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

Why is the Medicaid comparison limited to South Carolina 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. South Carolina (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.

Medical University Hospital Authority (NPI 1659435840)

Field	Value
Entity Type	Organization
Organization	Medical University Hospital Authority
Address	169 Ashley Ave
City	Charleston
State	SC
ZIP	29425
Taxonomy	General Acute Care Hospital
NPI Enumerated	December 21, 2006

Payer Source	Total Paid
Medicaid	$241.1M
Medicare	$0

Key Findings

MEDICAL UNIVERSITY HOSPITAL AUTHORITY is effectively a single-payer operation in the available data: there is no Medicare billing on file while Medicaid revenue totals $241.1M, which concentrates the observable payer mix entirely in Medicaid and limits comparisons to national Medicare peers. This absence of Medicare activity should be considered when benchmarking revenue or service mix against national acute-care hospitals that bill Medicare.

Revenue concentration is high: the precomputed top 3 Medicaid codes by revenue account for 35.4% of this provider's total Medicaid revenue, indicating a heavy dependence on a small set of high-volume outpatient and lab E/M services to drive Medicaid receipts. In particular, 99212 alone generates $17.5M (12.5% of Medicaid revenue), demonstrating that low-complexity outpatient visits are a major revenue driver.

The code mix indicates a broad hospital-based outpatient and diagnostic footprint: dominant codes include outpatient evaluation-and-management visits (99212, 99211), high-volume laboratory panels (80053, 80048, 80053 - CMP), routine phlebotomy (36415), and high-throughput infectious disease testing (U0003, 87491, 87637). This combination points to integrated ambulatory clinics plus large on-site lab capabilities rather than a narrow specialty clinic.

The provider is a statewide market leader across many Medicaid codes: numerous top codes rank at #1 in-state and are labeled "extreme outlier" or similarly, including 99212 (rank #1 of 607 providers, 100th percentile), 80053 (rank #1 of 212, 100th percentile), 99211 (rank #1 of 267, 100th percentile), and 36415 (rank #1 of 713, 100th percentile). These rankings indicate the hospital is a dominant provider of routine outpatient visits, blood draws, and basic labs within South Carolina.

Imaging and procedure-related revenue streams are meaningful and include high-cost contrast and radiotracer items: Q9967 accounts for $9.5M (6.8% of Medicaid revenue), A9585 $4.9M (3.5%), A9575 $4M (2.8%), and advanced imaging CPTs such as 70553 and 70551 each contribute multi-million dollar amounts. The presence of these codes with top in-state ranks suggests substantial MRI and contrast-based imaging capacity that complements outpatient clinic throughput.

Infusion, injection, and infusion-sequence codes are also material—96372 ($6.8M, 4.9%), 96365 ($2.6M, 1.8%), and 96375 ($2.5M, 1.8%)—supporting the interpretation of significant ambulatory infusion or procedure clinics (e.g., therapy administration, IV infusions) operating alongside diagnostic services. Several of these codes rank at or near the top statewide, reinforcing that the provider is a major venue for these services in Medicaid.

Clinical laboratory testing and pathology are high-volume contributors: comprehensive panels (80053), CMP/BMP variants (80048), blood bank screening (86850), surgical pathology (88305), and high-throughput infectious testing (U0003, 87491, 87637) together form a large, diversified lab revenue stream. Many of these codes are labeled "extreme outlier" or rank in the 98–100th percentiles in-state, indicating unusually large testing volume relative to peers and likely significant in-house lab infrastructure.

The provider has long tenure in the NPI registry, enumerated 2006-12-21 (~20 years ago), which together with the large Medicaid footprint and multiple top in-state ranks suggests an established health system role in South Carolina for ambulatory, diagnostic, imaging, and infusion services. Analysts should note the combination of longevity and concentrated Medicaid revenue when assessing market strategy or capacity for payer negotiations.

Medicaid: Complete Services Breakdown

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

1019 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	372,200	$50	$17.5M
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.	169,780	$100	$16.5M
99211	An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.	233,260	$70	$15.4M
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	246,760	$50	$13.1M
Q9967	Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml	52,590	$180	$9.5M
96372	A therapeutic, prophylactic, or diagnostic substance (a fluid, a drug, etc.) is injected via intramuscular or subcutaneous route into the patient's body. The procedure is performed by the physician…	31,100	$220	$6.8M
80048	The lab analyst performs a basic metabolic pane (BMP) test in which he measures the blood level of eight chemicals including total calcium, sodium, potassium, chloride, carbon dioxide, glucose, blood…	75,210	$70	$5M
A9585	Injection, gadobutrol, 0.1 ml	5,960	$820	$4.9M
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…	34,520	$130	$4.4M
87491	The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique.	52,140	$80	$4.2M

Showing 1–10 of 1019

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. South Carolina Distribution

Medical University Hospital Authority — 25 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — South Carolina

Full comparison — all codes billed, vs. South Carolina median

1019 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J2323	Injection, natalizumab, 1 mg	2	10	1,350	$2,790	$3.8M
J1745	Injection, infliximab, excludes biosimilar, 10 mg	2	10	810	$1,040	$1.7M
81229	The lab analyst performs the technical lab test using comparative genomic hybridization (CGH) microarray, also referred to as chromosomal microarray (CMA) or molecular karyotype performed by…	2	10	1,070	$880	$1.4M
J9312	Injection, rituximab, 10 mg	2	10	310	$4,370	$1.4M
J0178	Injection, aflibercept, 1 mg	5	10	110	$990	$881.7K
A9552	Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries	1	20	350	$1,170	$776.4K
J1569	Injection, immune globulin, (gammagard liquid), non-lyophilized, (e.g., liquid), 500 mg	3	10	250	$1,580	$769.5K
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…	40	340	2,970	$80	$711.1K
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.	1	210	1,470	$60	$615K
J0475	Injection, baclofen, 10 mg	2	10	1,220	$540	$596.8K

Showing 1–10 of 1019

Related Providers

Other providers that share a Tax Identification Number (TIN) with Medical University Hospital Authority, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
University Medical Associates Of The Medical University Of South Carol	SC	Family Medicine Physician	$0	$56.6M
Medical University Hospital Authority	SC	Psychologist	$0	$32.6M
Medical University Hospital Authority	SC	General Acute Care Hospital	$0	$28.3M
Providence Hospital, LLC	SC	General Acute Care Hospital	$0	$12.7M
Medical University Hospital Authority	SC	Pediatrics Physician	$0	$12.4M
Medical University Hospital Authority	SC	General Acute Care Hospital	$0	$12.1M
Medical University Hospital Authority	SC	General Acute Care Hospital	$0	$8.7M
Medical University Hospital Authority	SC	General Acute Care Hospital	$0	$8.5M
Kershaw Hospital LLC	SC	General Acute Care Hospital	$0	$8M
Medical University Hospital Authority	SC	General Acute Care Hospital	$0	$7M

Nearby Providers

Other providers in the same ZIP code as Medical University Hospital Authority, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Musc Affiliate Physicians	SC	Family Medicine Physician	$0	$14.7M
University Medical Associates	SC	Pediatrics Physician	$0	$9.2M
University Medical Associates Of The Medical University Of South Carol	SC	Obstetrics & Gynecology Physician	$0	$6.1M
University Medical Associates Of The Medical University Of South Carol	SC	Diagnostic Radiology Physician	$0	$5.4M
University Medical Associates Of The Medical University Of South Carol	SC	Emergency Medicine Physician	$0	$3.6M
University Medical Associates Of The Medical University Of South Carol	SC	Pediatrics Physician	$0	$3.5M
University Medical Associates Of The Medical University Of South Carol	SC	Psychiatry Physician	$0	$3.3M
Rosalee Unwin	SC	Family Nurse Practitioner	$2.9M	$0
Jennifer Douglas	SC	Physician Assistant	$2.9M	$0
University Medical Associates Of The Medical University Of South Carol	SC	Multi-Specialty Clinic/Center	$0	$2.8M

Medical University Hospital Authority — 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