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NPI 1548226988 · Galveston, TX · General Acute Care Hospital
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University Of Texas Medical Branch At Galveston is a general acute care hospital provider located in Galveston, Texas. This profile covers 0 Medicare and 429 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.
Provider details (source: NPPES NPI Registry)
| Field | Value |
|---|---|
| Entity Type | Organization |
| Organization | University Of Texas Medical Branch At Galveston |
| Address | 301 University Blvd |
| City | Galveston |
| State | TX |
| ZIP | 77555 |
| Taxonomy | General Acute Care Hospital |
| NPI Enumerated | April 25, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $150.3M |
| Medicare | $0 |
This provider reports no Medicare billing on file and a concentrated Medicaid footprint totaling $150.3M, making its commercial/Medicare exposure effectively nil and Medicaid the dominant (in practice, sole) source of fee‑for‑service revenue for the entity. Analysts should treat UNIVERSITY OF TEXAS MEDICAL BRANCH AT GALVESTON as a Medicaid‑dependent billing footprint for payer mix and utilization modeling because Medicare revenue is listed as none.
Revenue concentration is very high across a small set of outpatient E/M and ED codes: the precomputed top 3 Medicaid codes together account for 60.7% of the provider's total Medicaid revenue. Those top contributors are 99213 ($56M, 45.1% of Medicaid revenue), 99283 ($11.3M, 9.1%), and 99284 ($8M, 6.4%), indicating a heavy reliance on ambulatory/ED evaluation and management services for Medicaid revenue.
The code mix and volumes indicate a large ambulatory and emergency department operation: 99213 is the single largest revenue generator at $56M and the provider ranks as an extreme outlier in the state for this code, which signals an outsized outpatient visit volume relative to peers. High volumes in the nearby E/M codes 99212 (81.5K claims, $6.2M) and 99214 (67.9K claims, $6M) further reinforce a system that captures large numbers of established outpatient encounters in addition to ED visits.
Competitive standing for key codes shows dominance in several statewide measures: 99213 ranks #2 of 6037 providers in-state and is described as an extreme outlier, and other E/M codes like 99212 and 99214 are also at the 100th percentile with extreme outlier labels. In contrast, the ED codes 99283 and 99284 are ranked in high but less extreme percentiles (99283 described as notably above typical, 99284 as typical/unremarkable), so the provider is a dominant outpatient visit player and a strong but not singular ED competitor.
Lab and infectious‑disease testing is a prominent secondary service line: large volumes and high ranks for U0004 (68.5K claims, $5.3M; extreme outlier), 87502 (36.1K claims, $3.6M; extreme outlier), and multiple NAAT/STD/COVID codes (U0005, 87651, 87491, 87591, 87389) indicate substantial high‑throughput diagnostic capacity that contributes meaningfully to Medicaid revenue and suggests on‑site or closely affiliated lab capabilities.
Obstetrics and fetal imaging are significant contributors: multiple ultrasound codes such as 76816 (22.9K claims, $2.7M), 76805 (11.8K claims, $1.4M), 76801 (9.5K claims, $1.1M), and 76817 (16.6K claims, $1.7M) all rank at or near top percentiles in-state with several labeled extreme outliers. This pattern points to a substantial maternal–fetal service line driving recurring imaging volume and revenue from Medicaid.
Surgical and specialty procedures produce smaller but notable revenue pockets—42820 (tonsil/adenoid removal in <12) yields $2.1M despite only 451 claims because of a high avg paid/claim ($4639), and echocardiography codes such as 93303 and 93325 contribute meaningful single‑procedure revenues. These items indicate that while the core business is ambulatory/ED and lab/OB imaging, there are discrete inpatient/OR and specialty clinics adding supplemental procedural revenue.
The provider has been enumerated with an NPI since 2006-04-25 (~20 years ago), indicating a long tenure in the market; combined with the statewide dominance on multiple outpatient and lab codes, this tenure supports a stable, established role as a Medicaid safety‑net and tertiary/referral center in the Galveston, TX area.
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
View: By Year1 / 3
Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
429 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 99213 | The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the… | 708,490 | $80 | $56M |
| 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. | 47,260 | $240 | $11.3M |
| 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. | 14,960 | $530 | $8M |
| 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,… | 81,510 | $80 | $6.2M |
| 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… | 67,860 | $90 | $6M |
| 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… | 68,460 | $80 | $5.3M |
| 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… | 36,140 | $100 | $3.6M |
| 76816 | The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound. | 22,900 | $120 | $2.7M |
| 42820 | The provider removes the tonsils and adenoids in a patient younger than 12 years old. | 450 | $4,640 | $2.1M |
| 87651 | The lab analyst performs a test for the bacteria Streptococcus, group A, using amplified nucleic acid probe technique. Strep A commonly causes acute pharyngitis, or strep throat. | 56,070 | $40 | $2.1M |
Showing 1–10 of 429
How this provider's Medicaid billing volume and revenue compare to other Texas providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Texas median
429 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average 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. | 122 | 710 | 1,790 | $200 | $2.1M |
| 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 | 730 | 1,960 | $100 | $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. | 208 | 590 | 740 | $170 | $969.2K |
| 92507 | The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with… | 380 | 1,350 | 1,860 | $80 | $872.4K |
| 95782 | A patient under the age of 6 undergoes an attended sleep study with identification of sleep levels and at least four additional sleep parameters. | 19 | 30 | 330 | $1,020 | $750.2K |
| 93303 | The provider performs a complete transthoracic echocardiography to obtain images of the heart structures through the chest wall in patients born with heart defects. This study includes visualization… | 13 | 70 | 850 | $180 | $621.2K |
| 95810 | Polysomnography refers to the continuous and simultaneous monitoring and recording of various physiological and pathophysiological parameters of sleep for six or more hours with physician review,… | 22 | 60 | 340 | $590 | $491.5K |
| G0378 | Hospital observation service, per hour | 55 | 70 | 300 | $500 | $465K |
| 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)… | 58 | 120 | 340 | $120 | $422K |
| 42820 | The provider removes the tonsils and adenoids in a patient younger than 12 years old. | 21 | 110 | 80 | $1,260 | $398.1K |
Showing 1–10 of 429
Other providers in the same ZIP code as University Of Texas Medical Branch At Galveston, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Utmb Faculty Group Practice | TX | General Practice Physician | $0 | $98.9M |
| Qi Chen | TX | Diagnostic Radiology Physician | $253.3K | $78.2K |
| Jaafer Imam | TX | Critical Care Medicine (Internal Medicine) Physician | $301.1K | $0 |
| Muhie Dean Sabayon | TX | Clinical Cardiac Electrophysiology Physician | $238K | $0 |
| Cameron Ghaffary | TX | Surgery Physician | $235.9K | $0 |
| Audrey Nath | TX | Neurological Surgery Physician | $210.5K | $0 |
| Tomas Uribe Acosta | TX | Diagnostic Radiology Physician | $170.9K | $0 |
| Murtaza Mazhar | TX | Cardiovascular Disease Physician | $150.5K | $0 |
| Todd Swanson | TX | Radiation Oncology Physician | $137.7K | $0 |
| Kishore Patcha | TX | Nephrology Physician | $120K | $0 |
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