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

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

Northeast Georgia Medical Center, Inc. (NPI 1427055821)

Field	Value
Entity Type	Organization
Organization	Northeast Georgia Medical Center, Inc.
Address	743 Spring St Ne
City	Gainesville
State	GA
ZIP	30501
Taxonomy	General Acute Care Hospital
NPI Enumerated	June 30, 2005

Payer Source	Total Paid
Medicaid	$112.9M
Medicare	$0

Key Findings

NORTHEAST GEORGIA MEDICAL CENTER, INC. reports $112.9M in lifetime Medicaid revenue and has no Medicare billing on file, making it effectively a single-payer (Medicaid) billing profile in the available dataset. The provider’s NPI was enumerated 2005-06-30 (~21 years ago), indicating long-standing participation in public programs but with Medicaid as the dominant recorded payer.

Revenue is highly concentrated in emergency department evaluation and management codes: the top three Medicaid codes (99284, 99283, 99285) together account for 46.2% of total Medicaid revenue. Individually those codes generate $14.5M (99284, 18.7%), $12.4M (99283, 15.9%), and $9M (99285, 11.6%), signaling that ED care is the primary revenue driver for this provider.

The facility shows unusually large ED volumes relative to in‑state peers: 99282 ranks #1 of 50 providers in-state (100th percentile; extreme outlier) and 99283 and 99284 rank in the 98th and 97th percentiles respectively, with 99284 called an "extreme outlier" and 99283 a "notably above typical" volume. These rankings and percentiles indicate the center is a major regional ED destination with far higher Medicaid ED throughput than most Georgia hospitals.

Beyond E/M visits, ancillary acute care services are heavily used: observation (G0378, $2.9M, rank #2 of 21, 95th percentile), high-volume IV infusion/administration codes (96361, 96365, 96375, 96374 collectively representing multiple top-25 entries), and frequent imaging for acute presentations. The combination of high observation hours and repeated IV administration codes aligns with a high-acuity ED and inpatient observation workflow rather than a primarily outpatient or elective case mix.

Imaging and diagnostics contribute materially to Medicaid revenue and reinforce the acute-care profile: CT abdomen/pelvis with contrast 74177 ($4.8M, rank #2 of 70, 99th percentile), CT without contrast 74176 ($1.6M, rank #3 of 48, 96th percentile), chest CTA 71275 ($925.8K, rank #1 of 32, 100th percentile), and PET/CT 78815 ($1.3M, rank #1 of 11, 100th percentile) show substantial diagnostic throughput. Proprietary and high-throughput lab testing also appears, with 0202U ($2.8M, rank #2 of 8) and U0003 ($1.6M, rank #4 of 39), indicating in‑house or closely affiliated advanced testing capacity for infectious and respiratory panels.

Cardiac diagnostic services are an important revenue stream: echocardiography 93306 ($2.1M, rank #3 of 59, 97th percentile), ECG technical 93005 ($1.2M, rank #1 of 31, 100th percentile), and myocardial SPECT studies 78452 ($1.2M, rank #2 of 19, 94th percentile) all appear in the top-25 Medicaid codes. These placements suggest sustained cardiac diagnostic volume supporting emergency and inpatient cardiology workflows.

Several top codes are flagged as extreme outliers at the state level (e.g., 99282, 96361, 96375, 96374, 96365, 0241U, 71275, 93005, 59025), with multiple #1 rankings among peers; this pattern indicates the provider is a dominant Medicaid-volume center for a range of ED, infusion, imaging, and perinatal services in Georgia. Such concentration of top-percentile ranks supports the characterization of the hospital as a major regional hub for acute, high-throughput Medicaid care.

Given the concentration of revenue in a small set of ED E/M codes (top three = 46.2% of Medicaid revenue) and numerous top-percentile procedural and diagnostic codes, the provider’s financial performance on Medicaid is heavily tied to emergency and acute diagnostic services. Analysts should treat this profile as a Medicaid-dependent, ED-centric operation with extensive on-site diagnostic and infusion capacity rather than a balanced Medicare/Medicaid mix.

Medicaid: Complete Services Breakdown

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

580 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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.	63,180	$230	$14.5M
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.	71,050	$170	$12.4M
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.	31,240	$290	$9M
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.	38,330	$140	$5.2M
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.	15,030	$320	$4.8M
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.	50,030	$60	$3.1M
G0378	Hospital observation service, per hour	22,050	$130	$2.9M
0202U	This is a Proprietary Laboratory Analyses (PLA) code, meaning that the code applies to only one unique lab test made by a specific manufacturer or performed by a specific lab. Report 0202U for the…	8,610	$330	$2.8M
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…	11,190	$190	$2.1M
0241U	N/A	20,830	$100	$2M

Showing 1–10 of 580

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Georgia Distribution

Northeast Georgia Medical Center, Inc. — 18 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Georgia

Full comparison — all codes billed, vs. Georgia median

580 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
44970	Laparoscopy, surgical, appendectomy	2	10	20	$4,080	$2.5M
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.	13	140	200	$280	$1.9M
95810	Polysomnography refers to the continuous and simultaneous monitoring and recording of various physiological and pathophysiological parameters of sleep for six or more hours with physician review,…	5	10	360	$1,510	$1.6M
0202U	This is a Proprietary Laboratory Analyses (PLA) code, meaning that the code applies to only one unique lab test made by a specific manufacturer or performed by a specific lab. Report 0202U for the…	2	10	1,280	$270	$1.1M
G0378	Hospital observation service, per hour	2	20	2,070	$160	$1.1M
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…	4	40	850	$70	$983K
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.	7	230	120	$170	$937.5K
80081	The lab analyst performs an obstetric panel; this panel must include tests for a complete blood count with differential, a hepatitis B surface antigen test, a single–result test for HIV–1 antigens…	2	10	90	$40	$923.5K
70553	In this procedure, the provider performs a magnetic resonance imaging, or MRI, study of the brain including the brain stem. He performs this procedure without using contrast material. He then follows…	3	20	310	$900	$893.2K
70551	The provider uses magnetic resonance imaging, or MRI, to examine the brain and brain stem. The provider does not administer contrast for this exam.	4	30	550	$540	$834.8K

Showing 1–10 of 580

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Columbus Radiology Corp	OH	Diagnostic Radiology Physician	$0	$49.9M
Gainesville Radiology Group, PC	GA	Diagnostic Radiology Physician	$0	$2M
Bernardine King	GA	Cardiovascular Disease Physician	$360.3K	$0
Alok Gambhir	GA	Clinical Cardiac Electrophysiology Physician	$285K	$0
Joon Ahn	GA	Clinical Cardiac Electrophysiology Physician	$265.9K	$0
David Kimball	GA	Diagnostic Radiology Physician	$261K	$0
Heather Westmoreland	GA	Cardiovascular Disease Physician	$260.1K	$0
Shalabh Chandra	GA	Clinical Cardiac Electrophysiology Physician	$257.1K	$0
Allison Dupont	GA	Interventional Cardiology Physician	$246.6K	$0
Stephen Prater	GA	Clinical Cardiac Electrophysiology Physician	$246.2K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Georgia Emergency Department Services, P.C.	GA	Emergency Medicine Physician	$0	$17.9M
S.y.a.h.	GA	Urgent Care Clinic/Center	$0	$6.5M
Pediatric Associates LLP	GA	Pediatrics Physician	$0	$5M
William Chafin	GA	Rheumatology Physician	$3.3M	$0
Marta Bognar	GA	Rheumatology Physician	$2.3M	$0
Brent Flickinger	GA	Rheumatology Physician	$2.3M	$0
Hall County Georgia	GA	Land Ambulance	$1.6M	$0
Northeast Georgia Physicians Group Urgent Care LLC	GA	Family Medicine Physician	$0	$1.6M
Timothy Carey	GA	Medical Oncology Physician	$1.5M	$0
Gainesville Surg Ctr LP	GA	Ambulatory Surgical Clinic/Center	$1.4M	$0

Northeast Georgia Medical Center, Inc. — Billing Profile & Reimbursement Data

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Northeast Georgia Medical Center, Inc. — 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