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    OpenPayerNPI Medicare & MedicaidBaptist Healthcare System, Inc
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    Baptist Healthcare System, Inc — Billing Profile & Reimbursement Data

    NPI 1730264128 · Paducah, KY · General Acute Care Hospital

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    Baptist Healthcare System, Inc is a general acute care hospital provider located in Paducah, Kentucky. This profile covers 0 Medicare and 426 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

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    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeOrganization
    OrganizationBaptist Healthcare System, Inc
    Address2501 Kentucky Ave
    CityPaducah
    StateKY
    ZIP42003
    TaxonomyGeneral Acute Care Hospital
    NPI EnumeratedOctober 26, 2006

    Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)

    Payer SourceTotal Paid
    Medicaid$72.6M
    Medicare$0

    Key Findings

    This provider is effectively single-payer in our dataset: there is no Medicare billing on file and all reported lifetime revenue is Medicaid-based, totaling $72.6M. The absence of Medicare claims on file suggests Medicaid is the dominant payer relationship reflected in public billing records for this entity, rather than a mixed Medicare/Medicaid profile.

    Revenue concentration is high: the top three Medicaid codes (99283, 99284, 74177) together account for 38.3% of the provider's total Medicaid revenue. Those individual contributions are 99283: $7.4M (16.7%), 99284: $5.6M (12.6%), and 74177: $4M (9.0%), indicating a concentrated revenue base driven by emergency evaluation/management and CT imaging.

    The code mix points to a high-volume emergency and acute-care operation. Emergency E/M codes 99283 (50K claims, $148 avg paid/claim, $7.4M) and 99284 (25.1K claims, $222 avg paid/claim, $5.6M), supported by observation services G0378 (5.8K claims, $1.6M) and infusion codes such as 96365 (12.3K claims, $1.1M), indicate substantial ED throughput with on-site capabilities for extended observation and IV therapy.

    Imaging and in-house diagnostics are an important service line: CT abdomen/pelvis with contrast 74177 appears as a top revenue driver (11.3K claims, $353 avg paid/claim, $4M) and CT head 70450 (9.4K claims, $169 avg paid/claim, $1.6M) plus CTA 71275 (4K claims, $861K) and MRI 70553 (2.5K claims, $720.6K) show a robust radiology volume. Proprietary lab testing (0202U: 8.6K claims, $2.3M) and high-volume COVID testing (U0004: 14.5K claims, $911.5K) further demonstrate substantial on-site diagnostic services.

    Competitive standing within the state is mixed but leans toward above-typical presence for several acute-care codes: 99283 ranks #18 of 284 providers in-state (94th percentile), 74177 ranks #24 of 177 (87th percentile), and 0202U ranks #5 of 27 (85th percentile). Conversely, the highest-acuity ED code 99285 ranks #98 of 239 (59th percentile), indicating the hospital handles many moderate-to-low acuity ED visits at above-typical volumes but is only a mid-level participant for the most complex ED encounters.

    There are clear statistical outliers in the provider's Medicaid mix. 11042 (debridement) is an extreme outlier and ranks #2 of 108 providers in-state (99th percentile) with $1.1M revenue, and 96372 (therapeutic/prophylactic injections) is also labeled an extreme outlier, ranking #15 of 865 providers in-state (98th percentile) with $825.3K revenue. These outlier positions indicate the provider delivers substantially more of these specific services than typical state peers.

    The facility also reports notable procedural and surgical implant activity beyond ED and imaging lines: C1713 (anchor/screw implantable) generated $3.1M (1.6K claims) and 41899 (unlisted dental procedure) generated $2.8M (2.5K claims), together representing meaningful shares of Medicaid revenue and suggesting operating room and dental/oral surgery capacity. Those procedure-level revenues (C1713 at 6.9% and 41899 at 6.2% of Medicaid revenue) point to a diversified acute-care surgical mix rather than purely observational or outpatient-only activity.

    The NPI tenure is long-standing: the provider was enumerated on 2006-10-26 (~20 years ago), indicating an established presence in the market. Combined with the concentrated Medicaid revenue ($72.6M) and the code mix above, the longevity supports an interpretation of a mature acute-care hospital with significant Medicaid-dependent volume and limited or no Medicare billing reported in these records.

    Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

    Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.

    View: By Year1 / 3

    Medicaid: Complete Services Breakdown

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

    426 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    99283The 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.50,040$150$7.4M
    99284The 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.25,100$220$5.6M
    74177The 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.11,320$350$4M
    C1713Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable)1,590$1,940$3.1M
    41899Use this code to report a procedure on the teeth and adjoining alveolar structures for which there is no specific code available.2,480$1,120$2.8M
    0202UThis 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…8,550$270$2.3M
    99285The 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.7,060$290$2M
    G0378Hospital observation service, per hour5,790$280$1.6M
    70450The 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.9,360$170$1.6M
    93306The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent…3,940$360$1.4M

    Showing 1–10 of 426

    • More pages

    Medicaid: Competitive Analysis & Benchmarks

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

    Full comparison — all codes billed, vs. Kentucky median

    426 rows

    CPT/HCPCS CodeDescriptionRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    97535A healthcare provider is required to give  proper instruction to a person especially in cases of recovery from acute disease.244310830$120$3.7M
    99284The 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.532807,150$150$3M
    99285The 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.982404,710$150$2.6M
    99283The 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.182805,700$120$2M
    41899Use this code to report a procedure on the teeth and adjoining alveolar structures for which there is no specific code available.940740$1,170$1.7M
    74177The 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.241801,870$280$1.5M
    G0378Hospital observation service, per hour28902,770$190$1.3M
    0202UThis 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…5302,320$290$1.2M
    G0463Hospital outpatient clinic visit for assessment and management of a patient39807,740$30$1.1M
    C1713Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable)1240550$910$1.1M

    Showing 1–10 of 426

    • More pages

    Related Providers

    Other providers that share a Tax Identification Number (TIN) with Baptist Healthcare System, Inc, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Baptist Healthcare System, IncKYGeneral Acute Care Hospital$0$121.5M
    Baptist Healthcare System, IncKYGeneral Acute Care Hospital$0$98.1M
    Baptist Healthcare System IncKYGeneral Acute Care Hospital$0$95.7M
    Baptist Healthcare System Inc.KYGeneral Acute Care Hospital$0$62.4M
    Baptist Healthcare System, Inc.KYGeneral Acute Care Hospital$0$58.5M
    Hardin Memorial HospitalKYGeneral Acute Care Hospital$0$37.2M
    Baptist Healthcare System, Inc.INGeneral Acute Care Hospital$0$34.6M
    Baptist Healthcare System, Inc.KYGeneral Acute Care Hospital$0$16.1M
    Baptist Healthcare System, Inc.KYAmbulatory Surgical Clinic/Center$1.2M$183.5K
    Baptist Healthcare System IncKYLand Ambulance$424.7K$47.4K

    Nearby Providers

    Other providers in the same ZIP code as Baptist Healthcare System, Inc, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Mercy Health-lourdes Hospital LLCKYGeneral Acute Care Hospital$0$61.9M
    Baptist Health Medical Group IncKYFamily Medicine Physician$0$21.9M
    Mercy Health Physicians Kentucky LLCKYFamily Medicine Physician$0$11.9M
    Ambulatory Surgery Center LLCKYAmbulatory Surgical Clinic/Center$771.4K$8.7M
    Joseph BlackmonKYMOHS-Micrographic Surgery Physician$6.9M$0
    John Colgan Jr.KYPediatric Dentistry$0$5.6M
    Mercy Health Physicians Kentucky Specialty Care LLCKYSurgery Physician$0$4.7M
    Justin ColganKYPediatric Dentistry$0$4.6M
    Paducah Ophthalmology Asc LLCKYAmbulatory Surgical Clinic/Center$1.3M$467.8K
    Halden FordKYDermatology Physician$1.3M$4.5K

    Frequently Asked Questions

    References

    1. 1.Medicare Physician & Other Practitioner by Provider and Service. CMS.gov.Provider-level Medicare Part B utilization and payment data.
    2. 2.NPPES NPI Registry. CMS.gov.National Provider Identifier registry used for provider enumeration and taxonomy metadata.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

    Medicaid Revenue by Year vs. Kentucky Providers
    7 of 7 years billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Claims Volume vs. Kentucky Distribution
    Baptist Healthcare System, Inc — 2 of 25 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Kentucky