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.

Baystate Medical Center Inc (NPI 1487655064)

Field	Value
Entity Type	Organization
Organization	Baystate Medical Center Inc
Address	759 Chestnut St
City	Springfield
State	MA
ZIP	01199
Taxonomy	General Acute Care Hospital
NPI Enumerated	August 9, 2005

Payer Source	Total Paid
Medicaid	$374.8M
Medicare	$0

Key Findings

This provider is effectively a Medicaid-centric operator: there is no Medicare billing on file while total Medicaid revenue is $374.8M, indicating the organization’s documented payer scale is dominated by Medicaid rather than a split payer mix. The absence of Medicare claims on record makes the facility functionally single-payer in the available data.

Medicaid revenue is highly concentrated: the top three Medicaid codes (99211, 99284, 99285) account for 46.9% of the provider’s total Medicaid revenue. Those three contributors are 99211 with $72.4M (31.5%), 99284 with $18.2M (7.9%), and 99285 with $17.2M (7.5%), showing a small number of codes drive nearly half of Medicaid receipts.

The code mix points to a large outpatient and emergency department footprint combined with significant infusion/oncology activity. High-volume E/M codes (99284, 99285, 99283) alongside large volumes of infusion and chemotherapy codes such as 96361 ($11.8M), 96365 ($5.2M), 96415 ($5.1M), and 96413 ($4.4M) indicate both emergency care and ambulatory infusion/oncology services are important service lines.

99211 is an extreme statewide outlier and the single largest Medicaid revenue driver: it generated $72.4M and ranks #1 of 413 providers in-state (100th percentile; extreme outlier, far above typical state volume for this code). This dominance on 99211 suggests a very large clinic or nursing-led outpatient volume relative to peers.

Emergency department codes are similarly elevated versus in-state peers: 99284 produced $18.2M (ranks #8 of 827, 99th percentile; extreme outlier) and 99285 produced $17.2M (ranks #9 of 521, 98th percentile; extreme outlier). Those ranks and dollar volumes imply both high ED throughput and a meaningful share of higher-acuity ED visits compared with other Massachusetts providers.

The provider operates a sizeable hospital outpatient clinic footprint: G0463 shows 235.4K claims and $7.8M in revenue, ranking #7 of 106 providers in-state (94th percentile; notably above typical state volume for this code). Such clinic-level volume complements the high 99211 activity and supports the interpretation of a large ambulatory delivery platform.

Obstetrics and imaging are notable specialty areas based on code-specific leadership: fetal monitoring 59025 produced $4.8M and ranks #1 of 124 providers in-state (100th percentile; extreme outlier), and limited abdominal ultrasound 76705 produced $2.6M and ranks #1 of 169 providers in-state (100th percentile; extreme outlier). Combined with CT volumes (70450 $3M and 74177 $3M), these figures indicate robust maternal/diagnostic and imaging services on the Medicaid side.

The provider is an established entity with a long tenure in the NPI registry (NPI enumerated 2005-08-09 (~21 years ago)), consistent with the scale of reported Medicaid revenue ($374.8M) and the pattern of high-volume, recurring outpatient, ED, infusion, and imaging services. The longevity plus concentrated Medicaid receipts suggests mature operational lines centered on the services reflected in the top codes.

Medicaid: Complete Services Breakdown

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

895 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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.	495,590	$150	$72.4M
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.	117,580	$160	$18.2M
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.	87,550	$200	$17.2M
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.	108,520	$160	$17.1M
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,…	95,200	$140	$13.3M
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.	37,940	$310	$11.8M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	235,420	$30	$7.8M
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	41,110	$150	$6.2M
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…	83,650	$60	$5.3M
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.	29,450	$180	$5.2M

Showing 1–10 of 895

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

Baystate Medical Center Inc — 15 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

895 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
41899	Use this code to report a procedure on the teeth and adjoining alveolar structures for which there is no specific code available.	3	10	470	$2,670	$6.3M
J9271	Injection, pembrolizumab, 1 mg	6	10	210	$5,200	$5.5M
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.	6	90	7,560	$350	$4.2M
S9485	Crisis intervention mental health services, per diem	18	110	1,250	$540	$3.2M
J1745	Injection, infliximab, excludes biosimilar, 10 mg	6	10	1,380	$1,380	$2.7M
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…	7	20	310	$260	$2.1M
Q5103	Injection, infliximab-dyyb, biosimilar, (inflectra), 10 mg	5	10	1,200	$1,560	$2.1M
J2357	Injection, omalizumab, 5 mg	2	10	1,540	$850	$1.6M
J3380	Injection, vedolizumab, intravenous, 1 mg	5	10	330	$2,790	$1.6M
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…	6	50	1,870	$210	$1.4M

Showing 1–10 of 895

Related Providers

Other providers that share a Tax Identification Number (TIN) with Baystate Medical Center Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Baystate Medical Practices, Inc	MA	Emergency Medical Services (Emergency Medicine) Physician	$0	$60.5M
Sonia Riyaz	MA	Psychiatry Physician	$36.8K	$8.7K
Toussaint Casimir	MA	Psychiatric/Mental Health Nurse Practitioner	$32.9K	$0

Nearby Providers

Other providers in the same ZIP code as Baystate Medical Center Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Baystate Medical Center Inc	MA	Clinical Medical Laboratory	$0	$40.6M
Geoffrey Sakellis	MA	Diagnostic Radiology Physician	$750.9K	$0
Kathleen Kerrigan	MA	Emergency Medicine Physician	$171.3K	$80.5K
Sohail Waien	MA	Hospitalist Physician	$231K	$0
James Mueller	MA	Anatomic Pathology & Clinical Pathology Physician	$72.4K	$104.4K
Aimen Kasasbeh	MA	Diagnostic Radiology Physician	$97.2K	$73.2K
Varun Naragum	MA	Neuroradiology Physician	$114.7K	$0
Peters Okonoboh	MA	Critical Care Medicine (Internal Medicine) Physician	$113.4K	$0
Katya Ford	MA	Anatomic Pathology Physician	$51.9K	$58.9K
Howard Hoffman	MA	Vascular & Interventional Radiology Physician	$101.3K	$1.3K

Baystate Medical Center 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