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

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

Spotsylvania Medical Center Inc (NPI 1376876664)

Field	Value
Entity Type	Organization
Organization	Spotsylvania Medical Center Inc
Address	4600 Spotsylvania Parkway
City	Fredericksburg
State	VA
ZIP	22408
Taxonomy	General Acute Care Hospital
NPI Enumerated	September 17, 2009

Payer Source	Total Paid
Medicaid	$31M
Medicare	$0

Medicaid: Complete Services Breakdown

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

227 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	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.	49,260	$190	$9.3M
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.	36,820	$180	$6.4M
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.	10,620	$180	$2M
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.	6,850	$220	$1.5M
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.	6,370	$200	$1.3M
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.	6,720	$180	$1.2M
G0378	Hospital observation service, per hour	6,260	$130	$826.2K
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.	3,370	$210	$707.9K
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…	2,360	$280	$661.1K
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.	2,840	$230	$645.4K

Showing 1–10 of 227

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Virginia Distribution

Spotsylvania Medical Center Inc — 0 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Virginia

Full comparison — all codes billed, vs. Virginia median

227 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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.	72	90	9,030	$280	$3.2M
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.	99	340	160	$130	$1.3M
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.	34	630	90	$140	$1.1M
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.	30	140	3,240	$160	$1M
G0378	Hospital observation service, per hour	27	80	3,650	$160	$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.	44	620	70	$120	$1M
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.	49	180	2,950	$140	$783.2K
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.	54	170	3,390	$100	$658.8K
96365	The provider administers the initial intravenous infusion of a medication or other substance for a period up to one hour to prevent, treat, or diagnose a condition or disease.	100	110	2,780	$110	$471.1K
96360	The provider introduces a catheter intravenously for supplementation of fluid and electrolytes for 31 minutes to one hour to treat severe cases of dehydration.	69	90	2,670	$130	$444.4K

Showing 1–10 of 227

Related Providers

Other providers that share a Tax Identification Number (TIN) with Spotsylvania Medical Center Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Chippenham & Johnston-willis Hospitals Inc	VA	General Acute Care Hospital	$0	$103.7M
Hca Health Services Of Virginia Inc	VA	General Acute Care Hospital	$0	$64.5M
Columbia/hca John Randolph, Inc.	VA	General Acute Care Hospital	$0	$49.1M
El Paso Healthcare System Ltd	TX	General Acute Care Hospital	$0	$38.5M
Mission Health Community Multispecialty Providers, LLC	NC	Internal Medicine Physician	$0	$24.1M
Columbia Medical Center Of Arlington Subsidiary LP	TX	General Acute Care Hospital	$0	$21.8M
Columbia Hospital At Medical City Dallas Subsidiary LP	TX	General Acute Care Hospital	$0	$21.5M
Lewis Gale Physicians LLC	VA	Internal Medicine Physician	$0	$20.6M
Reston Hospital Center LLC	VA	General Acute Care Hospital	$0	$14.9M
Hca Health Services Of Florida, Inc.	FL	General Acute Care Hospital	$0	$11.4M

Nearby Providers

Other providers in the same ZIP code as Spotsylvania Medical Center Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Compass Counseling Services Of Northern Virginia	VA	Community/Behavioral Health Agency	$0	$54.4M
Pinnacle Treatment Centers Va-i, LLC	VA	Methadone Clinic	$152.9K	$15.6M
Assured Corporation	VA	Home Health Agency	$0	$12.8M
Lakshminarayanan Nandagopal	VA	Hematology & Oncology Physician	$2.9M	$0
Charles Maurer	VA	Hematology & Oncology Physician	$2.8M	$0
Bonny Moore	VA	Hematology & Oncology Physician	$2.7M	$0
Matthew Whitehurst	VA	Medical Oncology Physician	$2.1M	$0
Sudeep Menachery	VA	Hematology & Oncology Physician	$1.9M	$0
Arijit Chanda	VA	Interventional Cardiology Physician	$571.6K	$0
Anh Vu	VA	Cardiovascular Disease Physician	$549.9K	$90

Spotsylvania Medical Center Inc — Billing Profile & Reimbursement Data

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Spotsylvania Medical Center Inc — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References