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

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

Children's Hospital Colorado (NPI 1336245828)

Key Findings

Field	Value
Entity Type	Organization
Organization	Children's Hospital Colorado
Address	13123 E 16th Ave
City	Aurora
State	CO
ZIP	80045
Taxonomy	Children's Hospital
NPI Enumerated	September 15, 2006

Payer Source	Total Paid
Medicaid	$114.9M
Medicare	$0

CHILDREN'S HOSPITAL COLORADO is effectively a Medicaid-focused provider with no Medicare billing on file and $114.9M in lifetime Medicaid revenue; this makes its payer footprint effectively single-payer in the available claims data and indicates its operations are concentrated in pediatric Medicaid populations.

Revenue concentration is high: the top three Medicaid codes by revenue account for 57.0% of the provider's Medicaid revenue, demonstrating that a small set of services—particularly emergency department E/M and key pediatric procedures—drive the majority of Medicaid receipts.

Emergency department services dominate the Medicaid mix, led by 99283 ($37.3M, 39.2% of Medicaid revenue) and 99282 ($10.7M, 11.2% of Medicaid revenue). Together these codes show the hospital functions as a high-volume pediatric emergency care center with substantial low- and moderate-complexity ED visit volume.

CHILDREN'S HOSPITAL COLORADO is a statewide leader on many high-volume pediatric service lines: it ranks #2 of 285 for 99283 (100th percentile, labeled an extreme outlier) and #1 of 134 for 99282 (100th percentile, extreme outlier). These rankings indicate dominant market share in Medicaid for emergency department E/M services relative to in-state peers.

Beyond ED care, the provider shows concentrated specialty services consistent with a tertiary pediatric hospital: high-ranking volumes for sleep studies (95810: $4.7M, rank #3 of 31, 93rd percentile), therapeutic and rehabilitation services (97110: $2.3M, rank #7 of 631, 99th percentile; 97530: $1.4M, rank #13 of 680, 98th percentile), and pediatric ophthalmology/vision codes (92014 and 92012 combined prominence). This mix suggests integrated inpatient/outpatient specialty programs and allied therapy services.

Several codes reflect unusually large state-level volume for non-ED services as well: 97803 ranks #1 of 35 (100th percentile, extreme outlier) and G0382 ranks #1 of 6 (100th percentile, notably above typical volume), showing the hospital is a primary provider for outpatient ED-level care and medical nutrition/dietary reassessment in Medicaid. These positions underscore competitive dominance for select pediatric ancillary services.

Clinical procedure outliers include dental/OR dentistry procedures (41899: $6.2M, rank #4 of 16, 80th percentile) and high-throughput COVID testing and collection codes (U0003: $1.2M, rank #7 of 79, 92nd percentile; C9803: $867.9K, rank #1 of 16, 100th percentile). This pattern reflects broad service capacity—from dental procedures to infectious disease testing—consistent with a large pediatric hospital serving diverse clinical needs.

The provider has long tenure on the NPI file, enumerated since 2006-09-15 (~20 years), which supports interpretation of these high volumes as sustained service patterns rather than short-term spikes. Tenure combined with the concentrated revenue mix and repeat top-state rankings suggests established operational scale in pediatric Medicaid care.

Medicaid: Complete Services Breakdown

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

376 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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.	124,390	$300	$37.3M
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.	41,460	$260	$10.7M
41899	Use this code to report a procedure on the teeth and adjoining alveolar structures for which there is no specific code available.	2,630	$2,370	$6.2M
95810	Polysomnography refers to the continuous and simultaneous monitoring and recording of various physiological and pathophysiological parameters of sleep for six or more hours with physician review,…	3,400	$1,380	$4.7M
92507	The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with…	23,460	$200	$4.6M
G0382	Level 3 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is…	26,260	$160	$4.3M
95782	A patient under the age of 6 undergoes an attended sleep study with identification of sleep levels and at least four additional sleep parameters.	1,660	$1,510	$2.5M
92014	An ophthalmologist sees an established patient for a comprehensive level eye examination. Generally, a patient is considered to be "established" if the same physician, or any physician in the group…	15,400	$160	$2.5M
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…	42,960	$50	$2.3M
99281	The provider sees a patient for the lowest level emergency department visit.	8,600	$250	$2.1M

Showing 1–10 of 376

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Colorado Distribution

Children's Hospital Colorado — 12 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Colorado

Full comparison — all codes billed, vs. Colorado median

376 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
41899	Use this code to report a procedure on the teeth and adjoining alveolar structures for which there is no specific code available.	4	20	940	$1,150	$1.5M
H0035	Mental health partial hospitalization, treatment, less than 24 hours	8	10	770	$470	$1.2M
G0382	Level 3 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is…	1	10	600	$180	$1.1M
J0475	Injection, baclofen, 10 mg	1	10	1,000	$970	$970.8K
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.	170	210	730	$120	$966.7K
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.	2	290	1,390	$110	$958.7K
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.	76	270	1,290	$100	$937.1K
J0585	Injection, onabotulinumtoxina, 1 unit	33	50	340	$520	$452.1K
82542	The lab analyst performs the technical lab test to evaluate the specimen for the presence or amount of a nondrug analyte by using column chromatography and possibly mass spectrometry.	2	10	3,190	$130	$425.6K
G0381	Level 2 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is…	1	10	350	$170	$418.4K

Showing 1–10 of 376

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Prosthetic & Orthotic Group Pediatric Specialists - Colorado LLC	CO	Prosthetic/Orthotic Supplier	$0	$7.3M
Children's Optical, LLC	CO	Pediatric Optometrist	$0	$6.4M
Rmchs Management	CO	Pediatric Dentistry	$0	$4.4M
University Physicians Incorporated	CO	Clinical Medical Laboratory	$271.4K	$3.4M
Marisa Lau	CO	Ophthalmology Physician	$2M	$0
Jorge Monge Urrea	CO	Hematology & Oncology Physician	$1.9M	$18.9K
University Physicians Incorporated	CO	Clinical Medical Laboratory	$509.9K	$886.9K
Rachel Chen	CO	Retina Specialist (Ophthalmology) Physician	$1M	$0
Jeffrey Olson	CO	Ophthalmology Physician	$983.2K	$0
Signal Diagnostics LLC	CO	Clinical Medical Laboratory	$976K	$0

Children's Hospital Colorado — Billing Profile & Reimbursement Data

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Children's Hospital Colorado — 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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
University Physicians Incorporated	CO	Internal Medicine Physician	$0	$190.8M
Uch-mhs	CO	General Acute Care Hospital	$0	$69M
University Of Colorado Hospital Authority	CO	General Acute Care Hospital	$0	$58.1M
Johns Hopkins University	MD	Emergency Medicine Physician	$0	$21.1M
Children's Hospital Colorado	CO	Children's Hospital	$0	$17.8M
Children's Hospital Colorado	CO	Dental Clinic/Center	$0	$12.9M
Children's Hospital Colorado	CO	Children's Hospital	$0	$11.4M
University Physicians Incorporated	CO	Pediatrics Physician	$0	$7.8M
Children's Hospital Colorado	CO	Children's Hospital	$0	$7.3M
University Physicians Incorporated	CO	Clinical Medical Laboratory	$0	$6.7M