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

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

Barnes Jewish Hospital (NPI 1649299827)

Field	Value
Entity Type	Organization
Organization	Barnes Jewish Hospital
Address	1 Barnes-jewish Hospital Plz
City	Saint Louis
State	MO
ZIP	63110
Taxonomy	General Acute Care Hospital
NPI Enumerated	July 19, 2006

Payer Source	Total Paid
Medicaid	$61.4M
Medicare	$0

Key Findings

This provider has no Medicare billing on file and is effectively single-payer in the available claims set: Total Medicaid revenue is $61.4M and Total Medicare revenue is none. The absence of Medicare activity in the dataset means all observed clinical and revenue patterns derive from Medicaid business and state-level competitive dynamics rather than national Medicare competition.

Revenue is highly concentrated in a small set of Medicaid codes: the precomputed top 3 codes account for 54.4% of the provider's Medicaid revenue, with X4011 at 27.3%, G0463 at 15.6%, and 99285 at 11.6%. That concentration indicates a small number of service lines drive the majority of Medicaid cash flow and should be the focus for utilization and contract reviews.

The code mix points to large emergency and hospital outpatient operations. High-volume ED evaluation-and-management codes (99285: 17.3K claims, $330 avg paid/claim, $5.7M revenue; 99283: 15.6K claims, $153 avg paid/claim, $2.4M revenue; 99284: 7K claims, $195 avg paid/claim, $1.4M revenue) plus G0463 (102.3K claims, $75 avg paid/claim, $7.7M revenue) suggest sustained, substantial outpatient clinic and emergency department throughput.

X4011 (28.1K claims, $478 avg paid/claim, $13.4M revenue) is the single largest Medicaid revenue contributor and lacks a public description in the file; nonetheless its volume and revenue share (27.3% of Medicaid revenue) mark it as a critical service driver. The code ranks #10 of 106 providers in-state (91th percentile) and is described as notably above typical state volume, so this unspecified service represents a strategic revenue dependency for the hospital.

Laboratory and diagnostic testing are another clear service-line strength. Multiple lab test codes are extreme outliers or near the top statewide — for example 81002 (31.8K claims, $63 avg paid/claim, $2M revenue) ranks #1 of 260 providers in-state (100th percentile; extreme outlier), 86900 ranks #1 of 41 (100th percentile; extreme outlier), and 87491/87591 both rank in the 99th percentile — indicating the hospital is a dominant in-state provider for a broad set of common and infectious-disease lab testing.

Statewide competitive standing is strong across many Medicaid codes: several high-volume codes place the provider at or near #1 statewide (81002, 86900, 86850, 86901 are listed as 100th percentile or #1 for their code) and other key codes rank consistently in the high percentiles (for example 99285 ranks #23 of 596, 96th percentile). Taken together, these rank patterns characterize the hospital as a major in-state Medicaid provider across ED, outpatient clinic, and diagnostic/lab services.

Several codes are explicitly described as having only typical or unremarkable volumes despite high absolute claim counts — for example G0463 is 102.3K claims but is labeled typical/unremarkable and ranks #7 of 96 (94th percentile), and X4003 and X4006 are described as typical, unremarkable volumes at their respective percentiles. This suggests that, for some high-frequency outpatient services, the provider’s activity level is in line with other large hospitals in the state rather than uniquely concentrated.

The provider has long tenure in the NPI system, enumerated on 2006-07-19 (~20 years ago), which combined with its high-ranking code volumes implies an established role in regional Medicaid care delivery. Analysts should treat this as a mature facility with entrenched service lines where shifts in Medicaid policy or network contracts could materially affect a concentrated portion of its revenue base.

Medicaid: Complete Services Breakdown

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

245 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
X4011	N/A	28,130	$480	$13.4M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	102,270	$80	$7.7M
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.	17,310	$330	$5.7M
X4003	N/A	47,480	$60	$2.8M
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.	15,590	$150	$2.4M
81002	The lab analyst inserts a dip stick into a freshly collected urine specimen, removes the dip stick, and shakes off the excess urine. Alternatively, the analyst may place drops of the urine specimen…	31,830	$60	$2M
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…	73,410	$20	$1.8M
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.	7,000	$200	$1.4M
X4006	N/A	1,370	$860	$1.2M
93005	The provider records the electrical conduction of the heart to examine any abnormality in its functioning, based on signals from at least 12 leads, wires that connect the recording device to…	16,920	$50	$913.8K

Showing 1–10 of 245

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Missouri Distribution

Barnes Jewish Hospital — 16 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Missouri

Full comparison — all codes billed, vs. Missouri median

245 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
X4011	N/A	10	110	5,700	$340	$3.2M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	7	100	2,240	$80	$2.2M
Y7506	N/A	46	100	980	$250	$1.6M
X4003	N/A	7	70	1,480	$80	$1.1M
X4006	N/A	12	50	370	$780	$969.5K
Y7507	N/A	15	50	270	$360	$594.9K
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	25	90	1,850	$120	$384.1K
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.	23	600	140	$170	$384.1K
93005	The provider records the electrical conduction of the heart to examine any abnormality in its functioning, based on signals from at least 12 leads, wires that connect the recording device to…	7	110	2,100	$70	$364.3K
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.	11	240	1,740	$40	$353.4K

Showing 1–10 of 245

Nearby Providers

Other providers in the same ZIP code as Barnes Jewish Hospital, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Council For Extended Care	MO	Intellectual and/or Developmental Disabilities Residential Treatment Facility	$0	$98.1M
St. Louis Children's Hospital	MO	Children's Hospital	$0	$66.9M
Paraquad Inc	MO	Customized Equipment (DME)	$0	$56.3M
Washington University	MO	Multi-Specialty Clinic/Center	$0	$22M
Cooperative Home Care, Inc.	MO	Home Health Agency	$0	$20.6M
Washington University	MO	Multi-Specialty Clinic/Center	$0	$14.8M
New Beginnings In Home Services, LLC	MO	In Home Supportive Care Agency	$0	$11.6M
Washington University	MO	Multi-Specialty Clinic/Center	$0	$10.4M
Washington University	MO	Emergency Care Clinic/Center	$0	$9.1M
Bjc Home Care Services	MO	Durable Medical Equipment & Medical Supplies	$0	$8.2M

Barnes Jewish Hospital — Billing Profile & Reimbursement Data

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Barnes Jewish Hospital — 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

Nearby Providers

Frequently Asked Questions

References