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

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

Baptist Healthcare System Inc (NPI 1689282147)

Key Findings

Field	Value
Entity Type	Organization
Organization	Baptist Healthcare System Inc
Address	913 N Dixie Ave
City	Elizabethtown
State	KY
ZIP	42701
Taxonomy	General Acute Care Hospital
NPI Enumerated	July 21, 2020

Payer Source	Total Paid
Medicaid	$95.7M
Medicare	$0

This provider is effectively single‑payer in scope for federal programs: there is no Medicare billing on file and total Medicaid revenue is $95.7M, so Medicaid is the sole source of reported federal program revenue for this entity. The provider’s NPI was enumerated on 2020-07-21 (~6 years ago), indicating a relatively recent enrollment window for federal billing activity.

Revenue is highly concentrated in a small set of Medicaid services: the top three Medicaid codes account for 44.9% of the provider’s total Medicaid revenue, led by 99283 ($12.1M, 21.2%), followed by 74177 ($7.5M, 13.0%) and 99284 ($6.1M, 10.7%). This concentration signals that a handful of high-volume ED and advanced imaging services drive nearly half of reported Medicaid receipts.

The code mix indicates an operational profile centered on emergency care and high diagnostic imaging throughput. High claim volumes for ED evaluation-and-management codes (99283: 51.6K claims; 99284: 21.5K claims; 99285: 8.9K claims) alongside large CT and MRI volumes (74177: 11.8K claims; 70450: 7.5K claims; 71260: 3.7K claims; 70553: 2.2K claims) are consistent with a general acute care hospital that triages and images substantial ED and acute inpatients.

Competitive standing across in-state peers is mixed by service line: 99283 ranks #17 of 284 providers in-state (94th percentile) but is labeled in the dataset as "typical, unremarkable volume," while 99284 ranks #71 of 282 (75th percentile) and 99285 ranks #83 of 239 (66th percentile), all described as typical volumes. At the same time, the provider posts notably above-typical state volumes in several procedural and support areas—for example, 80053 (CMP) ranks #12 of 195 (94th percentile, noted as "notably above typical state volume"), 45385 (colon polypectomy) ranks #5 of 105 (96th percentile, "notably above typical state volume"), 45378 ranks #5 of 89 (95th percentile, "notably above typical state volume"), and 96372 ranks #24 of 865 (97th percentile, "notably above typical state volume").

The provider shows substantial infusion and medication-administration activity consistent with inpatient/ED therapeutics and outpatient infusion services: 96374 has 38.2K claims ($1.5M), 96375 has 20.2K claims ($1.4M), 96365 has 11.6K claims ($1.4M), and 96413 chemotherapy appears with $1.2M revenue (2.1%) and 2.6K claims. These volumes point to a meaningful throughput for IV pushes, infusions, and some oncology treatments as part of the facility’s service mix.

Gastrointestinal and procedural care are notable strengths: upper endoscopy with biopsy (43239: 4.2K claims, $1.9M) and colon procedures (45385 and 45378 together produce multiple high-percentile ranks and nearly $2.0M combined) indicate a strong procedural endoscopy footprint, which along with a high CMP volume (80053: 121.8K claims, $1.2M) supports substantial peri-procedural and inpatient lab activity. Analysts should view GI/endoscopy and routine lab testing as complementary high-intensity services supporting the hospital’s core acute-care throughput.

There are signs of specialized surgical and ancillary billing lines beyond ED and imaging: C1713 anchor/screw (1.1K claims, $1.3M) signals implantable-device orthopedics, and code 41899 (dental/adjacent alveolar procedures) generated $1.3M but ranks in a lower in-state position (37th percentile, labeled typical). These entries suggest a mix of operative and ancillary services contributing nontrivial Medicaid revenue outside pure ED/imaging flows.

For payers and provider-performance analysts, the lack of Medicare activity constrains national benchmarking and shifts comparative focus to in-state Medicaid peers and service-line detail. Given the heavy revenue weight in three codes (44.9%) and above-typical volumes in endoscopy, lab (CMP), and procedural injection codes, risk‑adjusted rate-setting or utilization management efforts should prioritize ED utilization patterns, diagnostic imaging protocols, and endoscopy/infusion pathways when assessing cost and capacity drivers.

Medicaid: Complete Services Breakdown

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

539 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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.	51,620	$240	$12.1M
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.	11,750	$630	$7.5M
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.	21,480	$290	$6.1M
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.	8,860	$360	$3.2M
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.	7,460	$290	$2.2M
74176	The provider performs computed tomography of the abdomen and pelvis without contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	3,530	$550	$2M
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.	4,170	$460	$1.9M
78452	In this procedure, the provider performs multiple SPECT studies of the heart to determine the areas of deficient blood flow. The goal of the procedure is to determine areas that have deficient blood…	3,420	$540	$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.	11,340	$140	$1.6M
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	38,220	$40	$1.5M

Showing 1–10 of 539

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Kentucky Distribution

Baptist Healthcare System Inc — 3 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Kentucky

Full comparison — all codes billed, vs. Kentucky median

539 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
97535	A healthcare provider is required to give proper instruction to a person especially in cases of recovery from acute disease.	123	310	830	$120	$3.7M
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.	71	280	7,150	$150	$3M
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.	83	240	4,710	$150	$2.6M
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.	17	280	5,700	$120	$2M
41899	Use this code to report a procedure on the teeth and adjoining alveolar structures for which there is no specific code available.	27	40	740	$1,170	$1.7M
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.	22	180	1,870	$280	$1.5M
G0378	Hospital observation service, per hour	55	90	2,770	$190	$1.3M
0202U	This is a Proprietary Laboratory Analyses (PLA) code, meaning that the code applies to only one unique lab test made by a specific manufacturer or performed by a specific lab. Report 0202U for the…	24	30	2,320	$290	$1.2M
C1776	Joint device (implantable)	12	20	130	$2,890	$1.1M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	20	80	7,740	$30	$1.1M

Showing 1–10 of 539

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Communicare Inc	KY	Community/Behavioral Health Agency	$0	$205.5M
Stepworks Recovery Centers LLC	KY	Substance Use Disorder Rehabilitation Clinic/Center	$0	$67.7M
Communicare Inc	KY	Community/Behavioral Health Agency	$0	$49.5M
Pinnacle Treatment Centers Ky-1, LLC	KY	Substance Abuse Rehabilitation Facility	$0	$33.6M
Lincoln Trail Area Development District	KY	Supports Brokerage Agency	$0	$31.4M
Astra Behavioral Health LLC	KY	Psychiatry Physician	$0	$26.1M
Renest Recovery Support Services	KY	Community/Behavioral Health Agency	$0	$19.9M
Baptist Health Medical Group Inc	KY	Internal Medicine Physician	$0	$13.7M
Elizabethtown Emergency Physicians, LLC	KY	Emergency Medicine Physician	$0	$11.9M
Recovery Center Of Kentucky, LLC	KY	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$8.6M

Baptist Healthcare System Inc — 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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Baptist Healthcare System, Inc	KY	General Acute Care Hospital	$0	$121.5M
Baptist Healthcare System, Inc	KY	General Acute Care Hospital	$0	$98.1M
Baptist Healthcare System, Inc	KY	General Acute Care Hospital	$0	$72.6M
Baptist Healthcare System Inc.	KY	General Acute Care Hospital	$0	$62.4M
Baptist Healthcare System, Inc.	KY	General Acute Care Hospital	$0	$58.5M
Hardin Memorial Hospital	KY	General Acute Care Hospital	$0	$37.2M
Baptist Healthcare System, Inc.	IN	General Acute Care Hospital	$0	$34.6M
Baptist Healthcare System, Inc.	KY	General Acute Care Hospital	$0	$16.1M
Baptist Healthcare System, Inc.	KY	Ambulatory Surgical Clinic/Center	$1.2M	$183.5K
Baptist Healthcare System Inc	KY	Land Ambulance	$424.7K	$47.4K