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 Washington (NPI 1609984889)

Field	Value
Entity Type	Organization
Organization	Upmc Washington
Address	155 Wilson Ave
City	Washington
State	PA
ZIP	15301
Taxonomy	General Acute Care Hospital
NPI Enumerated	August 28, 2006

Payer Source	Total Paid
Medicaid	$11.2M
Medicare	$0

Medicaid: Complete Services Breakdown

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

295 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.	19,660	$100	$1.9M
G0378	Hospital observation service, per hour	2,120	$810	$1.7M
T1015	Clinic visit/encounter, all-inclusive	28,370	$40	$1.1M
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.	4,170	$140	$579.6K
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.	4,400	$120	$528.4K
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	7,090	$50	$382.8K
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.	5,560	$60	$339.4K
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…	6,230	$40	$261.8K
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.	1,200	$160	$186K
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…	4,520	$40	$158.3K

Showing 1–10 of 295

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 Washington — 2 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

295 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
G0378	Hospital observation service, per hour	34	150	510	$870	$1.4M
T1015	Clinic visit/encounter, all-inclusive	111	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.	41	210	730	$40	$689.7K
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…	39	70	620	$60	$464.8K
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…	45	410	1,130	$60	$455.4K
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.	191	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.	41	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.	120	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.	128	710	320	$40	$241.4K
X0621	N/A	27	30	300	$230	$175.5K

Showing 1–10 of 295

Related Providers

Other providers that share a Tax Identification Number (TIN) with Upmc Washington, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Madeline Corson-o'donnell	PA	Family Nurse Practitioner	$35.9K	$0
David Johnson	WV	Certified Registered Nurse Anesthetist	$14K	$0

Nearby Providers

Other providers in the same ZIP code as Upmc Washington, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Positive Recovery Solutions, LLC	PA	General Practice Physician	$0	$29.2M
The Care Center	PA	Substance Use Disorder Rehabilitation Clinic/Center	$0	$19.5M
Phoenix-washington, Inc. - Tdba Greenbriar Treatment Center	PA	Substance Abuse Rehabilitation Facility	$0	$17.4M
Gateway Rehabilitation Center	PA	Substance Use Disorder Rehabilitation Clinic/Center	$0	$14.6M
Trpil Community Services	PA	Home Health Agency	$0	$12.4M
Ambulance And Chair Ems, Inc	PA	Land Ambulance	$904.2K	$5.6M
Abstinent Living At The Turning Point At Washington, Inc	PA	Addiction (Substance Use Disorder) Counselor	$0	$5.9M
E. Ronald Salvitti, M.d., Inc.	PA	Ambulatory Surgical Clinic/Center	$986.7K	$20.9K
Guy Avolio	PA	Emergency Medicine Physician	$558.1K	$234.2K
Ziad Simon Fawaz	PA	Radiation Oncology Physician	$453.1K	$0

Upmc Washington — Billing Profile & Reimbursement Data

Sign up for Upmc Washington — Billing Profile & Reimbursement Data policy alerts

Upmc Washington — Billing Profile & Reimbursement Data

Sign up for Upmc Washington — Billing Profile & Reimbursement Data policy alerts

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References