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NPI 1568403111 · New Orleans, LA · General Acute Care Hospital
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University Medical Center Management Corporation is a general acute care hospital provider located in New Orleans, Louisiana. This profile covers 0 Medicare and 404 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 Medical Center Management Corporation |
| Address | 2000 Canal St |
| City | New Orleans |
| State | LA |
| ZIP | 70112 |
| Taxonomy | General Acute Care Hospital |
| NPI Enumerated | June 8, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $87M |
| Medicare | $0 |
This entity is effectively a Medicaid-focused provider: there is no Medicare billing on file and total Medicaid revenue is $87M, making Medicaid the sole documented payer in the dataset and concentrating the provider’s financial exposure into a single public payer. Analysts should treat this as a single‑payer revenue profile rather than a mixed Medicare/Medicaid operation.
Revenue is highly concentrated in a few E/M codes: the precomputed top 3 Medicaid codes (99285, 99284, 99213) account for 65.3% of the provider’s total Medicaid revenue. Those three codes are 99285 ($27.3M, 37.0% of Medicaid revenue), 99284 ($10.6M, 14.4%), and 99213 ($10.2M, 13.9%), indicating a small number of services drive the majority of Medicaid dollars.
The code mix points to a hospital with a heavy emergency and ambulatory throughput: high‑revenue ED E/M codes 99285 and 99284 appear at the top of the list, while 99213 (established outpatient visits) is also a top revenue driver. This combination — large volumes of high-acuity ED visits alongside very high-volume established-patient outpatient visits — suggests integrated acute and ambulatory operations rather than a narrow specialty clinic.
Competitive standing within Louisiana is strong for several services. 99285 ranks #8 of 237 providers in‑state (97th percentile, described as notably above typical state volume), 99213 ranks #5 of 3226 providers (100th percentile; extreme outlier), and 99284 sits at #47 of 266 (83th percentile), collectively showing the provider is a major in‑state player for both high-acuity ED care and high-volume outpatient encounters.
The provider is a measurable outlier on diagnostic and procedural support services that underpin ED and inpatient care. Codes such as 93005 (61.2K claims, $2.6M; rank #3 of 133, 98th percentile; extreme outlier), 80053 (162K claims, $1.1M; rank #4 of 267, 99th percentile; extreme outlier), and 36415 (305.1K claims, $610.2K; rank #2 of 690, 100th percentile; extreme outlier) show very large volumes of EKGs, comprehensive metabolic panels, and phlebotomy respectively, consistent with a high-volume hospital diagnostic footprint.
Oncology and infusion services are meaningful secondary revenue streams: 96413 (10.3K claims, $2M; rank #3 of 41, 95th percentile; notably above typical state volume) and G0378 observation billing (5.9K claims, $1.6M; rank #4 of 77, 96th percentile; notably above typical state volume) indicate inpatient/observation stays and chemotherapy/infusion activity that extend revenue beyond acute ED E/M codes. Related IV administration codes (96374, 96375, 96361) further support a substantive infusion program reflected in Medicaid billing.
The provider also demonstrates substantial activity in testing related to infectious disease and toxicology screening: U0003 (31.5K claims, $2.1M; rank #11 of 97, 90th percentile) and 87635 (16.1K claims, $643.5K; rank #23 of 355, 94th percentile) show elevated COVID testing throughput, while G0480 (14.7K claims, $806.7K; rank #3 of 73, 97th percentile; extreme outlier) signals high-volume definitive drug testing. These volumes align with a facility serving a large, diverse patient population and supporting ED and behavioral health workflows.
This NPI has long tenure in the public data: enumerated/registered on 2006-06-08 (~20 years ago), indicating an established presence in the New Orleans market. Combined with the Medicaid concentration and the rank/percentile positions across many codes, the data portray a long-standing, high-volume safety‑net or acute care hub in‑state rather than a new or marginal entrant.
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.
404 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 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. | 76,150 | $360 | $27.3M |
| 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. | 47,730 | $220 | $10.6M |
| 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… | 329,840 | $30 | $10.2M |
| 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. | 27,410 | $170 | $4.8M |
| 93005 | The provider records the electrical conduction of the heart to examine any abnormality in its functioning, based on signals from at least 12 leads, wires that connect the recording device to… | 61,210 | $40 | $2.6M |
| 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… | 31,530 | $70 | $2.1M |
| 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… | 10,330 | $190 | $2M |
| G0378 | Hospital observation service, per hour | 5,930 | $270 | $1.6M |
| 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… | 32,470 | $50 | $1.5M |
| 43239 | The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis. | 4,450 | $290 | $1.3M |
Showing 1–10 of 404
How this provider's Medicaid billing volume and revenue compare to other Louisiana providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Louisiana median
404 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. | 47 | 270 | 9,980 | $110 | $2.6M |
| 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. | 8 | 240 | 4,030 | $130 | $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. | 69 | 270 | 11,250 | $90 | $1.8M |
| J9271 | Injection, pembrolizumab, 1 mg | 8 | 10 | 160 | $3,820 | $862.6K |
| 77386 | Intensity modulated radiation treatment delivery (IMRT), includes guidance and tracking, when performed; complex | 5 | 10 | 1,250 | $180 | $699.2K |
| J1745 | Injection, infliximab, excludes biosimilar, 10 mg | 4 | 10 | 110 | $3,420 | $584.5K |
| 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… | 11 | 100 | 620 | $40 | $560K |
| 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… | 21 | 30 | 1,340 | $60 | $499.3K |
| 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. | 35 | 100 | 760 | $100 | $441.2K |
| 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… | 14 | 90 | 1,270 | $50 | $375.3K |
Showing 1–10 of 404
Other providers in the same ZIP code as University Medical Center Management Corporation, ranked by combined Medicare and Medicaid revenue.
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