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

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

Baptist Healthcare System, Inc. (NPI 1568452290)

Key Findings

Field	Value
Entity Type	Organization
Organization	Baptist Healthcare System, Inc.
Address	801 Eastern Byp
City	Richmond
State	KY
ZIP	40475
Taxonomy	General Acute Care Hospital
NPI Enumerated	October 25, 2005

Payer Source	Total Paid
Medicaid	$58.5M
Medicare	$0

This provider reports no Medicare billing on file and $58.5M in lifetime Medicaid revenue, so its measurable payer footprint in this dataset is effectively single‑payer Medicaid rather than a mixed Medicare/Medicaid profile. Analysts should treat all utilization and revenue patterns below as Medicaid-dominant and not assume complementary Medicare volumes.

Revenue is highly concentrated in a small set of Medicaid codes: the precomputed top three Medicaid codes (99283, 99284, 74177) account for 49.1% of the provider’s total Medicaid revenue. Those three codes are reported individually as 99283 ($11.9M, 27.3%), 99284 ($5.7M, 13.1%), and 74177 ($3.8M, 8.8%), signaling a reliance on a few high‑revenue services.

The code mix points to an acute care hospital with a busy emergency department and strong diagnostic imaging capacity: high revenue shares for ED E/M codes 99283 ($11.9M) and 99284 ($5.7M) alongside advanced CT imaging such as 74177 ($3.8M) and 70450 ($1.4M) indicate the facility conducts large volumes of ED visits coupled with on‑site cross‑sectional imaging. Observation care (G0378, $865.8K, 2.0%) is present but represents a much smaller share of revenue, suggesting short stays are less central to overall billing.

On competitive standing within the state, the provider is a clear leader for lower‑complexity ED visits: 99283 ranks #13 of 284 providers in‑state (96th percentile), which places it among the highest statewide volumes for that code. By contrast, 99284 ranks #64 of 282 (78th percentile) and 99285 ranks #105 of 239 (56th percentile), indicating strong overall ED throughput but relatively heavier volume in lower‑to‑moderate acuity visit levels rather than the highest‑acuity ED visits.

The hospital shows notable strength in gastrointestinal procedures and endoscopy: 45380 (polypectomy) generates $1.2M (2.8%) and ranks #7 of 122 providers in‑state (95th percentile, labeled notably above typical state volume), and 43239 (EGD with biopsy) generates $1.6M (3.8%) and ranks #27 of 174 (85th percentile). These rankings support a conclusion that inpatient/outpatient GI procedural services are a meaningful service line for this provider.

The provider appears to deliver substantial infusion and procedural support services consistent with oncology and medication administration workflows: 96374 (rapid IV push) has 36.4K claims for $908.8K (2.1%, 88th percentile), 96375 (sequential IV push) has 19.2K claims for $920.4K (2.1%, 82nd percentile), and chemotherapy code 96413 yields $1.2M (2.8%, 62nd percentile). Together these entries indicate an active infusion/therapy program supporting outpatient drug administration.

The dataset also shows institutional lab and respiratory testing capacity: proprietary PLA code 0202U appears with $1.5M revenue (3.3%, rank #7 of 27, 77th percentile) and COVID PCR code U0004 appears with $762.2K (1.7%, rank #8 of 33, 78th percentile), while routine lab panels (80053 CMP at $695.4K and 85025 CBC at $411.4K) reflect high claim counts. This combination suggests on‑site molecular and standard lab services that support acute care, ED, and peri‑procedural workflows.

The provider is long‑tenured on the NPI registry (enumerated 2005-10-25, ~21 years ago), which, combined with the concentrated Medicaid revenue profile and strong state‑level ranks on key codes, points to an established community acute care hospital with persistent Medicaid reliance and operational emphasis on emergency medicine, imaging, endoscopy, and infusion services. Analysts should consider this a stable, Medicaid‑focused acute care facility when modeling network participation or Medicaid reimbursement risk.

Medicaid: Complete Services Breakdown

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

341 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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.	63,380	$190	$11.9M
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.	22,690	$250	$5.7M
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.	8,690	$440	$3.8M
74176	The provider performs computed tomography of the abdomen and pelvis without contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	6,000	$380	$2.3M
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.	6,350	$330	$2.1M
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.	3,960	$420	$1.6M
0202U	This is a Proprietary Laboratory Analyses (PLA) code, meaning that the code applies to only one unique lab test made by a specific manufacturer or performed by a specific lab. Report 0202U for the…	6,330	$230	$1.5M
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.	7,160	$200	$1.4M
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.	13,040	$100	$1.3M
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…	3,070	$390	$1.2M

Showing 1–10 of 341

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Kentucky Distribution

Baptist Healthcare System, Inc. — 3 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Kentucky

Full comparison — all codes billed, vs. Kentucky median

341 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.	64	280	7,150	$150	$3M
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.	105	240	4,710	$150	$2.6M
G0483	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…	65	70	1,650	$100	$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.	13	280	5,700	$120	$2M
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.	36	180	1,870	$280	$1.5M
G0378	Hospital observation service, per hour	52	90	2,770	$190	$1.3M
0202U	This is a Proprietary Laboratory Analyses (PLA) code, meaning that the code applies to only one unique lab test made by a specific manufacturer or performed by a specific lab. Report 0202U for the…	7	30	2,320	$290	$1.2M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	42	80	7,740	$30	$1.1M
C1713	Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable)	35	40	550	$910	$1.1M
74176	The provider performs computed tomography of the abdomen and pelvis without contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	34	170	2,610	$250	$1M

Showing 1–10 of 341

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
American Health Management, Inc.	KY	Adult Day Care Clinic/Center	$0	$99.1M
Fm Healing Center, LLC	KY	Addiction Medicine (Family Medicine) Physician	$0	$22M
Quality Care Case Management, LLC.	KY	Case Management Agency	$0	$17.5M
Nathaniel House, Inc.	KY	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$14.4M
Ethan Health LLC	KY	Substance Abuse Rehabilitation Facility	$0	$13.1M
Combined Physicians Lab LLC	KY	Clinical Medical Laboratory	$428.1K	$7.4M
Center For Behavioral Health Kentucky LLC	KY	Methadone Clinic	$198.1K	$7.2M
Bluegrass Pediatric Therapies, LLC	KY	Speech-Language Pathologist	$0	$4.5M
Madison Pediatric Assoc	KY	Pediatrics Physician	$0	$3.9M
Rose Bowling, LLC	KY	Rural Health Clinic/Center	$0	$3.9M

Baptist Healthcare System, Inc. — Billing Profile & Reimbursement Data

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Baptist Healthcare System, 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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Baptist Healthcare System, Inc	KY	General Acute Care Hospital	$0	$121.5M
Baptist Healthcare System, Inc	KY	General Acute Care Hospital	$0	$98.1M
Baptist Healthcare System Inc	KY	General Acute Care Hospital	$0	$95.7M
Baptist Healthcare System, Inc	KY	General Acute Care Hospital	$0	$72.6M
Baptist Healthcare System Inc.	KY	General Acute Care Hospital	$0	$62.4M
Baptist Health Medical Group Inc	KY	Nurse Practitioner	$0	$54.1M
Hardin Memorial Hospital	KY	General Acute Care Hospital	$0	$37.2M
Baptist Healthcare System, Inc.	IN	General Acute Care Hospital	$0	$34.6M
Baptist Health Medical Group Inc	KY	Internal Medicine Physician	$0	$27.9M
Baptist Health Medical Group Inc	KY	Urgent Care Clinic/Center	$0	$26.7M