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NPI 1346243375 · New Brunswick, NJ · General Acute Care Hospital
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Robert Wood Johnson University Hospital, Inc is a general acute care hospital provider located in New Brunswick, New Jersey. This profile covers 0 Medicare and 658 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.
Provider details (source: NPPES NPI Registry)
| Field | Value |
|---|---|
| Entity Type | Organization |
| Organization | Robert Wood Johnson University Hospital, Inc |
| Address | 1 Robert Wood Johnson Pl |
| City | New Brunswick |
| State | NJ |
| ZIP | 08901 |
| Taxonomy | General Acute Care Hospital |
| NPI Enumerated | May 23, 2005 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $198.3M |
| Medicare | $0 |
This provider is effectively single‑payer in the available data: there is no Medicare billing on file and Total Medicaid revenue is $198.3M, indicating Medicaid dominates its recorded reimbursement mix. Analysts should treat Medicaid as the primary commercial lens when modeling this entity’s revenue and service capacity.
Revenue is highly concentrated in a small set of services: the precomputed top 3 Medicaid codes account for 39.8% of this provider's total Medicaid revenue, driven primarily by observation and high‑acuity emergency visits (G0378, 99285, 99284). This concentration signals that a few operational areas (ED + observation) materially determine financial performance.
Operationally the hospital functions as a high‑volume emergency and observation center: G0378 shows 27.7K claims and $25.3M revenue (18.2% of Medicaid revenue) while 99285 (38.1K claims, $15.2M) and 99284 (38.9K claims, $14.9M) also register large claim volumes and revenue shares. These counts and revenue shares underline sustained ED throughput and a staffed observation unit as core service lines.
The provider runs a substantial oncology/infusion program: 96413 (22.4K claims, $8.5M; ranks #3 of 77, 97th percentile — labeled an extreme outlier), J1745 (1.8K claims, $7M; ranks #2 of 11, 90th percentile), J9271 (888 claims, $5.4M; ranks #3 of 11, 80th percentile), and J2505 (766 claims, $3.8M; ranks #2 of 9, 88th percentile) together show material revenue from chemotherapy and biologic infusions. High ranks and the extreme‑outlier designation for 96413 indicate oncology infusion care is a strategic, high‑volume service for the hospital.
In addition to ED and oncology lines, the hospital shows outsized procedural and surgical activity in specific areas: 42820 (tonsil/adenoid removal) is $2.1M and ranks #1 of 31 (100th percentile, extreme outlier), 36430 (venous catheter placement) is $1.4M and ranks #2 of 33 (97th percentile), and 43239 (EGD with biopsy) is $4.2M and ranks #21 of 284 (93rd percentile). These results point to significant surgical and endoscopy throughput alongside inpatient/ED care.
Outpatient and ancillary throughput is large by claim count: OP250 has 177.7K claims and $7.8M revenue (5.6% of Medicaid revenue; ranks #10 of 170, 95th percentile) and OP370 has 35K claims and $1.6M revenue (1.2% of Medicaid revenue; ranks #1 of 59, 100th percentile). The lab footprint is also substantial with 80053 at 113.2K claims and $2.3M revenue (1.6% of Medicaid revenue), suggesting heavy diagnostic and outpatient procedure volume feeding inpatient and ED services.
Competitive standing in‑state is strong for multiple lines: the hospital ranks in the top decile or better on numerous codes (for example, G0378 #8 of 78, 91st percentile; 99285 #25 of 282, 91st percentile; 99282 #6 of 141, 96th percentile) and is an extreme outlier or the top reporter for several services (42820 and OP370 both rank #1 of their peer groups at the 100th percentile). These rank and percentile positions indicate the provider is a major statewide player for ED/observation, oncology infusions, and select surgical procedures.
The NPI tenure supports an established operating footprint: the provider was enumerated on 2005-05-23 (~21 years ago), consistent with the mature, high‑volume Medicaid billing profile observed across emergency, observation, oncology infusion, procedural, and outpatient diagnostic services. Researchers should treat the patterns above as reflecting long‑standing service lines rather than a recent change in billing mix.
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
View: By Year1 / 3
Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
658 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| G0378 | Hospital observation service, per hour | 27,650 | $920 | $25.3M |
| 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. | 38,080 | $400 | $15.2M |
| 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. | 38,930 | $380 | $14.9M |
| 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. | 57,380 | $250 | $14.3M |
| 96413 | Chemotherapy is a therapeutic procedure used for the treatment of cancer via the use of chemical agents. These chemical agents (drugs) work on the cancerous cells of the body to destroy them. These… | 22,370 | $380 | $8.5M |
| OP250 | N/A | 177,650 | $40 | $7.8M |
| J1745 | Injection, infliximab, excludes biosimilar, 10 mg | 1,760 | $3,990 | $7M |
| 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. | 34,960 | $190 | $6.7M |
| J9271 | Injection, pembrolizumab, 1 mg | 890 | $6,070 | $5.4M |
| 43239 | The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis. | 3,300 | $1,260 | $4.2M |
Showing 1–10 of 658
How this provider's Medicaid billing volume and revenue compare to other New Jersey providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. New Jersey median
658 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| G0378 | Hospital observation service, per hour | 8 | 80 | 6,290 | $690 | $6.6M |
| J1745 | Injection, infliximab, excludes biosimilar, 10 mg | 2 | 10 | 680 | $1,920 | $5.1M |
| J9271 | Injection, pembrolizumab, 1 mg | 3 | 10 | 340 | $6,690 | $4.9M |
| 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. | 28 | 260 | 4,240 | $220 | $4.1M |
| 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. | 45 | 320 | 580 | $230 | $4M |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 24 | 30 | 9,660 | $310 | $3.4M |
| J9306 | Injection, pertuzumab, 1 mg | 2 | 10 | 480 | $6,460 | $3.1M |
| 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. | 25 | 280 | 920 | $200 | $2.6M |
| J9299 | Injection, nivolumab, 1 mg | 3 | 10 | 460 | $5,830 | $2.5M |
| J9312 | Injection, rituximab, 10 mg | 3 | 10 | 180 | $5,830 | $2.2M |
Showing 1–10 of 658
Other providers in the same ZIP code as Robert Wood Johnson University Hospital, Inc, ranked by combined Medicare and Medicaid revenue.
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