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

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

Vhs Harper-hutzel Hospital Inc (NPI 1427360700)

Key Findings

Field	Value
Entity Type	Organization
Organization	Vhs Harper-hutzel Hospital Inc
Address	3990 John R St
City	Detroit
State	MI
ZIP	48201
Taxonomy	General Acute Care Hospital
NPI Enumerated	July 2, 2010

Payer Source	Total Paid
Medicaid	$76.6M
Medicare	$0

This facility is effectively a Medicaid-centric provider: there is no Medicare billing on file and the reported lifetime Medicaid revenue is $76.6M. The absence of Medicare activity means analyses of payer mix should treat the hospital as operating primarily within the Medicaid population rather than a balanced Medicare/Medicaid case mix.

Revenue concentration is high in a small set of outpatient and emergency-service codes: the top three Medicaid codes — 99284 ($8.9M, 14.9%), G0463 ($7.7M, 13.0%), and 99285 ($6.8M, 11.3%) — together account for 39.2% of total Medicaid revenue. This concentration indicates a reliance on emergency-department and hospital outpatient assessment visits for a large share of billing.

The code mix points to an operational emphasis on emergency and observation care plus high outpatient clinic throughput. Large claim volumes for 99284 (44.2K claims) and G0463 (126.5K claims), combined with G0378 observation hours ($3.6M, 6.0%), suggest the hospital runs a high-volume ED with substantial same-site outpatient assessment and observation capacity.

Beyond emergency services, the provider maintains significant procedural and specialty activity consistent with inpatient surgical and interventional services. Notable Medicaid revenues include orthopedics/joint replacements such as 27447 ($3.4M, 5.6%) and 27130 ($1.4M, 2.4%), advanced imaging and cath lab interpretation like 93458 ($1.2M, 2.1%), and endoscopy/colonoscopy items (43239, 45385) that together show a mix of acute surgical throughput and GI procedural volume.

Several individual codes signal differentiated or above-typical specialty capacity within the state. The provider ranks #1 of 4 for 36512 (100th percentile; typical, unremarkable volume for this code) and #2 of 32 for 36556 (97th percentile; notably above typical state volume), and it ranks highly for GI and obstetric imaging codes (45385 at the 98th percentile; 76811 at the 97th percentile). These placements indicate the hospital is among a relatively small set of in-state providers delivering a sizeable share of apheresis, central line procedures, GI therapeutic work, and obstetric imaging.

There are extreme and notable outliers in obstetric and perinatal surveillance: 59025 appears as an extreme outlier (rank #6 of 242, 98th percentile; described as far above typical state volume) with 17.4K claims producing $1.4M (2.3% of Medicaid revenue). High volumes for fetal monitoring and repeat obstetric ultrasound (76816 and 76811, both at the 97th percentile) reinforce that maternity/perinatal services are a material service-line relative to peers.

Although emergency codes are high-volume, the provider’s percentile ranks show it is an upper-decile competitor statewide rather than a single dominant system across all top codes. For example, 99284 sits at the 92nd percentile (rank #41 of 477) and 99285 at the 84th percentile (rank #66 of 404), while G0463 is at the 90th percentile (rank #16 of 153); these positions indicate consistently strong but not top-of-market share across ED and outpatient assessment services.

The hospital has an established operational tenure: its NPI was enumerated on 2010-07-02 (~16 years ago). Combined with the concentrated Medicaid revenue base and the specialty procedure footprint, this suggests a long-standing, Medicaid-focused acute-care hospital with significant emergency, observational, surgical, and certain specialty service lines within the state.

Medicaid: Complete Services Breakdown

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

448 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.	44,150	$200	$8.9M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	126,520	$60	$7.7M
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.	20,980	$320	$6.8M
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.	54,400	$120	$6.5M
G0378	Hospital observation service, per hour	8,410	$430	$3.6M
27447	In this procedure, the provider replaces the damaged weight bearing surfaces of both the medial and lateral compartments in the knee joint using implants of metal or other strong materials. The…	520	$6,410	$3.4M
36512	Apheresis (also known as pheresis or therapeutic pheresis) is a medical procedure utilizing specialized equipment to remove selected blood constituents (plasma, leukocytes, platelets, or cells) from…	4,330	$460	$2M
36556	The provider inserts a central venous access catheter in the neck, chest, or groin to draw blood or administer medication or nutrients to a patient 5 years of age or older.	1,950	$1,000	$2M
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.	5,250	$370	$1.9M
45385	The provider examines the colon and rectum using a colonoscope, a long, thin flexible tubular instrument with a light source and camera. He removes one or more tumors, polyps, or other lesions with a…	3,940	$480	$1.9M

Showing 1–10 of 448

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Michigan Distribution

Vhs Harper-hutzel Hospital Inc — 9 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Michigan

Full comparison — all codes billed, vs. Michigan median

448 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
G0463	Hospital outpatient clinic visit for assessment and management of a patient	16	150	5,330	$50	$2.8M
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.	66	400	1,510	$190	$2.6M
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.	41	480	1,350	$110	$1.7M
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.	28	450	1,540	$90	$1.3M
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	30	150	7,610	$90	$1.2M
G0378	Hospital observation service, per hour	25	100	2,820	$180	$1.1M
81220	The lab analyst performs the technical lab test to detect the presence of changes in the gene for cystic fibrosis transmembrane conductance regulator, also known as CFTR. The test evaluates the CFTR…	4	10	190	$180	$910.5K
27447	In this procedure, the provider replaces the damaged weight bearing surfaces of both the medial and lateral compartments in the knee joint using implants of metal or other strong materials. The…	2	10	30	$1,930	$660.8K
36512	Apheresis (also known as pheresis or therapeutic pheresis) is a medical procedure utilizing specialized equipment to remove selected blood constituents (plasma, leukocytes, platelets, or cells) from…	1	10	1,680	$300	$611.1K
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…	40	160	2,720	$60	$546.6K

Showing 1–10 of 448

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Vhs Childrens Hospital Of Michigan Inc	MI	Children's Hospital	$0	$180.4M
University Pediatricians	MI	Pediatrics Physician	$0	$106.9M
University Physician Group	MI	Internal Medicine Physician	$0	$87.4M
The Children's Center Of Wayne Co., Inc.	MI	Community/Behavioral Health Agency	$0	$74.3M
Vhs Detroit Receiving Hospital Inc	MI	General Acute Care Hospital	$0	$60.6M
Medical Center Emergency Services	MI	Emergency Medical Services (Emergency Medicine) Physician	$0	$44.1M
Barbara Ann Karmanos Cancer Hospital	MI	General Acute Care Hospital	$0	$42.5M
Detroit Central City Community Mental Health Inc.	MI	Federally Qualified Health Center (FQHC)	$0	$29.2M
Vhs University Laboratories Inc	MI	Clinical Medical Laboratory	$677.7K	$26.3M
Vhs Rehabilitation Institute Of Michigan Inc	MI	Rehabilitation Hospital	$0	$24.1M

Vhs Harper-hutzel Hospital Inc — Billing Profile & Reimbursement Data

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Vhs Harper-hutzel Hospital 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

Nearby Providers

Frequently Asked Questions

References