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

Why is the Medicaid comparison limited to New Mexico 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. New Mexico (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.

Unm Hospital (NPI 1689747552)

Field	Value
Entity Type	Organization
Organization	Unm Hospital
Address	2211 Lomas Blvd., N.e.
City	Albuquerque
State	NM
ZIP	87106
Taxonomy	General Acute Care Hospital
NPI Enumerated	November 16, 2006

Payer Source	Total Paid
Medicaid	$462.9M
Medicare	$0

Key Findings

UNM HOSPITAL is effectively a single-payer Medicaid provider in the dataset: it has no Medicare billing on file and reports Total Medicaid revenue of $462.9M. The absence of Medicare claims limits cross-payer benchmarking and means analyses of scale, utilization, and competitive positioning should be framed primarily within the Medicaid population.

Revenue is highly concentrated in a few codes: the precomputed top 3 Medicaid codes account for 49.1% of this provider's total Medicaid revenue, led by G0463 ($71.9M, 29.4%), G9001 ($31.6M, 12.9%), and 99283 ($16.6M, 6.8%). This concentration implies that a small set of service lines—outpatient clinic assessments, coordinated care fees, and low-complexity ED evaluations—drive nearly half of Medicaid revenue.

The mix of top codes indicates a combined outpatient-clinic and emergency/observation operating model: G0463 (909.9K claims, $71.9M) is the single largest revenue driver and suggests heavy throughput in hospital outpatient clinic assessment and management, while 99283 (115.1K claims, $16.6M), 99284 (49.8K claims, $8.7M), 99285 (40.5K claims, $10.5M) and G0378 (24.1K claims, $10.2M) point to substantial emergency department volume and hospital observation-hour billing. Together these codes characterize a hospital that funnels large ambulatory and ED patient flows through observation and outpatient clinic pathways.

UNM HOSPITAL is a dominant statewide player for multiple high-revenue codes: it ranks #1 of 38 providers for G0463 (100th percentile; extreme outlier), #1 of 18 for G9001 (100th percentile; extreme outlier), #1 of 23 for G0439 (100th percentile; extreme outlier), and #1 of 35 for G0378 (100th percentile; extreme outlier). Several additional codes are extreme outliers or in very high percentiles (for example, 99283 at 98th percentile and 80048 at 98th percentile), supporting the characterization of UNM HOSPITAL as a statewide leader for both high-volume ambulatory services and ancillary diagnostic services.

Claims and unit-payment patterns indicate significant specialty and high-cost services alongside high-volume basic care: 95004 yields $12.1M with an average paid/claim of $4256 (2.8K claims), and high-cost drugs such as J1745 ($6.4M), J9271 ($6.4M), and J9312 ($3.9M) appear in the top-tier revenue list. These entries reflect on-site capability for specialized testing and infusion/biologic administration in addition to broad ambulatory and emergency operations.

High diagnostic and lab throughput supports the care-volume profile suggested by ED and outpatient codes: 80048 appears with 229.6K claims for $3.4M (rank #2 of 50, 98th percentile) and 80307 shows 75.7K claims for $3M (rank #1 of 77, 100th percentile), while imaging codes such as 74177 ($5.8M) and 70450 ($5.2M) are also high on the revenue list. This pattern is consistent with a high-throughput hospital that captures a large share of routine labs, drug screens, and imaging for Medicaid patients.

UNM HOSPITAL also shows notable non-routine transport and regional referral activity: air-transport codes A0430 ($6.5M) and A0435 ($5M) rank #2 of 12 providers in-state (91st percentile) and indicate meaningful fixed-wing transport billing. These line items, combined with high volumes in specialty infusions and advanced imaging, support a profile of a regional referral center handling both routine and complex Medicaid cases.

The provider’s operational tenure is long-standing: NPI enumerated (registered) 2006-11-16 (~20 years ago), and the scale of reported Medicaid revenue ($462.9M) together portray a large, established hospital with entrenched Medicaid-facing service lines. Analysts should interpret utilization and competitive dynamics in the context of a long-running, Medicaid-centric institution that is a statewide outlier on multiple high-revenue codes.

Medicaid: Complete Services Breakdown

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

1105 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
G0463	Hospital outpatient clinic visit for assessment and management of a patient	909,870	$80	$71.9M
G9001	Coordinated care fee, initial rate	91,580	$350	$31.6M
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.	115,120	$140	$16.6M
95004	The provider performs a percutaneous test with allergenic extracts to determine which substances (allergens) trigger an allergic reaction in the patient.	2,840	$4,260	$12.1M
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.	40,550	$260	$10.5M
G0439	Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	91,150	$120	$10.5M
G0378	Hospital observation service, per hour	24,140	$420	$10.2M
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.	49,770	$180	$8.7M
A0430	Ambulance service, conventional air services, transport, one way (fixed wing)	3,240	$2,010	$6.5M
J1745	Injection, infliximab, excludes biosimilar, 10 mg	2,080	$3,090	$6.4M

Showing 1–10 of 1105

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. New Mexico Distribution

Unm Hospital — 14 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — New Mexico

Full comparison — all codes billed, vs. New Mexico median

1105 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H0020	Alcohol and/or drug services; methadone administration and/or service (provision of the drug by a licensed program)	16	20	290,440	$20	$12.3M
A0430	Ambulance service, conventional air services, transport, one way (fixed wing)	2	10	2,080	$2,410	$5.2M
H2033	Multisystemic therapy for juveniles, per 15 minutes	2	10	4,640	$370	$4.3M
A0435	Fixed wing air mileage, per statute mile	2	10	2,070	$1,980	$4.2M
G9001	Coordinated care fee, initial rate	1	20	730	$320	$4M
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.	9	80	12,050	$160	$3.9M
J9312	Injection, rituximab, 10 mg	1	10	780	$4,980	$3.9M
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.	6	70	6,920	$210	$3.5M
J9271	Injection, pembrolizumab, 1 mg	1	10	420	$7,810	$3.2M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	1	40	3,670	$80	$3.2M

Showing 1–10 of 1105

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Unm Medical Group Inc	NM	Multi-Specialty Clinic/Center	$0	$113.5M
Unm Sandoval Regional Medical Center, Inc	NM	General Acute Care Hospital	$0	$27.4M
Unm Hospital	NM	Psychiatric Hospital Unit	$228.5K	$17.6M
Shoshone-paiute Tribes	NV	Clinic/Center	$0	$16.9M
University Of New Mexico Dental Services	NM	General Practice Dentistry	$0	$3.3M
Medical Foundation, Inc.	MS	Geriatric Medicine (Family Medicine) Physician	$0	$1.8M
Cecilia Arana Yi	AZ	Hematology & Oncology Physician	$1.8M	$0
Mehraboon Irani	IL	Blood Banking & Transfusion Medicine Physician	$4.6K	$677.4K
Anthony Martinez	FL	Anatomic Pathology & Clinical Pathology Physician	$511.5K	$0
Daniel Davis	NM	MOHS-Micrographic Surgery Physician	$506.2K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Presbyterian Healthcare Services	NM	General Acute Care Hospital	$0	$345.3M
Dungarvin New Mexico LLC	NM	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$84.6M
Perinatal Associates Of New Mexico, Ltd	NM	Maternal & Fetal Medicine Physician	$0	$62.6M
Optumcare New Mexico LLC	NM	Family Medicine Physician	$0	$23.6M
Family Eye Care/children's Eye Center Of New Mexico, P.C.	NM	Ophthalmology Physician	$0	$13.3M
Pediatrix Medical Group Of New Mexico, P.C.	NM	Neonatal-Perinatal Medicine Physician	$0	$11.9M
Guardian Flight LLC	NM	Air Ambulance	$372.6K	$6.9M
Climbing Tree Therapy, Inc.	NM	Occupational Therapist	$0	$6.6M
Albuquerque Indian Health Center	NM	Clinic/Center	$0	$6.6M
Presbyterian Hospital Asc	NM	Ambulatory Surgical Clinic/Center	$38.2K	$6.2M

Unm Hospital — Billing Profile & Reimbursement Data

Sign up for Unm Hospital — Billing Profile & Reimbursement Data policy alerts

Unm Hospital — Billing Profile & Reimbursement Data

Sign up for Unm Hospital — Billing Profile & Reimbursement Data policy alerts

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