of 49

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. South Carolina Distribution

Shriners Hospitals For Children — 9 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — South Carolina

Full comparison — all codes billed, vs. South Carolina median

49 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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.	90	350	2,590	$70	$550.2K
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	98	290	2,600	$60	$414.4K
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…	584	2,770	210	$60	$254.5K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	498	710	350	$60	$247.2K
J7120	Ringers lactate infusion, up to 1000 cc	39	70	1,700	$40	$198.5K
G0463	Hospital outpatient clinic visit for assessment and management of a patient	46	70	320	$40	$159.1K
J3490	Unclassified drugs	30	130	2,450	$30	$118.9K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	184	610	190	$50	$98.4K
99211	An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.	4	270	120	$50	$93.2K
81025	The lab analyst performs the pregnancy test on a urine specimen using a methodology or kit that the analyst can read visually for a direct readout.	349	380	660	$30	$90K

Showing 1–10 of 49

Related Providers

Other providers that share a Tax Identification Number (TIN) with Shriners Hospitals For Children, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Shriners Hospitals For Children	WA	Children's Hospital	$0	$6.1M
Shriners Hospitals For Children	OR	Children's Hospital	$0	$3.9M
Shriners Hospitals For Children	HI	Children's Hospital	$0	$2.8M
Peggy Liao	HI	Ophthalmology Physician	$3.3K	$968K
John Vanaalst	KY	Plastic and Reconstructive Surgery Physician	$672K	$0
Shriners Hospitals For Children	UT	Children's Hospital	$0	$605.5K
Ryan Nunley	MO	Adult Reconstructive Orthopaedic Surgery Physician	$469.2K	$0
Robert Tychsen	MO	Ophthalmology Physician	$8.6K	$455.1K
Steven Wilhelm	WA	Diagnostic Radiology Physician	$439.1K	$0
Mohammadali Mojarrad	MA	Diagnostic Radiology Physician	$343.4K	$40.3K

Nearby Providers

Other providers in the same ZIP code as Shriners Hospitals For Children, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Prisma Health-upstate	SC	General Acute Care Hospital	$0	$86.9M
Prisma Health-upstate	SC	General Acute Care Hospital	$0	$25M
Prisma Health-upstate	SC	General Acute Care Hospital	$0	$22M
Heavenly Care Services Inc.	SC	Nursing Care Agency	$0	$12.1M
Speechworks, Inc.	SC	Speech-Language Pathologist	$0	$10.5M
Plan Home Health Care	SC	Nursing Care Agency	$0	$8.9M
Prisma Health-upstate	SC	General Acute Care Hospital	$0	$8.3M
Prisma Health-upstate	SC	Land Ambulance	$4.5M	$3.7M
Prisma Health-upstate	SC	Infusion Therapy Clinic/Center	$0	$7.5M
Prisma Health University Medical Group	SC	Diagnostic Radiology Physician	$0	$7.5M

Shriners Hospitals For Children — Billing Profile & Reimbursement Data

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Shriners Hospitals For Children — 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