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

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

Seattle Children's Hospital (NPI 1467536276)

Field	Value
Entity Type	Organization
Organization	Seattle Children's Hospital
Address	4800 Sand Point Way Ne
City	Seattle
State	WA
ZIP	98105
Taxonomy	Children's Hospital
NPI Enumerated	October 25, 2006

Payer Source	Total Paid
Medicaid	$219.4M
Medicare	$0

Key Findings

SEATTLE CHILDREN'S HOSPITAL reports no Medicare billing on file and $219.4M in lifetime Medicaid revenue, making its public payer footprint effectively single‑payer (Medicaid) in the available data. The absence of Medicare revenue means comparisons should focus on Medicaid-state peer dynamics rather than national Medicare benchmarks.

Revenue is highly concentrated in a small set of outpatient and ED evaluation & management codes: the top three Medicaid codes (99214, 99212, 99283) account for 47.2% of the provider's Medicaid revenue. In dollar terms those top contributors are 99214 ($49.9M, 32.3%), 99212 ($13.2M, 8.5%), and 99283 ($9.9M, 6.4%), so nearly half of Medicaid dollars flow from high-volume E/M and emergency visit activity.

The code mix points to a large ambulatory and emergency care operation: very high volumes for established and new patient office visits (99214: 383.9K claims; 99212: 82.2K claims; 99204: 62.2K claims; 99202: 20K claims) alongside substantial ED visit codes (99283, 99284, 99282). This pattern is consistent with a pediatric system that delivers both routine outpatient management and high-throughput urgent care/ED services, and it likely supports strong outpatient clinic capacity and ED throughput.

Specialty infusion and complex therapeutics are material revenue drivers: J1745 (infliximab) contributes $5.8M (3.7%) and ranks #1 of 21 providers in-state (100th percentile), while J1569 (immune globulin) contributes $4.4M (2.9%) and also ranks #1 of 4 providers (100th percentile). The presence of 96415 (additional chemotherapy infusion hours, $2M, 1.3%) further signals inpatient/infusion center capabilities for chronic biologic and oncology treatments.

Advanced diagnostics and procedural specialties are prominent across cardiology, imaging, sleep, and neurophysiology: 93306 echocardiography ($4.9M, 3.2%), 70551 brain MRI ($3.2M, 2.1%), polysomnography 95810 ($3.5M, 2.3%), and EEG 95812 ($2.2M, 1.4%) all appear in the top code list, with several codes ranking at or near the 100th percentile in-state. These volumes indicate robust pediatric cardiology, radiology, sleep medicine, and neurology programs that serve a large referral population.

Surgical and procedural pediatric throughput is evident in ENT and operating room services: 42820 (tonsil/adenoid removal) yields $4.9M (3.2%) and ranks #2 of 34 providers (97th percentile), while 69436 (tympanostomy with tube) yields $3.3M (2.1%) and ranks #1 of 32 providers (100th percentile). Combined with dental extractions (D7140) and endoscopy (43239), the mix reflects substantial perioperative and ambulatory surgical volume for children.

Competitive standing within Washington State is dominant for many pediatric services: multiple top codes rank #1 in-state or sit at the 100th percentile (examples include 99212, 99204, 99202, J1745, J1569, 95810, 95812), and several additional codes are in the top decile or better. Where codes are described as “extreme outlier” or “notably above typical state volume,” the provider functions as a regional referral center and volume leader for those services rather than a modest participant.

The provider has long tenure in the NPI registry (enumerated 2006-10-25, ~20 years ago), and large claim counts across numerous codes (for example 383.9K claims for 99214, 49.7K claims for 97530, 18.5K claims for G0378) point to a mature, high-volume pediatric delivery system. Operationally, high observation-service (G0378) and ED E/M volumes imply sizeable observation and throughput capacity, which aligns with its role as a statewide pediatric hub.

Medicaid: Complete Services Breakdown

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

758 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99214	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…	383,900	$130	$49.9M
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	82,210	$160	$13.2M
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.	60,510	$160	$9.9M
99204	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the provider…	62,200	$130	$8.1M
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.	44,840	$160	$7M
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.	38,010	$160	$6M
J1745	Injection, infliximab, excludes biosimilar, 10 mg	2,770	$2,090	$5.8M
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…	11,510	$430	$4.9M
42820	The provider removes the tonsils and adenoids in a patient younger than 12 years old.	2,890	$1,700	$4.9M
J1569	Injection, immune globulin, (gammagard liquid), non-lyophilized, (e.g., liquid), 500 mg	2,150	$2,050	$4.4M

Showing 1–10 of 758

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Washington Distribution

Seattle Children's Hospital — 17 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Washington

Full comparison — all codes billed, vs. Washington median

758 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	54	100	2,830	$80	$3.8M
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.	54	110	5,950	$270	$2.6M
J1569	Injection, immune globulin, (gammagard liquid), non-lyophilized, (e.g., liquid), 500 mg	1	10	1,290	$1,830	$2.4M
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.	43	230	5,440	$90	$1.8M
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.	14	230	6,220	$100	$1.8M
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.	90	190	5,130	$100	$1.8M
H2020	Therapeutic behavioral services, per diem	6	10	930	$480	$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.	82	140	2,830	$150	$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…	29	100	1,940	$70	$1M
J1745	Injection, infliximab, excludes biosimilar, 10 mg	1	20	190	$1,670	$956.2K

Showing 1–10 of 758

Related Providers

Other providers that share a Tax Identification Number (TIN) with Seattle Children's Hospital, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Seattle Children's Hospital	WA	Home Infusion Agency	$0	$32.2M
The Association Of Chrmc And University Physicians	WA	Pediatrics Physician	$0	$25M
Seattle Children's Hospital	WA	Specialist	$0	$19.9M
Seattle Children's Hospital	WA	Dental Clinic/Center	$0	$2.8M
Frank Virant	WA	Allergy & Immunology Physician	$170.6K	$0
Nicholas Weiss	WA	Psychiatry Physician	$166.1K	$0
Jeremy Neuman	NY	Diagnostic Radiology Physician	$116.6K	$10K
Manjiri Dighe	WA	Diagnostic Radiology Physician	$95.8K	$0
Ryan Bahr	WA	Surgical Physician Assistant	$59.9K	$0
Eric Krieger	WA	Cardiovascular Disease Physician	$45.5K	$0

Nearby Providers

Other providers in the same ZIP code as Seattle Children's Hospital, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Kean Lawlor	WA	Dermatology Physician	$668.3K	$0
Jeremy Kampp	WA	MOHS-Micrographic Surgery Physician	$339.2K	$0
Matthew Saltzman	WA	Orthopaedic Surgery Physician	$234.7K	$39.2K
Cheryl Gustafson	WA	MOHS-Micrographic Surgery Physician	$222.8K	$0
Sand Point Pharmacy & Health	WA	Community/Retail Pharmacy	$220.2K	$0
Colin Sisco	WA	Physical Therapist	$186.8K	$0
John Falardeau	WA	Diagnostic Radiology Physician	$158.5K	$0
Fred Meyer Stores Inc	WA	Community/Retail Pharmacy	$77.8K	$74.2K
Brianne Noel	WA	Physician Assistant	$73K	$0
Timothy Carey	WA	Ophthalmology Physician	$58.9K	$0

Seattle Children's Hospital — 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