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

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

Falmouth Hospital Association Inc (NPI 1336106806)

Falmouth Hospital Association Inc is a general acute care hospital provider located in Falmouth, Massachusetts. This profile covers 0 Medicare and 244 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Medicaid: Complete Services Breakdown

Field	Value
Entity Type	Organization
Organization	Falmouth Hospital Association Inc
Address	100 Ter Heun Dr
City	Falmouth
State	MA
ZIP	02540
Taxonomy	General Acute Care Hospital
NPI Enumerated	April 28, 2006

Payer Source	Total Paid
Medicaid	$25.4M
Medicare	$0

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

244 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.	24,970	$160	$3.9M
96361	The provider administers intravenous, or IV, fluids with electrolytes through an already established intravenous route for each additional hour to treat more severe dehydration.	8,950	$360	$3.2M
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.	16,420	$150	$2.5M
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.	15,130	$150	$2.3M
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…	19,010	$70	$1.3M
96365	The provider administers the initial intravenous infusion of a medication or other substance for a period up to one hour to prevent, treat, or diagnose a condition or disease.	7,730	$100	$788.9K
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…	13,370	$50	$682K
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.	5,680	$120	$669.8K
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.	4,310	$150	$651.1K
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.	2,790	$190	$515.6K

Showing 1–10 of 244

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Massachusetts Distribution

Falmouth Hospital Association Inc — 0 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Massachusetts

Full comparison — all codes billed, vs. Massachusetts median

244 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
96361	The provider administers intravenous, or IV, fluids with electrolytes through an already established intravenous route for each additional hour to treat more severe dehydration.	38	90	7,560	$350	$4.2M
S9485	Crisis intervention mental health services, per diem	91	110	1,250	$540	$3.2M
G0378	Hospital observation service, per hour	43	70	7,250	$100	$1.3M
96365	The provider administers the initial intravenous infusion of a medication or other substance for a period up to one hour to prevent, treat, or diagnose a condition or disease.	33	80	4,380	$140	$1.1M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	66	110	5,660	$30	$1.1M
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.	56	520	120	$130	$1M
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…	25	130	1,830	$60	$974.3K
96366	The provider administers an intravenous infusion or infusions of a medication for an additional hour or subsequent hours after the first hour to prevent, treat, or diagnose a condition or disease.	32	60	1,750	$260	$907.4K
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	550	110	$120	$865.5K
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.	327	410	140	$110	$742.2K

Showing 1–10 of 244

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Victor Aviles	MA	Hematology & Oncology Physician	$1.8M	$0
John Jardine	RI	Emergency Medicine Physician	$23.9K	$1.2M
John Hostetter	MA	Cardiovascular Disease Physician	$397.1K	$0
Jorge Alfonso	MA	Internal Medicine Physician	$297.5K	$0
Mark Durfee	MA	Emergency Medicine Physician	$160.3K	$131.7K
Marcial Santos	MA	Hospitalist Physician	$227.6K	$0
Daniel Canaday	MA	Radiation Oncology Physician	$210.8K	$0
Ryan Bemis	MA	Emergency Medicine Physician	$149.8K	$0
Basia Mcanaw	MA	Radiation Oncology Physician	$104.8K	$0
Edward Williams	NH	Emergency Medicine Physician	$98K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Gosnold, Inc.	MA	Children's Substance Abuse Rehabilitation Facility	$0	$27.6M
Trinity Hospice LLC	MA	Community Based Hospice Care Agency	$0	$11.5M
Town Of Falmouth	MA	Land Ambulance	$1.1M	$1.9M
James Bleiler	MA	Urology Physician	$941K	$0
Cvs Pharmacy Inc	MA	Pharmacy	$756.9K	$0
Paul Dimond	MA	Orthopaedic Surgery Physician	$346.8K	$0
Mir Shuttari	MA	Pulmonary Disease Physician	$194.9K	$130.8K
David Rancourt	MA	Internal Medicine Physician	$315.4K	$0
David Whitney	MA	Primary Podiatric Medicine Podiatrist	$300.2K	$0
John Guerin	MA	Cardiovascular Disease Physician	$265.5K	$0

Falmouth Hospital Association Inc — Billing Profile & Reimbursement Data

Sign up for Falmouth Hospital Association Inc — Billing Profile & Reimbursement Data policy alerts

Falmouth Hospital Association Inc — Billing Profile & Reimbursement Data

Sign up for Falmouth Hospital Association Inc — Billing Profile & Reimbursement Data policy alerts

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References