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

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

Kaiser Foundation Hospitals (NPI 1528138088)

Field	Value
Entity Type	Organization
Organization	Kaiser Foundation Hospitals
Address	6600 Bruceville Rd
City	Sacramento
State	CA
ZIP	95823
Taxonomy	General Acute Care Hospital
NPI Enumerated	November 9, 2006

Payer Source	Total Paid
Medicaid	$128M
Medicare	$0

Key Findings

This provider reports none (no Medicare billing on file) in Medicare revenue and $128M in lifetime Medicaid revenue, making its public billing footprint effectively single‑payer in the available dataset. Analysts should treat Medicaid as the dominant—and for practical purposes only—payer when assessing clinical volumes, revenue drivers, and competitive positioning for this entity.

Revenue is highly concentrated in emergency department evaluation-and-management codes: the top 3 Medicaid codes by revenue account for 56.9% of this provider's total Medicaid revenue, driven by 99284 (25.8%), 99283 (21.1%), and 99282 (10.0%). This concentration indicates that more than half of Medicaid dollars for this hospital are generated from ED E/M services rather than elective procedures or outpatient clinics.

The code mix and volumes point to an ED- and acute-care operational profile: 99284 has 38.7K claims ($26.9M), 99283 has 46.2K claims ($22M), and 99282 has 39.7K claims ($10.4M). Complementary codes such as 99291 (critical care; 1.4K claims, $1.5M) and G0378 (hospital observation service; 7.6K claims, $5.2M) further indicate frequent use of observation and higher-acuity ED/short-stay management.

99282 is an outlier in statewide benchmarking, ranking #3 of 481 providers in-state (100th percentile; extreme outlier, far above typical state volume for this code), which signals exceptionally high volumes for the straightforward-level ED visits relative to peers. That extreme standing suggests either a very high overall ED throughput or systematic routing of lower-acuity Medicaid patients through the hospital ED.

By contrast, 99283 ranks #110 of 1570 (93th percentile; notably above typical state volume), while 99284 ranks #137 of 1395 (90th percentile; typical, unremarkable volume), indicating that the hospital shows notably above-average volumes for low-to-moderate complexity ED visits but only typical volumes for the mid/high complexity ED level. Together these rank patterns imply a competitive position that is especially strong for certain ED tiers rather than uniformly dominant across all ED complexity levels.

Imaging and diagnostic support services appear as meaningful secondary revenue streams tied to acute care: 74177 (CT abdomen/pelvis with contrast) produced $3.9M (13.2K claims) and ranks in the 92th percentile, 70450 (CT head without contrast) generated $2M (17.7K claims) in the 93th percentile, and 71046 (chest x‑ray, 2 views) shows 36.8K claims and $2.3M in revenue at the 98th percentile. These volumes are consistent with heavy ED and observation unit utilization that requires frequent cross-sectional imaging and radiography.

High laboratory and pathology throughput complements the ED and inpatient activity: 85025 (CBC) shows 133.8K claims and $668.8K revenue (97th percentile in-state), and 88305 (surgical pathology, level IV) accounts for 18.8K claims and $1.7M (93th percentile). The combination of very large CBC claim counts and substantial pathology billing supports a picture of continuous inpatient/ED clinical processing and specimen flow.

This NPI was enumerated on 2006-11-09 (~20 years ago), indicating an established presence in the Sacramento market as a General Acute Care Hospital. Given the $128M Medicaid revenue base and the ED-centered code mix, the provider should be viewed as a long-tenured, large Medicaid-serving acute care facility with concentrated dependence on emergency and observation services for its Medicaid revenue.

Medicaid: Complete Services Breakdown

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

353 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.	38,710	$700	$26.9M
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.	46,240	$480	$22M
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.	39,700	$260	$10.4M
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.	13,770	$660	$9.1M
G0378	Hospital observation service, per hour	7,620	$690	$5.2M
0450	N/A	94,750	$50	$4.7M
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.	13,190	$300	$3.9M
71046	In this diagnostic procedure, the provider performs a minimum of two radiological views of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and…	36,750	$60	$2.3M
99281	The provider sees a patient for the lowest level emergency department visit.	16,560	$130	$2.2M
70450	The provider performed computed tomography, or CT scanning, of the head or brain, without contrast. He performs the procedure to diagnose any brain or intracranial abnormalities.	17,690	$110	$2M

Showing 1–10 of 353

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. California Distribution

Kaiser Foundation Hospitals — 8 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — California

Full comparison — all codes billed, vs. California median

353 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
G0390	Trauma response team associated with hospital critical care service	5	10	250	$8,790	$6.1M
0450	N/A	66	450	16,140	$90	$3.6M
0121	N/A	69	70	130	$4,600	$2.6M
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.	110	1,570	680	$110	$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.	211	1,300	510	$100	$943K
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…	155	750	950	$50	$890K
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.	137	1,400	470	$80	$884.5K
99281	The provider sees a patient for the lowest level emergency department visit.	57	430	1,140	$90	$769.9K
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)…	11	250	800	$110	$625.7K
G0378	Hospital observation service, per hour	10	200	550	$310	$605.9K

Showing 1–10 of 353

Nearby Providers

Other providers in the same ZIP code as Kaiser Foundation Hospitals, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
County Of Sacramento	CA	Adult Mental Health Clinic/Center	$0	$903M
County Of Sacramento	CA	Community/Behavioral Health Agency	$0	$179.8M
Dignity Community Care	CA	General Acute Care Hospital	$0	$86.1M
Prithipal Sethi	CA	Urology Physician	$1.1M	$0
Dawei Zheng	CA	Family Medicine Physician	$918.2K	$0
Treatment Associates, Inc.	CA	Methadone Clinic	$475.2K	$19K
Gregory Smith	CA	Internal Medicine Physician	$433K	$0
Paramjit Takhar	CA	Family Medicine Physician	$333.4K	$0
Stephen Howell	CA	Orthopaedic Surgery Physician	$270.7K	$0
Ushir Patel	CA	Nephrology Physician	$251.2K	$0

Kaiser Foundation Hospitals — 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

Nearby Providers

Frequently Asked Questions

References