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.

Rochester General Hospital (NPI 1356412712)

Rochester General Hospital is a family medicine physician provider located in Rochester, New York. This profile covers 0 Medicare and 160 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Medicaid: Complete Services Breakdown

Field	Value
Entity Type	Organization
Organization	Rochester General Hospital
Address	2350 Ridgeway Ave
City	Rochester
State	NY
ZIP	14626
Taxonomy	Family Medicine Physician
NPI Enumerated	November 10, 2006

Payer Source	Total Paid
Medicaid	$25.2M
Medicare	$0

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

160 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	139,190	$60	$8.4M
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…	95,470	$90	$8.3M
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.	8,930	$70	$616.2K
90460	In this procedure, the provider administers a single live attenuated vaccine through a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age.	14,440	$40	$519.7K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	9,450	$50	$510.4K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	5,180	$90	$455.5K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	4,370	$100	$423.6K
71046	In this diagnostic procedure, the provider performs a minimum of two radiological views of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and…	46,830	$10	$421.5K
77067	The provider takes two X–ray views of each breast for routine screening and may use specially designed computer software to help identify any potential abnormalities within the images; the software…	13,170	$30	$408.2K
93306	The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent…	7,320	$50	$395.3K

Showing 1–10 of 160

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

Rochester General Hospital — 12 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

160 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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.	326	1,420	90	$130	$715.2K
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.	292	2,210	80	$130	$473K
66984	The provider inserts an artificial lens after removing an extracapsular cataract by aspiration or use of ultrasonic waves. This procedure is done without the use of an endoscopic laser probe to…	136	160	140	$720	$423.8K
93458	In this procedure, the provider performs imaging supervision and interpretation for a coronary angiography with left heart catheterization and intraprocedural injections for left ventriculography. He…	55	80	90	$1,300	$403.9K
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.	470	610	310	$380	$397.9K
90935	Hemodialysis is a procedure that involves drawing blood via an intra–arterial or intravenous catheter, then sieving it through a semi permeable membrane to remove the impurities and finally…	193	280	210	$150	$381K
95165	In this procedure, the provider mixes and prepares the antigens for allergen immunotherapy. Use this code when the provider prepares one or more antigens.	192	200	470	$150	$336.9K
77067	The provider takes two X–ray views of each breast for routine screening and may use specially designed computer software to help identify any potential abnormalities within the images; the software…	24	490	840	$90	$323.6K
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…	76	19,110	360	$70	$321K
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.	30	810	220	$150	$230.6K

Showing 1–10 of 160

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Rochester General Hospital	NY	General Acute Care Hospital	$0	$226.8M
Rochester General Hospital-lab	NY	Clinical Medical Laboratory	$0	$33.4M
Rochester General Hospital	NY	General Acute Care Hospital	$0	$21.7M
Vijay Aluri	IA	Rheumatology Physician	$2M	$0
Anthony Andrews	PA	Ophthalmology Physician	$1.3M	$100
Matthew Witmer	NY	Retina Specialist (Ophthalmology) Physician	$889.6K	$46K
Edward Hall	NY	Retina Specialist (Ophthalmology) Physician	$736.3K	$8.8K
Brian Connolly	NY	Retina Specialist (Ophthalmology) Physician	$695.8K	$3.2K
Michael Fazio	IL	Diagnostic Radiology Physician	$294.3K	$184.3K
Wesley Pruett	MN	Diagnostic Radiology Physician	$441.3K	$770

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
The Unity Hospital Of Rochester	NY	General Acute Care Hospital	$0	$55.3M
Ginel Gordon	NY	Nurse Practitioner	$342.3K	$58.5K
Kristi Cowell-kusak	NY	Internal Medicine Physician	$111.1K	$0
Danielle Beatty	NY	Physical Therapist	$97.9K	$0
Keith Schroeder	NY	Diagnostic Radiology Physician	$83.7K	$0
Yu Zhao	NY	Internal Medicine Physician	$78.8K	$0
Daniel Grace	NY	Maternal & Fetal Medicine Physician	$3.7K	$65.4K
Ronald D Angelo	NY	Audiologist	$53.6K	$0
Amol Shrikhande	NY	Nephrology Physician	$37.4K	$610
Elizabeth Westen	NY	Maternal & Fetal Medicine Physician	$4.3K	$31.6K

Rochester General Hospital — Billing Profile & Reimbursement Data

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Rochester General Hospital — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

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