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

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

Upmc Williamsport (NPI 1609801976)

Upmc Williamsport is a general acute care hospital provider located in Williamsport, Pennsylvania. This profile covers 0 Medicare and 169 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Medicaid: Complete Services Breakdown

Field	Value
Entity Type	Organization
Organization	Upmc Williamsport
Address	700 High St
City	Williamsport
State	PA
ZIP	17701
Taxonomy	General Acute Care Hospital
NPI Enumerated	July 12, 2006

Payer Source	Total Paid
Medicaid	$9.7M
Medicare	$0

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

169 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.	32,720	$90	$3M
G0378	Hospital observation service, per hour	2,880	$510	$1.5M
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.	19,140	$60	$1.2M
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.	8,810	$110	$951.8K
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.	2,440	$160	$385.7K
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	14,720	$20	$353.4K
87633	The lab analyst performs a test to identify a respiratory virus using amplified nucleic acid probe technique. He may also use a multiplex reverse transcription technique. The provider does this for…	550	$430	$235.4K
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.	3,430	$50	$181.9K
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	1,240	$120	$150.2K
96375	Following the administration of a drug or other substance via intravenous, or IV, push, the provider sequentially infuses a different medication or medications, also via IV push. He administers the…	8,830	$20	$150.1K

Showing 1–10 of 169

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Pennsylvania Distribution

Upmc Williamsport — 5 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Pennsylvania

Full comparison — all codes billed, vs. Pennsylvania median

169 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
G0378	Hospital observation service, per hour	24	150	510	$870	$1.4M
T1015	Clinic visit/encounter, all-inclusive	555	1,690	760	$170	$1.2M
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.	38	210	730	$40	$689.7K
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…	112	200	990	$70	$517.5K
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.	36	1,600	270	$120	$409.7K
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.	42	1,060	150	$130	$405.4K
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.	80	1,230	250	$130	$284K
97530	The provider uses various activities during direct contact with the patient to improve the patient’s functional performance. Use this code for each 15 minutes of activity.	229	710	320	$40	$241.4K
G0463	Hospital outpatient clinic visit for assessment and management of a patient	56	100	330	$40	$166K
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…	76	90	440	$120	$162.5K

Showing 1–10 of 169

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Hope Enterprises, Inc.	PA	Voluntary or Charitable Agency	$0	$36.1M
River Valley Health	PA	Federally Qualified Health Center (FQHC)	$0	$22.2M
Bayada Home Health Care, Inc.	PA	Home Health Agency	$0	$17.6M
Crossroads Counseling, Inc	PA	Clinic/Center	$0	$11.2M
Pediatric Services Of America, LLC	PA	Home Health Agency	$0	$10.8M
Diakon Child, Family & Community Ministries	PA	Community/Behavioral Health Agency	$0	$9.1M
Lycoming-clinton Joinder Board	PA	Case Management Agency	$0	$8.4M
Lycoming-clinton Mhmr Program	PA	Psychologist	$0	$7.8M
Maxim Healthcare Services, Inc.	PA	Home Health Agency	$0	$7.7M
Williamsport Family Medical Center, LLC	PA	Methadone Clinic	$96.1K	$6.5M

Upmc Williamsport — Billing Profile & Reimbursement Data

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Upmc Williamsport — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

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