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

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

Valley Medical Group-renton (NPI 1619209574)

Valley Medical Group-renton is a general acute care hospital provider located in Renton, Washington. This profile covers 0 Medicare and 160 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	Valley Medical Group-renton
Address	400 S 43rd St
City	Renton
State	WA
ZIP	98055
Taxonomy	General Acute Care Hospital
NPI Enumerated	February 3, 2010

Payer Source	Total Paid
Medicaid	$28.3M
Medicare	$0

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

160 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	269,110	$50	$12.4M
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…	121,710	$40	$4.7M
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	66,860	$20	$1.5M
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	42,520	$30	$1.3M
99203	The provider sees a new 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 provider…	18,460	$60	$1.1M
99204	The provider sees a new 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 provider…	13,080	$70	$955.1K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	15,940	$50	$828.8K
99291	Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is…	7,180	$70	$523.8K
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	8,260	$60	$470.8K
99205	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the provider…	2,980	$110	$316K

Showing 1–10 of 160

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Washington Distribution

Valley Medical Group-renton — 12 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Washington

Full comparison — all codes billed, vs. Washington median

160 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.	144	230	5,440	$90	$1.8M
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.	148	230	6,220	$100	$1.8M
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.	88	140	2,410	$110	$593.3K
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…	7	1,820	480	$60	$379.6K
93306	The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent…	11	130	890	$100	$337.8K
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.	42	120	590	$230	$331.2K
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…	17	1,860	610	$40	$295.5K
95810	Polysomnography refers to the continuous and simultaneous monitoring and recording of various physiological and pathophysiological parameters of sleep for six or more hours with physician review,…	49	60	240	$380	$276.1K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	6	170	580	$30	$270.4K
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	5	140	490	$40	$268.5K

Showing 1–10 of 160

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Public Hospital District 1 Of King County	WA	General Acute Care Hospital	$0	$120.6M
Franciscan Medical Group	WA	Family Medicine Physician	$0	$92.6M
Multicare Health System	WA	Family Medicine Physician	$0	$25.8M
Franciscan Medical Group	WA	Internal Medicine Physician	$0	$7.7M
Franciscan Health System	WA	Internal Medicine Physician	$0	$6.4M
Pacmed Clinics	WA	Multi-Specialty Clinic/Center	$0	$4.5M
Franciscan Medical Group	WA	Internal Medicine Physician	$0	$4.5M
Manoj Agarwal	WA	Medical Oncology Physician	$1M	$0
Daniel Kim	WA	Rheumatology Physician	$1M	$0
Manas Jain	WA	Urology Physician	$489.2K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Associated Emergency Room Physicians, Inc P.s.	WA	Emergency Medicine Physician	$0	$12M
Retina Institute, PLLC	WA	Retina Specialist (Ophthalmology) Physician	$0	$5.5M
Valley Children's Clinic	WA	Pediatric Adolescent Medicine Physician	$0	$5.2M
Proliance Surgery Center At Valley, LLC	WA	Ambulatory Surgical Clinic/Center	$3.3M	$0
Vantage Radiology & Diagnostic Services, A Professional Services Corp	WA	Diagnostic Radiology Physician	$0	$2.6M
George Ko	WA	Retina Specialist (Ophthalmology) Physician	$1.7M	$0
Kenneth Fung	WA	Ophthalmology Physician	$1.6M	$0
Renton Regional Fire Authority	WA	Land Ambulance	$229.9K	$186.7K
Craig Fujisaki	WA	Dermatology Physician	$376.9K	$0
Timothy Alton	WA	Orthopaedic Surgery Physician	$313.4K	$0

Valley Medical Group-renton — Billing Profile & Reimbursement Data

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Valley Medical Group-renton — 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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