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

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

Kentucky Medical Services Foundation (NPI 1376852061)

Kentucky Medical Services Foundation is a clinical pathology/laboratory medicine physician provider located in Lexington, Kentucky. This profile covers 0 Medicare and 31 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	Kentucky Medical Services Foundation
Address	800 Rose St
City	Lexington
State	KY
ZIP	40536
Taxonomy	Clinical Pathology/Laboratory Medicine Physician
NPI Enumerated	September 29, 2010

Payer Source	Total Paid
Medicaid	$3M
Medicare	$0

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

31 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
88305	The physician, typically a pathologist, performs a level IV examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally…	32,870	$50	$1.7M
88307	The physician, typically a pathologist, performs a level V examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally…	5,820	$70	$407.5K
88112	Selective cellular enhancement for cytopathology, such as the method of using a liquid–based slide preparation, uses a liquid–based medium to collect samples and preserve cells which can aid in…	5,330	$40	$213.2K
88108	The analyst prepares smears of cytopathology fluids, washings, or brushings, except for cervical or vaginal fluid, using a concentration technique and interprets his findings. Cytopathology is the…	7,360	$20	$139.8K
88189	The clinician, typically a pathologist, interprets flow cytometry results of 16 or more markers.	1,400	$70	$96.5K
86077	The lab analyst performs a cross match of a specimen that requires interpretation and a written report from the blood bank physician due to a difficult cross match, evaluation of irregular…	2,660	$30	$77.1K
88342	The lab analyst applies an initial single antibody stain on a slide or slides prepared from a single patient specimen, such as tumor tissue. Then a qualified provider, typically a pathologist,…	2,680	$30	$72.4K
88304	The physician, typically a pathologist, performs a level III examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally…	6,340	$10	$50.7K
85060	The physician, typically a clinical pathologist, performs a peripheral blood smear review and provides an interpretation and written report of the examination.	3,840	$10	$46K
88141	The physician analyzes and interprets a cervical or vaginal cytopathology specimen, using any reporting system, such as Bethesda or non–Bethesda. This code is for the professional interpretation by…	2,080	$20	$35.3K

Showing 1–10 of 31

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Kentucky Distribution

Kentucky Medical Services Foundation — 10 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Kentucky

Full comparison — all codes billed, vs. Kentucky median

31 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
88305	The physician, typically a pathologist, performs a level IV examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally…	4	130	2,450	$60	$382.4K
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	264	290	520	$30	$156.6K
88307	The physician, typically a pathologist, performs a level V examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally…	4	70	540	$70	$131.1K
88341	The lab analyst applies an additional single antibody stain on a slide or slides prepared from the same patient specimen as the initial antibody stain, such as tumor tissue. Then a qualified…	14	30	260	$100	$91.4K
88342	The lab analyst applies an initial single antibody stain on a slide or slides prepared from a single patient specimen, such as tumor tissue. Then a qualified provider, typically a pathologist,…	15	60	1,020	$40	$83.8K
88304	The physician, typically a pathologist, performs a level III examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally…	5	90	950	$30	$54.3K
88141	The physician analyzes and interprets a cervical or vaginal cytopathology specimen, using any reporting system, such as Bethesda or non–Bethesda. This code is for the professional interpretation by…	4	20	410	$20	$46.8K
88112	Selective cellular enhancement for cytopathology, such as the method of using a liquid–based slide preparation, uses a liquid–based medium to collect samples and preserve cells which can aid in…	2	20	310	$40	$43.7K
88189	The clinician, typically a pathologist, interprets flow cytometry results of 16 or more markers.	1	10	350	$60	$35.8K
86077	The lab analyst performs a cross match of a specimen that requires interpretation and a written report from the blood bank physician due to a difficult cross match, evaluation of irregular…	1	10	1,260	$30	$33.9K

Showing 1–10 of 31

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Kentucky Medical Services Foundation, Inc	KY	Internal Medicine Physician	$0	$110.4M
Columbus Radiology Corp	OH	Diagnostic Radiology Physician	$0	$49.9M
Kentucky Medical Services Foundation	KY	Nurse Practitioner	$0	$12.5M
Kyle Thompson	ID	Retina Specialist (Ophthalmology) Physician	$4.5M	$0
Matthew Cole	TN	Ophthalmology Physician	$3.3M	$0
North Fork Valley Community Health Board, Inc.	KY	Family Medicine Physician	$0	$3.2M
Gregory Lee	GA	Ophthalmology Physician	$2.9M	$6.3K
Shivani Reddy	IN	Ophthalmology Physician	$2.4M	$0
Mark Kleinman	TN	Retina Specialist (Ophthalmology) Physician	$1.9M	$0
Cheryl Lee	WA	Ophthalmology Physician	$1.5M	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
University Of Kentucky	KY	General Acute Care Hospital	$0	$716.8M
University Of Kentucky	KY	Dentist	$0	$4.3M
Romulo Albuquerque	KY	Retina Specialist (Ophthalmology) Physician	$3.8M	$0
Kentucky Medical Services Foundation	KY	Physician Assistant	$0	$3.4M
Kentucky Medical Services Foundation	KY	Pediatrics Physician	$0	$3.3M
Jameson Dupree	KY	Ophthalmology Physician	$1.5M	$0
Elena Samoilova	KY	Anatomic Pathology & Clinical Pathology Physician	$110.7K	$974.6K
Sun Yi	KY	Radiation Oncology Physician	$646.6K	$0
Frances Martin	KY	Urology Physician	$532.8K	$0
Andrew Savoie	KY	Physical Medicine & Rehabilitation Physician	$470.2K	$0

Kentucky Medical Services Foundation — Billing Profile & Reimbursement Data

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Kentucky Medical Services Foundation — 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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