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

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

Tufts Medical Center, Inc. (NPI 1730132515)

Field	Value
Entity Type	Organization
Organization	Tufts Medical Center, Inc.
Address	800 Washington St
City	Boston
State	MA
ZIP	02111
Taxonomy	General Acute Care Hospital
NPI Enumerated	May 19, 2006

Payer Source	Total Paid
Medicaid	$164.6M
Medicare	$0

Key Findings

TUFTS MEDICAL CENTER, INC. reports no Medicare billing on file and $164.6M in lifetime Medicaid revenue, making Medicaid effectively the sole payer represented in the available claims data. This single-payer footprint means analyses of utilization and revenue exposure should focus on Medicaid payment policy and state-level market dynamics rather than Medicare trends.

Revenue is highly concentrated in a small set of outpatient E/M and emergency visit codes: the precomputed top 3 Medicaid codes by revenue account for 38.1% of the provider's total Medicaid revenue. Those top revenue drivers are 99214 ($17.8M, 16.5%), 99213 ($15.8M, 14.6%), and 99283 ($7.6M, 7.1%), indicating that outpatient office visits and ED evaluation-and-management encounters are the primary sources of Medicaid dollars.

The code mix and volumes point to a large hospital-based ambulatory platform and high ED throughput: G0463 (208.8K claims, $6.5M, 6.0%) ranks #8 of 106 providers in-state (93th percentile; notably above typical state volume) and observation/ED codes such as G0378 (26K claims, $2.9M) and 99283/99284/99285 all appear among the top revenue codes. This pattern suggests the provider operates substantial hospital outpatient clinic capacity alongside a busy emergency department and observation services.

TUFTS is a statewide leader for routine office evaluation-and-management volume: 99214 (125.1K claims, $17.8M) and 99213 (120.3K claims, $15.8M) both rank #22 in the state and are labeled 100th percentile, extreme outlier, far above typical state volume for these codes. Several other outpatient visit codes (99215, 99212, 99204, 99203) also rank in very high percentiles, reinforcing the center's dominant position in ambulatory visit volume within Massachusetts.

Emergency department acuity distribution is broad but above typical volumes: 99283 (49.4K claims, $7.6M) ranks #30 of 547 providers (95th percentile; notably above typical), while higher-acuity ED codes like 99285 (27.3K claims, $4.6M) and 99284 (34.4K claims, $5.3M) fall in the 91th and 94th percentile ranges respectively. These placements indicate consistently elevated ED activity across low-to-high acuity encounters compared with in-state peers.

Specialty procedural services also contribute meaningfully to Medicaid revenue: GI procedures 43239 ($3.4M) and 45380 ($3.3M) rank in the 93th and 94th percentiles, MRI brain 70553 ($1.4M) and echo 93306 ($1.4M) are in high percentiles, and oncology/infusion codes 96413 and 96365/96361 together represent a meaningful infusion/chemotherapy footprint. Collectively these codes support an interpretation of a multi-specialty, hospital-based service line mix that extends beyond basic ED/clinic care into endoscopy, imaging, and oncology infusion.

Operationally, the provider shows heavy reliance on relatively few high-volume codes and a single payer stream: the top 3 Medicaid codes account for 38.1% of Medicaid revenue and total Medicare revenue is recorded as none. That concentration means changes to state Medicaid reimbursement, coverage, or referral patterns for these E/M and ED services could disproportionately affect this provider's Medicaid revenue base.

The organization has an NPI enumeration date of 2006-05-19 (~20 years ago), indicating long-tenured enrollment in payer systems. Combined with the statewide dominance on multiple visit codes, this tenure supports a mature operational footprint and established referral/volume patterns within Massachusetts Medicaid networks.

Medicaid: Complete Services Breakdown

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

731 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	125,090	$140	$17.8M
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…	120,350	$130	$15.8M
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.	49,440	$150	$7.6M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	208,790	$30	$6.5M
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	37,880	$150	$5.5M
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.	34,390	$150	$5.3M
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.	13,140	$390	$5.1M
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.	27,290	$170	$4.6M
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,…	33,490	$140	$4.6M
96365	The provider administers the initial intravenous infusion of a medication or other substance for a period up to one hour to prevent, treat, or diagnose a condition or disease.	16,530	$230	$3.9M

Showing 1–10 of 731

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Massachusetts Distribution

Tufts Medical Center, Inc. — 9 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Massachusetts

Full comparison — all codes billed, vs. Massachusetts median

731 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J9271	Injection, pembrolizumab, 1 mg	8	10	210	$5,200	$5.5M
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.	32	90	7,560	$350	$4.2M
J2506	Injection, pegfilgrastim, excludes biosimilar, 0.5 mg	5	10	590	$1,880	$2.8M
J1745	Injection, infliximab, excludes biosimilar, 10 mg	11	10	1,380	$1,380	$2.7M
Q5103	Injection, infliximab-dyyb, biosimilar, (inflectra), 10 mg	7	10	1,200	$1,560	$2.1M
J2505	Injection, pegfilgrastim, 6 mg	6	10	650	$1,880	$1.8M
96413	Chemotherapy is a therapeutic procedure used for the treatment of cancer via the use of chemical agents. These chemical agents (drugs) work on the cancerous cells of the body to destroy them. These…	7	50	1,870	$210	$1.4M
G0378	Hospital observation service, per hour	13	70	7,250	$100	$1.3M
J1569	Injection, immune globulin, (gammagard liquid), non-lyophilized, (e.g., liquid), 500 mg	6	10	550	$1,240	$1.2M
96365	The provider administers the initial intravenous infusion of a medication or other substance for a period up to one hour to prevent, treat, or diagnose a condition or disease.	15	80	4,380	$140	$1.1M

Showing 1–10 of 731

Related Providers

Other providers that share a Tax Identification Number (TIN) with Tufts Medical Center, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Andre Witkin	MA	Retina Specialist (Ophthalmology) Physician	$2.9M	$0
Anthony Joseph	AZ	Retina Specialist (Ophthalmology) Physician	$2.2M	$0
Michelle Liang	MA	Ophthalmology Physician	$2.1M	$0
Shilpa Desai	MA	Ophthalmology Physician	$1.6M	$0
Jeffrey Sobell	MA	Dermatology Physician	$1.3M	$0
Christopher Robinson	MA	Ophthalmology Physician	$1M	$0
Zachary Bohart	MA	Physical Medicine & Rehabilitation Physician	$645.1K	$5.9K
Linda Specht	NH	Neurology with Special Qualifications in Child Neurology Physician	$0	$578.1K
Daniel Finn	MA	MOHS-Micrographic Surgery Physician	$566.6K	$0
Mohamad El-zaru	MA	Cardiovascular Disease Physician	$543.5K	$0

Nearby Providers

Other providers in the same ZIP code as Tufts Medical Center, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Boston Senior Home Care	MA	Case Management Agency	$0	$118.8M
Boston Senior Home Care	MA	Case Management Agency	$0	$38.9M
South Cove Community Health Center, Inc.	MA	Federally Qualified Health Center (FQHC)	$0	$20.5M
Trustees Of Tufts College	MA	Dental Clinic/Center	$0	$18.2M
Pratt Pediatric Associates Inc	MA	Pediatrics Physician	$0	$7.7M
Boston Center For Independent Living, Inc.	MA	Personal Care Attendant	$0	$7.2M
Tufts Medical Center Ep LLC	MA	Emergency Medicine Physician	$0	$6.6M
Minping Liu	MA	Internal Medicine Physician	$14.7K	$6.6M
Pet-ct Services By Tufts Medical Center And Shields LLC	MA	Mobile Radiology Clinic/Center	$779.1K	$1.2M
Dennis Lee	MA	Dermatology Physician	$1.1M	$0

Tufts Medical Center, 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