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

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

University Of Rochester (NPI 1346285657)

Field	Value
Entity Type	Organization
Organization	University Of Rochester
Address	601 Elmwood Ave
City	Rochester
State	NY
ZIP	14642
Taxonomy	General Acute Care Hospital
NPI Enumerated	June 19, 2006

Payer Source	Total Paid
Medicaid	$368.3M
Medicare	$0

Key Findings

UNIVERSITY OF ROCHESTER reports no Medicare billing on file and $368.3M in lifetime Medicaid revenue, making its publicly observed commercial/government footprint effectively single‑payer (Medicaid) in the available data. The absence of Medicare activity in this dataset is notable for a general acute care hospital and means analyses of payer diversification must focus on Medicaid dynamics.

Revenue concentration in Medicaid is meaningful but not extreme: the precomputed top‑3 Medicaid CPT/HCPCS codes account for 23.7% of the provider's total Medicaid revenue. Those three top drivers are 90791 ($20.2M, 9.9%), 90834 ($14.5M, 7.1%), and T1040 ($13.9M, 6.8%), indicating that roughly one quarter of Medicaid revenue is tied to a small set of high‑volume behavioral health/per‑diem services.

The code mix strongly signals that behavioral health services are a primary service line. High‑revenue behavioral health CPTs and H/T codes appear throughout the top code list (90791, 90834, 90832, 90837, S9485, H2011, H0035, H0040, H0020), with several of those codes bringing multi‑million dollar contributions (for example, 90791 $20.2M and 90834 $14.5M). This pattern points to large outpatient psychiatry, crisis intervention, and remaining community behavioral health clinic activity embedded in the hospital's Medicaid volume.

Emergency and ambulatory evaluation‑and‑management activity also represents a sizable Medicaid revenue stream: 99213 ($12.8M), 99214 ($9.7M), 99284 ($10.7M), 99283 ($8.8M), 99282 ($3.6M) and 99285 ($3.3M) are all among the top codes. These entries and their claim volumes indicate high ED throughput and substantial outpatient clinic visits that operate alongside the behavioral health programs.

The provider also supports high‑cost infusion and specialty drug administration as a component of its Medicaid business: J9271 (pembrolizumab) $11.2M, J2350 (ocrelizumab) $8.7M, J1459 (privigen) $4.6M, Q5103 (infliximab‑dyyb) $4.9M and J3380 (vedolizumab) $3.4M appear in the top 25 list. Rank/percentile data for these drugs are mixed (for example, J9271 ranks #8 of 23 at the 68th percentile), which suggests the hospital runs specialty infusion services at scale but is not uniformly dominant statewide in every high‑cost biological agent.

Competitive standing in New York is strongest in behavioral health and certain outpatient services: several behavioral health codes are labeled "extreme outlier" or at the 99th–100th percentile statewide (examples include 90791: ranks #5 of 1315, 100th percentile, extreme outlier; 90834: ranks #26 of 2199, 99th percentile, extreme outlier; S9485: ranks #1 of 31, 100th percentile, extreme outlier). These rank patterns indicate the provider is a dominant, high‑volume statewide player for multiple mental health and crisis intervention service lines.

The provider has an established operational tenure, with its NPI enumerated on 2006-06-19 (~20 years ago), consistent with a mature hospital operating substantial outpatient and specialty clinics. That longevity, combined with the concentrated Medicaid exposure, implies institutional infrastructure supporting sustained behavioral health, ED, and infusion operations.

From a payer‑risk and strategic perspective, the combination of: (a) no Medicare billing on file, (b) $368.3M concentrated in Medicaid, and (c) the top‑3 codes representing 23.7% of Medicaid revenue, indicates material dependence on Medicaid policy and reimbursement trends. Any changes to Medicaid coverage, rates, or utilization management for behavioral health, ED services, or high‑cost infusible drugs could disproportionately affect this provider relative to peers with more diversified payer mixes.

Medicaid: Complete Services Breakdown

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

912 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	30,260	$670	$20.2M
90834	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	96,990	$150	$14.5M
T1040	Medicaid certified community behavioral health clinic services, per diem	134,600	$100	$13.9M
99213	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…	96,120	$130	$12.8M
90832	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	84,710	$140	$11.9M
J9271	Injection, pembrolizumab, 1 mg	1,290	$8,630	$11.2M
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.	56,750	$190	$10.7M
99214	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…	71,830	$140	$9.7M
S9485	Crisis intervention mental health services, per diem	7,610	$1,220	$9.3M
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…	110,220	$80	$8.8M

Showing 1–10 of 912

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. New York Distribution

University Of Rochester — 17 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — New York

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

912 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1040	Medicaid certified community behavioral health clinic services, per diem	10	30	47,730	$120	$24.8M
J2350	Injection, ocrelizumab, 1 mg	3	10	210	$26,790	$10.9M
J9271	Injection, pembrolizumab, 1 mg	8	20	750	$8,890	$8.1M
H0040	Assertive community treatment program, per diem	14	90	1,990	$1,780	$5.3M
H2014	Skills training and development, per 15 minutes	160	160	3,210	$200	$4.5M
H0020	Alcohol and/or drug services; methadone administration and/or service (provision of the drug by a licensed program)	20	120	61,480	$30	$4.4M
T1016	Case management, each 15 minutes	21	40	3,630	$220	$3.7M
J1745	Injection, infliximab, excludes biosimilar, 10 mg	10	20	730	$2,870	$3.5M
S9342	Home therapy; enteral nutrition via pump; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (enteral formula and nursing visits…	15	20	1,400	$80	$2.7M
J2323	Injection, natalizumab, 1 mg	4	10	360	$4,710	$2.5M

Showing 1–10 of 912

Related Providers

Other providers that share a Tax Identification Number (TIN) with University Of Rochester, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Eli Eliav	NJ	Dentist	$0	$19.5M
Ginel Gordon	NY	Nurse Practitioner	$342.3K	$58.5K
Marc Brown	NY	MOHS-Micrographic Surgery Physician	$131.9K	$0
Albert Tricomi	NY	Cardiovascular Disease Physician	$92.3K	$10.9K
Adam Juersivich	NY	Neurology Physician	$90.6K	$0
Gissou Azabdaftari	NY	Anatomic Pathology & Clinical Pathology Physician	$86.8K	$0
Adam Carinci	LA	Interventional Pain Medicine Physician	$49.5K	$30.5K
Eugene Storozynsky	PA	Advanced Heart Failure and Transplant Cardiology Physician	$73.9K	$3.8K
Lioudmila Lipetskaia	NJ	Obstetrics & Gynecology Physician	$68.5K	$0
Franki Lambert Smith	NY	Dermatology Physician	$58.7K	$0

Nearby Providers

Other providers in the same ZIP code as University Of Rochester, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
U Of R Neurology Department	NY	Neurology Physician	$0	$61.8M
Emergency Associates - University Of Rochester	NY	Emergency Care Clinic/Center	$0	$26.1M
Sana Idrees	NY	Retina Specialist (Ophthalmology) Physician	$1.7M	$1.6K
Daniel Ginat	NY	Diagnostic Radiology Physician	$202.7K	$867.5K
Andrew Chen	NY	Diagnostic Radiology Physician	$373.4K	$0
Andrew Dunn	NY	Anatomic Pathology & Clinical Pathology Physician	$358.9K	$0
Ankur Chandra	NY	Vascular Surgery Physician	$293.6K	$0
David Wagner	NY	Anatomic Pathology & Clinical Pathology Physician	$174.7K	$0
Sherry Wang	NY	Diagnostic Radiology Physician	$151.5K	$0
Tyler Slyngstad	NY	Cardiovascular Disease Physician	$145.3K	$0

University Of Rochester — 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