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

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

Nantucket Cottage Hospital (NPI 1447214622)

Nantucket Cottage Hospital is a rural acute care hospital provider located in Nantucket, Massachusetts. This profile covers 0 Medicare and 175 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	Nantucket Cottage Hospital
Address	57 Prospect St
City	Nantucket
State	MA
ZIP	02554
Taxonomy	Rural Acute Care Hospital
NPI Enumerated	April 14, 2006

Payer Source	Total Paid
Medicaid	$7.1M
Medicare	$0

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

175 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.	10,910	$140	$1.5M
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.	7,620	$110	$846K
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.	1,380	$510	$699.8K
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.	2,500	$210	$511.7K
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	8,910	$50	$463.1K
92507	The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with…	2,960	$120	$361K
87637	The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, influenza B, and respiratory syncytial virus (RSV)…	3,140	$110	$354.4K
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…	4,570	$70	$329K
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.	820	$260	$213.5K
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…	4,340	$30	$147.4K

Showing 1–10 of 175

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Massachusetts Distribution

Nantucket Cottage Hospital — 0 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Massachusetts

Full comparison — all codes billed, vs. Massachusetts median

175 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.	59	90	7,560	$350	$4.2M
G0378	Hospital observation service, per hour	66	70	7,250	$100	$1.3M
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.	63	80	4,380	$140	$1.1M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	98	110	5,660	$30	$1.1M
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.	95	520	120	$130	$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…	48	130	1,830	$60	$974.3K
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.	77	550	110	$120	$865.5K
99211	An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.	97	410	140	$110	$742.2K
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.	79	830	130	$120	$671K
80307	The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date.	177	370	500	$40	$605.1K

Showing 1–10 of 175

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Lawrence Proano	RI	Emergency Medicine Physician	$48.4K	$2.3M
Daniel Gorin	MA	Surgery Physician	$1.1M	$0
Evangelos Geraniotis	MA	Urology Physician	$758.4K	$0
John Kalin	MA	Cardiovascular Disease Physician	$617.9K	$0
Michael Mecley	MA	Cardiovascular Disease Physician	$479.3K	$0
James Chrzan	MA	Foot & Ankle Surgery Podiatrist	$340.2K	$0
Dean Lurie	MD	Surgery Physician	$325.4K	$0
Marc Silver	NC	Clinical Cardiac Electrophysiology Physician	$266K	$0
Andrew Kramer	MA	Urology Physician	$238.5K	$0
Alfred Hanmer	MA	Orthopaedic Surgery Physician	$220.8K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Joseph Manning	MA	Physical Therapist	$180K	$0
Michael Ruby	MA	Optometrist	$89.7K	$0
Christopher Burns	MA	Surgery Physician	$49.3K	$0
Jill Samale	MA	Obstetrics & Gynecology Physician	$920	$1.1K

Nantucket Cottage 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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