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

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

Winchester Medical Center (NPI 1619928017)

Key Findings

Field	Value
Entity Type	Organization
Organization	Winchester Medical Center
Address	1840 Amherst St
City	Winchester
State	VA
ZIP	22601
Taxonomy	General Acute Care Hospital
NPI Enumerated	May 12, 2006

Payer Source	Total Paid
Medicaid	$69.9M
Medicare	$0

WINCHESTER MEDICAL CENTER reports no Medicare billing on file and $69.9M in lifetime Medicaid revenue, making its public-facing activity effectively single-payer (Medicaid) in the available data. This concentration means analyses of utilization and competitive positioning should treat Medicaid as the primary revenue driver rather than Medicare.

Revenue is highly concentrated in emergency department evaluation-and-management codes: the precomputed top 3 Medicaid codes by revenue account for 41.6% of this provider's total Medicaid revenue, led by 99285 ($9.6M, 19.6%), followed by 99284 ($5.4M, 11.0%) and 99283 ($5.4M, 10.9%). These three codes together drive a plurality of Medicaid dollars, signaling the ED is the hospital’s central revenue-generating service line.

The provider’s operational profile is ED- and acute-care–centric: high claim counts for 99285 (45.7K claims), 99284 (29.3K claims), and 99283 (32.9K claims) alongside observation billing G0378 (12.3K claims, $1.8M, 3.6%) indicate heavy emergency throughput and substantial short-stay observation activity. State-level ranks for these ED codes sit in the upper percentiles (99285 ranks #20 of 340, 94th percentile; 99284 ranks #57 of 620, 91th percentile; 99283 ranks #53 of 626, 92th percentile), consistent with a high-volume regional ED rather than a low-volume community hospital.

Infusion and dehydration-related services are another material component of the clinical mix: 96361 ($4.7M, 9.5%, 19.2K claims), 96360 ($855K, 1.7%), 96365 ($895.5K, 1.8%), and 96374 (28.8K claims, $833.8K, 1.7%) together show routine use of IV fluids, medication infusions, and rapid IV administrations. The combination of these infusion codes with the ED E/M dominance suggests frequent acute medical presentations requiring fluid resuscitation or IV therapeutics.

Imaging and procedural care appear as complementary drivers of Medicaid revenue: CT and CTA codes such as 74177 ($2.4M, 5.0%), 74176 ($1M, 2.0%), 70450 ($1.6M, 3.2%), and 71275 ($776.2K, 1.6%) alongside endoscopy codes (43239 $1.1M, 2.2%; 45385 $691.9K, 1.4%; 45380 $649.9K, 1.3%) point to an on-site radiology and procedural capability supporting ED and inpatient workflows. These services are distributed across typical in-state percentile bands (many in the 70th–90th percentiles), indicating above-average but not uniquely dominant imaging and procedural volumes.

Laboratory and basic ambulatory services show unusually high throughput in specific codes: 36415 has 93.9K claims for $750.9K revenue and is flagged as an "extreme outlier, far above typical state volume for this code" (rank #9 of 941, 99th percentile), and 80307 contributes $712.1K (1.4%). That pattern is consistent with very large-scale phlebotomy and point-of-care testing activity—likely reflecting both ED lab draws and broader outpatient or ancillary lab services tied to the hospital.

State-level competitive positioning is strong but targeted: multiple high-volume codes rank in the 80th–90th+ percentiles (examples include 99285 at the 94th percentile and 36415 at the 99th percentile), signaling that WINCHESTER MEDICAL CENTER is a major Medicaid acute-care provider in Virginia for ED visits, imaging, infusion therapies, and lab throughput. However, the absence of Medicare billing on record means its market footprint and payer risk profile are concentrated in Medicaid, which should be treated as a key strategic and financial exposure.

WINCHESTER MEDICAL CENTER has an NPI enumerated on 2006-05-12 (~20 years ago), indicating long-standing presence in the market; the tenure supports interpreting current high-volume patterns as established operational behavior rather than a transient surge.

Medicaid: Complete Services Breakdown

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

407 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.	45,650	$210	$9.6M
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.	29,340	$190	$5.4M
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.	32,900	$160	$5.4M
96361	The provider administers intravenous, or IV, fluids with electrolytes through an already established intravenous route for each additional hour to treat more severe dehydration.	19,220	$240	$4.7M
41899	Use this code to report a procedure on the teeth and adjoining alveolar structures for which there is no specific code available.	3,070	$1,320	$4.1M
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.	8,900	$270	$2.4M
G0378	Hospital observation service, per hour	12,320	$150	$1.8M
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.	9,460	$160	$1.6M
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…	20,780	$70	$1.4M
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.	2,230	$500	$1.1M

Showing 1–10 of 407

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Virginia Distribution

Winchester Medical Center — 1 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Virginia

Full comparison — all codes billed, vs. Virginia median

407 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
96361	The provider administers intravenous, or IV, fluids with electrolytes through an already established intravenous route for each additional hour to treat more severe dehydration.	17	90	9,030	$280	$3.2M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	34	70	3,200	$110	$2.8M
41899	Use this code to report a procedure on the teeth and adjoining alveolar structures for which there is no specific code available.	5	30	600	$1,370	$1.7M
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.	20	340	160	$130	$1.3M
77386	Intensity modulated radiation treatment delivery (IMRT), includes guidance and tracking, when performed; complex	5	10	450	$540	$1.3M
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.	53	630	90	$140	$1.1M
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.	52	140	3,240	$160	$1M
G0378	Hospital observation service, per hour	11	80	3,650	$160	$1M
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.	57	620	70	$120	$1M
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.	38	180	2,950	$140	$783.2K

Showing 1–10 of 407

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Winchester Medical Center	VA	Obstetrics & Gynecology Physician	$0	$10M
Winchester Medical Center	VA	Clinical Medical Laboratory	$2M	$4.8M
Eric Steuer	VA	Retina Specialist (Ophthalmology) Physician	$2.7M	$0
Jason Ruggiero	VA	Retina Specialist (Ophthalmology) Physician	$2.5M	$0
Shaina Rubino Loverde	VA	Retina Specialist (Ophthalmology) Physician	$1.8M	$0
Rabia Arshad	VA	Cardiovascular Disease Physician	$469.8K	$0
William Jones	VA	Urology Physician	$468.4K	$0
Shaik Samdani	VA	Physical Medicine & Rehabilitation Physician	$402.4K	$0
Edward Smith	VA	Internal Medicine Physician	$402K	$0
Frederick Kozlowski	VA	Internal Medicine Physician	$399.4K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Grafton School, Inc.	VA	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$92M
Grafton School Inc	VA	Psychiatric Residential Treatment Facility	$0	$33M
Shenandoah Valley Community Residences, Inc.	VA	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$17.4M
Compassionate Home Care	VA	In Home Supportive Care Agency	$0	$14.5M
Nova Family Services, Inc.	VA	Intellectual and/or Developmental Disabilities Residential Treatment Facility	$0	$13.5M
Uncle Sam Transportation LLC	VA	Taxi	$0	$12M
National Counseling Group, Inc	VA	Mental Health Counselor	$0	$11.2M
Pediatrix Medical Group PC	VA	Neonatal-Perinatal Medicine Physician	$0	$10.8M
Gaurav Agarwal Dds, Msd, PLLC	VA	Dental Clinic/Center	$0	$8.9M
Valley Regional Enterprises, Inc	VA	Urgent Care Clinic/Center	$0	$8.6M

Winchester Medical Center — 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