Peacehealth — Billing Profile & Reimbursement Data
NPI 1578552402 · Florence, OR · Critical Access Hospital
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Peacehealth is a critical access hospital provider located in Florence, Oregon. This profile covers 0 Medicare and 87 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 | Peacehealth |
| Address | 400 9th St |
| City | Florence |
| State | OR |
| ZIP | 97439 |
| Taxonomy | Critical Access Hospital |
| NPI Enumerated | October 13, 2005 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $20.2M |
| Medicare | $0 |
Key Findings
PEACEHEALTH in FLORENCE, OR shows an effectively single-payer footprint: there is no Medicare billing on file while reported Medicaid revenue totals $20.2M. This concentration means payer risk and growth opportunities will be driven almost entirely by Medicaid trends and state-level policy changes rather than Medicare dynamics.
Revenue is highly concentrated in a small set of outpatient and emergency visit codes: the precomputed top 3 Medicaid codes account for 64.3% of the provider's total Medicaid revenue. Those top drivers are 99285 ($4.8M revenue, 9.4K claims, $507 avg paid/claim, 24.0%), 99284 ($4.5M revenue, 12.6K claims, $355 avg paid/claim, 22.4%), and G0463 ($3.6M revenue, 65.1K claims, $55 avg paid/claim, 18.0%).
The service-mix points to an ED-forward, hospital outpatient clinic model consistent with its Critical Access Hospital taxonomy: 99284 and 99285 together generate large shares of revenue and volume, and G0463 shows very high outpatient clinic encounter volume at 65.1K claims. High counts for 99284 (12.6K claims) and 99285 (9.4K claims) indicate sustained ED throughput, while the scale of G0463 suggests a substantial hospital-run outpatient assessment and management operation.
Competitive standing is mixed by code: G0463 ranks #4 of 44 in-state (93th percentile) but is described in the data as a "typical, unremarkable volume for this code," which indicates the provider is among the larger hospital outpatient clinics statewide despite the dataset's characterization. In contrast, the high-acuity ED code 99285 ranks #47 of 129 (64th percentile) and 99284 ranks #62 of 145 (58th percentile), both labeled "typical, unremarkable volume for this code," signaling average-to-modest market share in emergency care relative to statewide peers.
Office-based outpatient activity is a notable secondary service line: 99214 generated $2.1M (10.5% of Medicaid revenue) on 28.3K claims and ranks #53 of 1503 providers in-state (97th percentile), explicitly labeled "notably above typical state volume for this code." This suggests stronger-than-typical capacity for established outpatient visits or primary/specialty clinic continuity within the hospital's outpatient mix.
Ancillary and diagnostic services contribute modestly but diversely to revenue: lab and procedure codes such as 80053 ($334.7K), 36415 ($328.1K), 85025 ($276.9K), and 87635 ($180.6K) appear across the top-25 list. Individually these lines are small percentages of total Medicaid revenue, but together they indicate on-site lab and diagnostic capability that supports both ED and outpatient throughput.
From a tenure and strategic posture perspective, PEACEHEALTH's NPI has been enumerated since 2005-10-13 (~21 years ago) and the provider is classified as a Critical Access Hospital. That longstanding registration plus the observed mix of ED, clinic (G0463), and above-typical 99214 office volumes fits the profile of a stable rural hospital operating both emergency services and a busy outpatient clinic network largely funded by Medicaid.
Medicaid: Total Revenue Breakdown by CPT/HCPCS Code
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
Medicaid: Complete Services Breakdown
Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
87 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. | 9,430 | $510 | $4.8M |
| 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. | 12,550 | $360 | $4.5M |
| G0463 | Hospital outpatient clinic visit for assessment and management of a patient | 65,080 | $60 | $3.6M |
| 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. | 12,760 | $210 | $2.6M |
| 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… | 28,270 | $70 | $2.1M |
| 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… | 13,510 | $40 | $513.3K |
| 80053 | The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel. | 13,950 | $20 | $334.7K |
| 36415 | In this procedure, the provider inserts a needle into a vein to collect a blood sample. | 18,230 | $20 | $328.1K |
| 85025 | A complete blood count (better known as a CBC) is a blood test request by a doctor that provides detailed information about various types of cells in a patient's blood. Usually a pathologist or a… | 11,080 | $30 | $276.9K |
| 87635 | Using an amplified nucleic acid probe technique, the lab analyst performs the necessary steps to identify the nucleic acids from the severe acute respiratory syndrome coronavirus 2 (SARS–COV–2) virus… | 4,300 | $40 | $180.6K |
Showing 1–10 of 87
Medicaid: Competitive Analysis & Benchmarks
How this provider's Medicaid billing volume and revenue compare to other Oregon providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Oregon median
87 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. | 62 | 150 | 7,400 | $170 | $2.8M |
| 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. | 47 | 130 | 2,610 | $200 | $2.3M |
| 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. | 66 | 140 | 10,160 | $130 | $2.3M |
| G0463 | Hospital outpatient clinic visit for assessment and management of a patient | 4 | 40 | 3,200 | $60 | $1.5M |
| 96374 | The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition. | 49 | 60 | 3,620 | $90 | $623.7K |
| G0480 | 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… | 45 | 60 | 420 | $60 | $405.1K |
| 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. | 55 | 80 | 1,130 | $90 | $327.2K |
| 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… | 53 | 1,500 | 650 | $70 | $312.4K |
| 80307 | The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date. | 59 | 80 | 1,210 | $40 | $294.3K |
| 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… | 81 | 90 | 530 | $50 | $281.6K |
Showing 1–10 of 87
Nearby Providers
Other providers in the same ZIP code as Peacehealth, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Western Lane Ambulance District | OR | Land Ambulance | $485K | $756.6K |
| Mindwise Counseling | OR | Clinical Social Worker | $0 | $997.2K |
| Fred Meyer Stores Inc | OR | Community/Retail Pharmacy | $122K | $0 |
| Thrifty Payless Inc | OR | Community/Retail Pharmacy | $91K | $0 |
| Eunlee Chung | OR | Hospitalist Physician | $56.2K | $0 |
| Pernilla Johansson | OR | Clinical Social Worker | $37.3K | $5K |
| Stephen Kerner | OR | Family Medicine Physician | $23.4K | $0 |
| Emily Pfaff | OR | Medical Physician Assistant | $22.7K | $0 |
| Gregory Page | OR | Chiropractor | $17.2K | $0 |
| Gail Lowther | OR | Rehabilitation Hospital | $7.4K | $0 |
Frequently Asked Questions
References
- 1.Medicare Physician & Other Practitioner by Provider and Service. CMS.gov.Provider-level Medicare Part B utilization and payment data.
- 2.NPPES NPI Registry. CMS.gov.National Provider Identifier registry used for provider enumeration and taxonomy metadata.
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