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

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

Spring Valley Medical Center (NPI 1346230323)

Key Findings

Field	Value
Entity Type	Organization
Organization	Spring Valley Medical Center
Address	5400 S Rainbow Blvd
City	Las Vegas
State	NV
ZIP	89118
Taxonomy	General Acute Care Hospital
NPI Enumerated	October 21, 2005

Payer Source	Total Paid
Medicaid	$33.5M
Medicare	$0

SPRING VALLEY MEDICAL CENTER shows a concentrated payer footprint: there is no Medicare billing on file and total Medicaid revenue is $33.5M, so the provider is effectively operating on a single major public payer base. Its NPI was enumerated on 2005-10-21 (~21 years ago), indicating roughly two decades of presence in the market and an established billing history with Medicaid.

Revenue is highly concentrated in a few high-acuity service lines: the top 3 Medicaid codes (99285, G0378, 99284) account for 48.5% of the provider's total Medicaid revenue. Those three codes include high- and moderate-complexity emergency department E/M visits and hospital observation hours, signaling that nearly half of Medicaid dollars flow from acute ED and observation care.

The code mix points to a large emergency/observation operation: 99285 (62K claims, $115 avg paid/claim, $7.1M revenue, 26.0%) and 99284 (31.9K claims, $91 avg paid/claim, $2.9M revenue, 10.6%) are top revenue drivers, and G0378 (28.4K claims, $116 avg paid/claim, $3.3M revenue, 12.0%) further emphasizes sustained observation utilization. Together these patterns are consistent with a general acute care hospital that relies on ED throughput and observation unit stays as primary Medicaid revenue engines.

Imaging and diagnostic services are a meaningful secondary revenue stream: CT abdomen/pelvis with contrast 74177 (9.4K claims, $229 avg paid/claim, $2.2M revenue, 7.9%) and CT head 70450 (15.2K claims, $86 avg paid/claim, $1.3M revenue, 4.8%) are among the higher-revenue codes. These radiology volumes—each at high in-state percentiles (74177 at 93rd, 70450 at 95th)—support the picture of an ED-focused hospital with substantial on-site imaging capacity used to evaluate acute presentations.

The provider shows elevated utilization of IV/infusion and ED-adjunct services: high-usage codes include 96374 (44K claims, $18 avg paid/claim, $791.9K revenue), 96361 (34.5K claims, $22 avg paid/claim, $758.4K revenue), 96375 (35K claims, $18 avg paid/claim, $629.9K revenue) and 96365 (8.6K claims, $29 avg paid/claim, $249.4K revenue). Several of these infusion/administration codes are described as “notably above typical” in state volume, indicating frequent procedural treatments consistent with an active emergency department and short-stay therapeutic interventions.

Competitive standing in-state is strong for emergency services: 99285 ranks #10 of 352 providers in Nevada (97th percentile) and 99284 ranks #22 of 398 (95th percentile), which places the hospital among the top ED service-volume providers statewide. By contrast, the observation code G0378 is ranked #4 of 38 (92th percentile) but labeled “typical, unremarkable volume,” suggesting that while the hospital appears high-volume for observation in absolute ranking, that utilization is within expected statewide patterns for that specific code.

There are clear statistical outliers in procedural mix that warrant attention: 96372 (22.5K claims, $14 avg paid/claim, $315K revenue, 1.1%) is flagged as an “extreme outlier, far above typical state volume” (98th percentile), and several lab/monitoring codes such as 93005 and 84484 are described as “notably above typical.” These flags indicate areas of unusually high utilization relative to peers that shape the provider’s Medicaid revenue profile.

From a business-risk perspective, the combination of concentrated Medicaid dependence (no Medicare revenue on file) and revenue driven by ED, observation, imaging, and infusion services suggests sensitivity to shifts in Medicaid reimbursement policy or utilization management. Any payer policy changes targeting ED/observation reimbursement, imaging utilization, or infusion services could disproportionately affect this provider’s revenue mix given that the top codes drive a large share of Medicaid dollars.

Medicaid: Complete Services Breakdown

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

279 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.	61,950	$120	$7.1M
G0378	Hospital observation service, per hour	28,360	$120	$3.3M
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.	31,890	$90	$2.9M
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.	9,420	$230	$2.2M
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.	31,540	$50	$1.6M
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.	15,200	$90	$1.3M
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.	6,280	$170	$1M
71275	In this procedure, the provider performs a computed tomographic angiography, or CTA imaging of the chest to get detailed images of the blood vessels but not the heart. He performs this study using a…	4,040	$240	$982.7K
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	43,990	$20	$791.9K
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.	34,470	$20	$758.4K

Showing 1–10 of 279

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Nevada Distribution

Spring Valley Medical Center — 4 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Nevada

Full comparison — all codes billed, vs. Nevada median

279 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
G0378	Hospital observation service, per hour	4	40	4,770	$110	$1.2M
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.	10	350	240	$110	$685.4K
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…	83	150	1,060	$50	$482K
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.	22	400	200	$90	$442.5K
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.	11	140	210	$140	$421K
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.	41	310	680	$50	$373.3K
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	60	680	$60	$364.3K
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.	19	390	200	$60	$289.8K
87798	The lab analyst performs a test for an infectious agent not specified in another code using an amplified nucleic acid probe technique. Use this code if you know the laboratory technique is amplified…	24	30	290	$60	$260.3K
71275	In this procedure, the provider performs a computed tomographic angiography, or CTA imaging of the chest to get detailed images of the blood vessels but not the heart. He performs this study using a…	7	60	330	$150	$250.4K

Showing 1–10 of 279

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Option 1 Nutrition Solutions, LLC	NV	Parenteral & Enteral Nutrition Supplies (DME)	$0	$15.1M
Optum Frontier Therapies Ii, LLC	NV	Community/Retail Pharmacy	$0	$9.3M
J Paul Wiesner & Associates Chartered	NV	Diagnostic Radiology Physician	$0	$5.6M
Spring Valley Dialysis Center LLC	NV	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$5.4M
Little Smiles LLC	NV	Pediatric Dentistry	$0	$4.2M
Procare Medical Group LLC	NV	Urgent Care Clinic/Center	$0	$2.9M
1 Love Wellness Society LLC	NV	Community/Behavioral Health Agency	$0	$2.1M
Mobile Mental Health Support Services, Inc.	NV	Physical Disabilities Residential Treatment Facility	$0	$2.1M
Rosa Bellota	NV	Child & Adolescent Psychiatry Physician	$51.1K	$2M
My Genius Lab LLC	NV	Clinical Medical Laboratory	$544.7K	$1.5M

Spring Valley Medical Center — Billing Profile & Reimbursement Data

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Spring Valley 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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Valley Hospital Medical Center	NV	General Acute Care Hospital	$0	$47M
Summerlin Hospital Medical Center L L C	NV	General Acute Care Hospital	$0	$30.3M
Centennial Hills Hospital Medical Center	NV	General Acute Care Hospital	$0	$25.1M
Valley Hospital Medical Center	NV	Emergency Care Clinic/Center	$0	$1.5M
Spring Valley Medical Center	NV	Emergency Care Clinic/Center	$0	$1.3M