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

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

The Cleveland Clinic Foundation (NPI 1679525919)

Field	Value
Entity Type	Organization
Organization	The Cleveland Clinic Foundation
Address	9500 Euclid Ave
City	Cleveland
State	OH
ZIP	44195
Taxonomy	General Acute Care Hospital
NPI Enumerated	May 16, 2006

Payer Source	Total Paid
Medicaid	$864.1M
Medicare	$0

Key Findings

THE CLEVELAND CLINIC FOUNDATION is effectively a single-payer Medicaid hospital in these files: it has no Medicare billing on file and reports $864.1M in Medicaid revenue, indicating its observed reimbursement footprint in this dataset is dominated by Medicaid. The provider has been NPI-enumerated since 2006-05-16 (~20 years ago), confirming long tenure in the market.

Revenue concentration is highly skewed to a very small set of outpatient codes: the precomputed top 3 Medicaid codes by revenue account for 62.2% of total Medicaid revenue, signaling a narrow set of services that drive the majority of reported Medicaid dollars. This level of concentration suggests financial sensitivity to volume or rate changes for those top codes.

G0463 is the single largest Medicaid revenue source at $271.2M (47.7% of the provider’s Medicaid revenue) and ranks #1 of 151 providers in-state; this dominant share and 100th-percentile rank mark the facility as the statewide epicenter for hospital outpatient clinic assessment and management visits. The operational implication is that a very large portion of outpatient clinic workload and revenue is captured by this single clinic-visit code.

Emergency department E/M services are the other major drivers: 99285 ($45.1M, 7.9%) and 99284 ($37.3M, 6.6%) together represent substantial ED revenue and both rank #1 in-state for their code volumes, each described as an extreme outlier. This code mix—very high-volume, high-acuity ED E/M codes—indicates a heavy emergency care and acute evaluation workload contributing meaningfully to Medicaid revenue.

Beyond the top three, the provider shows programmatic breadth in both high-cost biologic/infusion drugs and diagnostics: J2350 (ocrelizumab, $34.3M) and J9271 (pembrolizumab, $14.6M) appear among top lines and rank at or near the top in-state, while high-volume services such as 96361, 96365, and major imaging and pathology codes (93306, 88305) are also prominent. This pattern suggests integrated specialty infusion, oncology, imaging, and lab services driving tertiary-care activity.

Competitive standing across many codes is extreme: numerous codes (including G0463, 99285, 99284, J2350, J0585, 93306, 81513, 76816, 96365, and others) are ranked #1 in-state and labeled as “extreme outlier” or “notably above typical,” indicating the provider is a dominant statewide hub for a wide set of Medicaid services rather than a marginal participant. Such concentration at the top of state rankings underlines market leadership in acute, outpatient, and specialty care.

The claims and unit-payment pattern show both high-volume low-unit services and low-volume high-unit-cost services coexist: large claim counts for evaluation-and-management codes (e.g., 806.6K for 99213, 619.2K for 99214) sit alongside high-dollar drug claims (e.g., $19,027 avg paid/claim for J2350 and $8,831 for J9271). Operationally, that signals scale across frontline outpatient throughput and high-cost specialty therapies, with corresponding revenue diversification by service intensity.

Preventive, maternity/fetal, and rehabilitation services are also notable contributors: codes such as 99391/99392 (preventive visits), 76816 (fetal reexam ultrasound), and 97110 (therapeutic exercise) rank at very high percentiles and together indicate the provider maintains comprehensive ambulatory services spanning preventive care, obstetrics imaging, and rehabilitation within its Medicaid population. This breadth complements the facility’s heavy outpatient clinic and ED footprint.

Medicaid: Complete Services Breakdown

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

1579 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
G0463	Hospital outpatient clinic visit for assessment and management of a patient	2,534,310	$110	$271.2M
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.	518,210	$90	$45.1M
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.	582,360	$60	$37.3M
J2350	Injection, ocrelizumab, 1 mg	1,800	$19,030	$34.3M
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…	619,200	$40	$21.7M
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…	806,650	$30	$20.2M
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.	238,830	$60	$14.6M
J9271	Injection, pembrolizumab, 1 mg	1,650	$8,830	$14.6M
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.	30,940	$370	$11.3M
J0585	Injection, onabotulinumtoxina, 1 unit	13,550	$750	$10.1M

Showing 1–10 of 1579

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Ohio Distribution

The Cleveland Clinic Foundation — 23 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Ohio

Full comparison — all codes billed, vs. Ohio median

1579 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J2350	Injection, ocrelizumab, 1 mg	1	10	310	$20,560	$10M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	1	150	4,030	$100	$5.9M
J9271	Injection, pembrolizumab, 1 mg	3	20	360	$8,480	$5M
J2323	Injection, natalizumab, 1 mg	4	10	440	$4,300	$3.2M
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.	9	170	4,660	$300	$2.6M
J9299	Injection, nivolumab, 1 mg	2	10	210	$6,940	$2.1M
J9144	Injection, daratumumab, 10 mg and hyaluronidase‑fihj	1	10	280	$5,660	$2M
81479	Use 81479 to report a molecular pathology procedure that does not have a specific code.	8	10	760	$50	$2M
Q5104	Injection, infliximab-abda, biosimilar, (renflexis), 10 mg	1	10	1,030	$1,520	$1.9M
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.	3	480	4,510	$90	$1.8M

Showing 1–10 of 1579

Related Providers

Other providers that share a Tax Identification Number (TIN) with The Cleveland Clinic Foundation, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Ohiohealth Corporation	OH	Family Medicine Physician	$0	$89.1M
Columbus Radiology Corp	OH	Diagnostic Radiology Physician	$0	$49.9M
Partners Physician Group	OH	Surgery Physician	$0	$28.5M
Quick Med Urgent Care LLC	OH	Urgent Care Clinic/Center	$0	$21.8M
Clinic Medical Services Company LLC	OH	Diagnostic Radiology Physician	$0	$10.8M
Cleveland Clinic Home Care Services	OH	Community Based Hospice Care Agency	$0	$10.8M
The Cleveland Clinic Foundation	OH	Clinical Medical Laboratory	$144K	$9M
Wooster Clinic, LLC	OH	Multi-Specialty Clinic/Center	$0	$6.9M
Community Memorial Hospital Association	MN	Critical Access Hospital	$0	$4.3M
Brittney Statler	CO	Ophthalmology Physician	$3.7M	$0

Nearby Providers

Other providers in the same ZIP code as The Cleveland Clinic Foundation, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Walter Henricks	OH	Anatomic Pathology Physician	$1.9M	$880
Yasha Modi	OH	Ophthalmology Physician	$1.4M	$279.8K
Shalini Moningi	OH	Radiation Oncology Physician	$723.2K	$0
Lawrence Tsao	OH	Hematology (Pathology) Physician	$659.9K	$0
Balasubramanya Rangaswamy	OH	Diagnostic Radiology Physician	$549.5K	$45.6K
Ananth Sastry	OH	Retina Specialist (Ophthalmology) Physician	$557.7K	$0
Alex Yuan	OH	Ophthalmology Physician	$471.3K	$0
Pamela Bryant	OH	Family Nurse Practitioner	$469.8K	$0
Shiby Paul	OH	Radiation Oncology Physician	$417.5K	$0
Jeffrey Rossi	OH	Internal Medicine Physician	$408.2K	$0

The Cleveland Clinic Foundation — 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