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

Why is the Medicaid comparison limited to New York 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. New York (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.

Rochester General Hospital-lab (NPI 1477746063)

Rochester General Hospital-lab is a clinical medical laboratory provider located in Rochester, New York. This profile covers 0 Medicare and 268 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	Rochester General Hospital-lab
Address	1425 Portland Ave
City	Rochester
State	NY
ZIP	14621
Taxonomy	Clinical Medical Laboratory
NPI Enumerated	August 27, 2007

Payer Source	Total Paid
Medicaid	$33.4M
Medicare	$0

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

268 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
U0004	2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc, making use of high throughput technologies as described by…	66,410	$70	$4.9M
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.	48,290	$50	$2.4M
87591	The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique.	62,460	$30	$1.9M
87491	The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique.	62,430	$30	$1.9M
U0005	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, cdc or non-cdc,…	62,710	$30	$1.6M
88305	The physician, typically a pathologist, performs a level IV examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally…	11,170	$140	$1.5M
87502	The lab analyst performs a test to determine the presence of multiple types or subtypes of influenza virus through nucleic acid detection using multiplex amplified probe technique and possibly…	17,650	$80	$1.3M
84443	The lab analyst performs a test to measure the amount of thyroid–stimulating hormone (TSH), a hormone produced in the pituitary gland that helps regulate thyroid function. The typical specimen is the…	72,070	$20	$1.1M
87480	The lab analyst performs a test for Candida species using direct nucleic acid probe technique.	45,390	$20	$816.9K
87510	The lab analyst performs a test for Gardnerella vaginalis using direct nucleic acid probe technique. Gardnerella vaginalis typically causes bacterial vaginosis, an infection of the vagina that…	44,610	$20	$802.9K

Showing 1–10 of 268

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. New York Distribution

Rochester General Hospital-lab — 19 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — New York

Full comparison — all codes billed, vs. New York median

268 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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…	230	340	1,090	$70	$1.4M
U0004	2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc, making use of high throughput technologies as described by…	8	100	1,490	$70	$1.3M
G0481	Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but…	33	40	440	$90	$511.9K
U0005	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, cdc or non-cdc,…	18	300	1,710	$20	$458.6K
G0480	Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but…	31	110	690	$50	$442K
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.	15	290	1,900	$30	$390.6K
81420	The lab analyst performs a genomic sequence analysis panel to evaluate circulating cell free fetal DNA in maternal blood for genetic sequences of at least the genes on chromosomes 13, 18, and 21,…	22	30	260	$480	$329.6K
86481	The lab analyst performs a test to evaluate an antigen response to certain tuberculosis (TB) antibodies by enumerating T cells that produce gamma interferon.	7	30	1,350	$40	$300.8K
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.	22	590	1,160	$20	$277.2K
88305	The physician, typically a pathologist, performs a level IV examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally…	57	640	1,080	$60	$251.5K

Showing 1–10 of 268

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Rochester General Hospital	NY	General Acute Care Hospital	$0	$226.8M
Rochester General Hospital	NY	Family Medicine Physician	$0	$25.2M
Rochester General Hospital	NY	General Acute Care Hospital	$0	$21.7M
Vijay Aluri	IA	Rheumatology Physician	$2M	$0
Anthony Andrews	PA	Ophthalmology Physician	$1.3M	$100
Matthew Witmer	NY	Retina Specialist (Ophthalmology) Physician	$889.6K	$46K
Edward Hall	NY	Retina Specialist (Ophthalmology) Physician	$736.3K	$8.8K
Brian Connolly	NY	Retina Specialist (Ophthalmology) Physician	$695.8K	$3.2K
Michael Fazio	IL	Diagnostic Radiology Physician	$294.3K	$184.3K
Wesley Pruett	MN	Diagnostic Radiology Physician	$441.3K	$770

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mary M. Gooley Hemophilia Center Inc	NY	Clinic/Center	$0	$22.9M
Tahira Ahmed	NY	Diagnostic Radiology Physician	$708.7K	$0
Anees Ahmad	NY	Internal Medicine Physician	$231K	$45.3K
Kevin Geary	NY	Vascular Surgery Physician	$213K	$49.6K
Amanda Baldauf	NY	Medical Physician Assistant	$209.6K	$0
Angel Boev	NY	Neurological Surgery Physician	$70.2K	$4K
Daniel Demilio	NY	Physician Assistant	$52K	$0
Bipul Baibhav	NY	Cardiovascular Disease Physician	$33.5K	$2.7K
Vasyl Kasiyan	NY	Geriatric Medicine (Internal Medicine) Physician	$29.7K	$0
Ryan Lydon	NY	Vascular Surgery Physician	$28K	$0

Rochester General Hospital-lab — Billing Profile & Reimbursement Data

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Rochester General Hospital-lab — 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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