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

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

Gila Regional Medical Center (NPI 1336220839)

Field	Value
Entity Type	Organization
Organization	Gila Regional Medical Center
Address	3202 N. Ridge Loop
City	Silver City
State	NM
ZIP	88061
Taxonomy	Critical Access Hospital
NPI Enumerated	October 18, 2006

Payer Source	Total Paid
Medicaid	$33.3M
Medicare	$0

Key Findings

GILA REGIONAL MEDICAL CENTER is effectively a single‑payer Medicaid facility: it has no Medicare billing on file and reports $33.3M in lifetime Medicaid revenue, indicating Medicaid is the dominant — and in this dataset the only — federal payer flow for this provider. This concentration implies analyses of payer mix, reimbursement risk, and population served should treat the hospital as Medicaid‑dependent.

Revenue concentration is moderate: the precomputed top‑three Medicaid codes account for 36.3% of the provider's total Medicaid revenue, signaling that a small set of services (chiefly emergency department E/M and abdominal/pelvic CT) drive more than one‑third of Medicaid receipts. That reliance on a compact set of high‑revenue codes increases sensitivity to changes in ED utilization and imaging reimbursement.

The highest single Medicaid revenue codes are emergency department E/M services and advanced imaging: 99284 generated $3.9M (14.8% of Medicaid revenue), 99283 generated $3.7M (13.8%), and 74177 generated $2.1M (7.8%). This mix points to an operational profile dominated by urgent/emergency care throughput plus CT imaging capacity, consistent with a rural critical access hospital that must stabilize and image acute presentations on site.

Emergency department volume is roughly typical among in‑state peers rather than dominant: 99284 ranks #35 of 76 (55th percentile) and 99283 ranks #30 of 84 (65th percentile), both described as "typical, unremarkable volume for this code." These rankings suggest GILA REGIONAL serves a steady ED caseload but is not a regional ED volume leader within New Mexico.

By contrast, the hospital shows relative strength as an EMS/transport hub and lab/testing site: A0427 (ALS emergency transport) produced $1.8M and ranks #8 of 53 (87th percentile), A0425 (ground mileage) produced $1.1M and ranks #9 of 65 (88th percentile), and 87637 (multiplex respiratory PCR) produced $890.5K and ranks #3 of 15 (86th percentile); each of these entries is labeled "typical, unremarkable volume for this code" despite high statewide percentiles. Together these items indicate above‑average ambulance throughput and in‑house molecular testing relative to many New Mexico providers.

Imaging and inpatient‑adjacent services represent meaningful secondary revenue streams: 70450 (CT head without contrast) generated $1.1M (4.2% of Medicaid revenue) and 74176/74177 (CT abdomen/pelvis without/with contrast) together appear among the top producers, while observation services G0378 contributed $778K (2.9%). These patterns are consistent with a facility that both evaluates acute ED patients and provides short‑term observation and diagnostic imaging rather than high volumes of elective inpatient procedures.

Routine diagnostics and monitoring also contribute across a broad base: high claim counts for panels and basic labs (80053 CMP $880.8K; 85025 CBC $408.7K) and monitoring/ECG work (93005 $817.8K) suggest the hospital performs a wide range of standard inpatient and ED diagnostic workups on site, supporting acute care workflows. Many of these codes rank in the upper half of in‑state distributions (for example CMP at the 82nd percentile and CBC at the 86th percentile) and are described as "typical, unremarkable volume for this code," indicating consistent throughput.

The provider has established tenure in the NPI registry, enumerated on 2006-10-18 (~20 years ago), which supports interpreting current patterns as the result of a sustained local operating presence rather than a recent entrant; combined with its Critical Access Hospital taxonomy and the observed code mix, the profile fits a long‑standing rural ED/acute care hub with notable EMS and laboratory roles within its region.

Medicaid: Complete Services Breakdown

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

213 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.	14,800	$270	$3.9M
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.	16,460	$220	$3.7M
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.	3,190	$650	$2.1M
A0427	Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency)	7,060	$260	$1.8M
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.	3,460	$390	$1.4M
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.	7,770	$160	$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.	3,390	$330	$1.1M
A0425	Ground mileage, per statute mile	12,310	$90	$1.1M
A0429	Ambulance service, basic life support, emergency transport (bls-emergency)	3,630	$270	$975.4K
87637	The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, influenza B, and respiratory syncytial virus (RSV)…	3,410	$260	$890.5K

Showing 1–10 of 213

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. New Mexico Distribution

Gila Regional Medical Center — 0 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — New Mexico

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

213 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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.	35	80	12,050	$160	$3.9M
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.	41	70	6,920	$210	$3.5M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	19	40	3,670	$80	$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.	30	80	10,650	$130	$2.4M
A0427	Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency)	8	50	1,320	$270	$2M
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.	28	60	3,070	$210	$1.4M
A0429	Ambulance service, basic life support, emergency transport (bls-emergency)	15	60	1,850	$260	$1.2M
G0378	Hospital observation service, per hour	14	40	1,000	$400	$1M
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.	27	60	2,820	$110	$799.5K
93005	The provider records the electrical conduction of the heart to examine any abnormality in its functioning, based on signals from at least 12 leads, wires that connect the recording device to…	16	50	7,300	$60	$737.6K

Showing 1–10 of 213

Related Providers

Other providers that share a Tax Identification Number (TIN) with Gila Regional Medical Center, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Gregg Franklin	NM	Radiation Oncology Physician	$2.5M	$0
Medical Foundation, Inc.	MS	Geriatric Medicine (Family Medicine) Physician	$0	$1.8M
Paul Butros	VA	Diagnostic Radiology Physician	$844.4K	$0
Robbie Shoots	NM	Diagnostic Radiology Physician	$597.6K	$10.1K
David August	AZ	Diagnostic Radiology Physician	$430.2K	$0
Govardhanan Nagaiah	AZ	Hematology & Oncology Physician	$322.9K	$0
Daniel Arsenault	TX	Radiation Oncology Physician	$293.5K	$0
Stefan Franciosa	FL	Vascular & Interventional Radiology Physician	$266K	$0
Bryan Goss	NM	Radiation Oncology Physician	$229.6K	$0
John Morelli	OK	Diagnostic Radiology Physician	$214.5K	$0

Nearby Providers

Other providers in the same ZIP code as Gila Regional Medical Center, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Trauma And Recovery Centers	NM	Mental Health Counselor	$0	$9.9M
Silver Health Care PC	NM	Internal Medicine Physician	$0	$5.7M
Victor A. Nwachuku, M.d., PC	NM	Obstetrics Physician	$0	$2.6M
Supporting People In Need	NM	Social Worker	$0	$2.4M
Border Area Mental Health Services, Inc	NM	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$2.4M
Kids In Need Of Supportive Services	NM	Community/Behavioral Health Agency	$0	$2.1M
Recovery Management Center, PC	NM	Addiction (Substance Use Disorder) Counselor	$0	$2M
Hidalgo Medical Services	NM	Federally Qualified Health Center (FQHC)	$0	$1.9M
Home Medical Equipment Specialists, LLC	NM	Durable Medical Equipment & Medical Supplies	$0	$1.7M
James Skee	NM	Internal Medicine Physician	$303.2K	$0

Gila Regional Medical Center — 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

Related Providers

Nearby Providers

Frequently Asked Questions

References