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

Why is the Medicaid comparison limited to West 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. West 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.

City Hospital, Inc (NPI 1457389249)

Key Findings

Field	Value
Entity Type	Organization
Organization	City Hospital, Inc
Address	2500 Hospital Dr
City	Martinsburg
State	WV
ZIP	25401
Taxonomy	General Acute Care Hospital
NPI Enumerated	June 29, 2006

Payer Source	Total Paid
Medicaid	$41.1M
Medicare	$0

CITY HOSPITAL, INC reports no Medicare billing on file while recording $41.1M in lifetime Medicaid revenue, making it effectively a Medicaid-focused provider in this dataset. The absence of Medicare activity suggests its reported revenue and operating footprint in our data are driven entirely by Medicaid claims rather than a mixed Medicare/Medicaid payer mix.

Revenue is highly concentrated in emergency department evaluation-and-management codes: the precomputed top 3 Medicaid codes (99285, 99284, 99283) account for 56.8% of the provider’s total Medicaid revenue. Those three codes individually generate $6M (99285), $5.6M (99284), and $3.6M (99283), indicating that more than half of Medicaid dollars flow from ED visits.

The code mix points to an ED-centric acute care operation with broad ancillary services. High-revenue ED codes are complemented by large volumes of laboratory testing (80053, 85025, 80307), diagnostic imaging (74177, 74176), physical therapy (97110), and infusion/injection services (96413, 96365, 96374, 96375), consistent with a general acute care hospital providing emergency, diagnostic, and procedural support.

Within the state Medicaid market the hospital is a major ED volume participant: 99284 ranks #8 of 168 providers (96th percentile) and 99283 ranks #6 of 163 providers (97th percentile), both described as notably above typical state volume. 99285 sits at #13 of 132 providers (91th percentile) and is characterized as typical/unremarkable volume, so the provider’s strongest competitive position is in moderate- and low–level ED visits rather than the very highest-acuity ED billing.

Several service lines are statistical outliers versus in-state peers. 97110 (therapeutic exercise) is ranked #3 of 207 providers (99th percentile) and flagged as an extreme outlier (far above typical state volume), and 96372 (injections) is ranked #7 of 309 providers (98th percentile) and also described as an extreme outlier, indicating unusually high volumes of physical therapy and injection procedures relative to peers.

Laboratory and testing activity is a materially visible revenue stream: 80053 (CMP) and 85025 (CBC) each produce about $1.1M in Medicaid revenue and rank in the mid-90s percentiles statewide, while COVID and respiratory testing codes such as U0004 ($553.7K, rank #2 of 22, 95th percentile) and 87637 ($468.7K) show elevated pandemic-era testing volumes. These patterns support a sizable on-site lab capacity and diagnostic throughput tied to ED and inpatient workflows.

The provider’s tenure—NPI enumerated 2006-06-29 (~20 years ago)—identifies it as an established acute care facility in Martinsburg, WV. Despite this longevity, the lack of Medicare billing in our files suggests either limited Medicare contracting/claims activity or that the reported dataset captures primarily its Medicaid-facing operations.

Operationally, heavy dependence on ED E/M revenue (the three ED codes comprising 56.8% of Medicaid revenue) creates concentration risk and makes the provider sensitive to changes in Medicaid emergency reimbursement or utilization patterns. At the same time, the combination of high ED volumes and strong ancillary throughput (labs, imaging, PT, infusions) represents an integrated service platform that could be leveraged to pursue diversification of payer mix or outpatient initiatives if contracting opportunities arise.

Medicaid: Complete Services Breakdown

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

454 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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.	16,610	$360	$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.	39,200	$140	$5.6M
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.	43,970	$80	$3.6M
80053	The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel.	81,820	$10	$1.1M
85025	A complete blood count (better known as a CBC) is a blood test request by a doctor that provides detailed information about various types of cells in a patient's blood. Usually a pathologist or a…	91,190	$10	$1.1M
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.	19,690	$50	$1.1M
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.	5,940	$160	$932.9K
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.	15,940	$50	$749.3K
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…	20,070	$40	$702.6K
96413	Chemotherapy is a therapeutic procedure used for the treatment of cancer via the use of chemical agents. These chemical agents (drugs) work on the cancerous cells of the body to destroy them. These…	4,790	$140	$665.5K

Showing 1–10 of 454

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. West Virginia Distribution

City Hospital, Inc — 9 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — West Virginia

Full comparison — all codes billed, vs. West Virginia median

454 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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	130	2,090	$210	$1.5M
87661	The lab analyst performs a test for Trichomonas vaginalis using nucleic acid amplified probe technique.	2	20	270	$20	$1.5M
41899	Use this code to report a procedure on the teeth and adjoining alveolar structures for which there is no specific code available.	12	10	580	$1,120	$1.3M
87491	The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique.	9	40	820	$30	$1.2M
87591	The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique.	9	40	820	$30	$1.2M
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.	8	170	3,350	$120	$1.1M
87798	The lab analyst performs a test for an infectious agent not specified in another code using an amplified nucleic acid probe technique. Use this code if you know the laboratory technique is amplified…	11	30	180	$40	$773.3K
87624	The lab analyst performs a test to determine the presence of human papillomavirus, or HPV. The provider uses nucleic acid detection for high–risk types and produces a pooled result.	6	20	720	$20	$721.7K
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.	6	160	3,690	$80	$714.8K
J1745	Injection, infliximab, excludes biosimilar, 10 mg	3	10	160	$1,800	$564.7K

Showing 1–10 of 454

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
City Hospital, Inc.	WV	Internal Medicine Physician	$0	$1.9M
Randall J. Hill, M.d., P.L.L.C.	WV	Specialist	$0	$1.9M
Jessica Matheny	WV	Obstetrics & Gynecology Physician	$3.1K	$492.9K
Cathy Funk	WV	Internal Medicine Physician	$175.6K	$0
Sonia Nasery	WV	Internal Medicine Physician	$174K	$0
Kolawale Oshiyoye	WV	Urgent Care Clinic/Center	$162.5K	$0
Manie Juneja	WV	Hospitalist Physician	$118.9K	$0
Michael Londner	VA	Emergency Medicine Physician	$89.2K	$0
Brian Richardson	WV	Emergency Medicine Physician	$80K	$0
Edward Ofori	UT	Obstetrics & Gynecology Physician	$17.7K	$60.9K

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Shenandoah Valley Medical System, Inc.	WV	Federally Qualified Health Center (FQHC)	$0	$61M
Eastern Panhandle Mental Health Center (waiver)	WV	Community/Behavioral Health Agency	$0	$28.8M
Stepping Stones Cottages, LLC	WV	Counseling Psychologist	$0	$26.6M
University Healthcare Physicians, Inc.	WV	Family Medicine Physician	$0	$17.5M
American Family Matters LLC	WV	Community/Behavioral Health Agency	$0	$16.9M
Berkeley County Emergency Ambulance Authority	WV	Land Ambulance	$864.6K	$5.6M
Eastern Panhandle Mental Health (rehab)	WV	Community/Behavioral Health Agency	$0	$5.7M
City Of Martinsburg	WV	Land Ambulance	$222.2K	$2.7M
Lance Pittman	WV	Orthodontics and Dentofacial Orthopedics Dentistry	$0	$2.3M
Wv Pediatric Dentistry PLLC	WV	Pediatric Dentistry	$0	$2M

City 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

Related Providers

Nearby Providers

Frequently Asked Questions

References