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

Why is the Medicaid comparison limited to South Carolina 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. South Carolina (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.

Upstate Carolina Radiology PA (NPI 1750348595)

Upstate Carolina Radiology PA is a diagnostic radiology physician provider located in Spartanburg, South Carolina. This profile covers 0 Medicare and 40 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Medicaid: Complete Services Breakdown

Field	Value
Entity Type	Organization
Organization	Upstate Carolina Radiology PA
Address	101 E Wood St
City	Spartanburg
State	SC
ZIP	29303
Taxonomy	Diagnostic Radiology Physician
NPI Enumerated	April 26, 2006

Payer Source	Total Paid
Medicaid	$3.2M
Medicare	$0

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

40 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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.	16,100	$50	$853.2K
71045	In this diagnostic procedure, the provider performs a single radiological view of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and nearby…	83,930	$10	$503.6K
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.	20,020	$30	$500.5K
71046	In this diagnostic procedure, the provider performs a minimum of two radiological views of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and…	38,430	$10	$307.4K
77067	The provider takes two X–ray views of each breast for routine screening and may use specially designed computer software to help identify any potential abnormalities within the images; the software…	7,610	$30	$212.9K
70553	In this procedure, the provider performs a magnetic resonance imaging, or MRI, study of the brain including the brain stem. He performs this procedure without using contrast material. He then follows…	2,730	$60	$163.6K
71260	In this diagnostic procedure, the provider performs a computed tomography, or CT, examination of the thorax using contrast material.	4,500	$40	$157.5K
74018	Report this code for one X–ray view of the structures and organs in the abdomen to diagnose certain abdominal problems.	13,120	$10	$78.7K
76642	In this procedure, the provider performs a focused ultrasound of one breast on a limited area. The procedure includes documentation of the images.	2,550	$20	$53.6K
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.	950	$50	$48.5K

Showing 1–10 of 40

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. South Carolina Distribution

Upstate Carolina Radiology PA — 8 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — South Carolina

Full comparison — all codes billed, vs. South Carolina median

40 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
70553	In this procedure, the provider performs a magnetic resonance imaging, or MRI, study of the brain including the brain stem. He performs this procedure without using contrast material. He then follows…	6	60	170	$430	$434.9K
70551	The provider uses magnetic resonance imaging, or MRI, to examine the brain and brain stem. The provider does not administer contrast for this exam.	11	50	90	$220	$222.7K
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.	3	130	2,060	$30	$112.5K
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.	3	130	1,660	$30	$108.3K
73721	In this diagnostic procedure, the provider performs magnetic resonance imaging of a lower extremity joint without using contrast material.	5	50	30	$300	$105.2K
72148	In this diagnostic procedure, the provider performs magnetic resonance imaging (MRI) of the lumbar spinal canal and contents without using contrast.	55	60	70	$320	$96.4K
71045	In this diagnostic procedure, the provider performs a single radiological view of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and nearby…	4	180	2,270	$10	$64.1K
77063	The provider captures three dimensional images of the breast using X–rays at various angles for routine checkup. He checks for the presence of any abnormality within the breasts. Tomosynthesis…	11	80	460	$60	$61.8K
71046	In this diagnostic procedure, the provider performs a minimum of two radiological views of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and…	3	260	420	$20	$58.1K
76830	The provider performs a transvaginal ultrasound to assess the reproductive organs, that is, the uterus, fallopian tubes, ovaries, cervix, and vagina in a female patient.	50	120	180	$90	$51.6K

Showing 1–10 of 40

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Spartanburg Medical Center	SC	General Acute Care Hospital	$0	$187.7M
Axcess Healthcare Services, LLC	SC	Nursing Care Agency	$0	$98.5M
South Carolina Dept Of Mental Health Accounting Office	SC	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$40M
Spartanburg Medical Center	SC	Emergency Medicine Physician	$0	$17.2M
Spartanburg Medical Center	SC	Family Medicine Physician	$0	$17M
Spartanburg Medical Center	SC	Maternal & Fetal Medicine Physician	$0	$11.5M
Better Beginnings, Inc	SC	Pediatric Occupational Therapist	$0	$6.9M
Whitney Road Dental Health Center, P.C.	SC	General Practice Dentistry	$0	$6.3M
Foothills Pediatric Dentistry, PA	SC	Pediatric Dentistry	$0	$4.9M
Bhg Xxxviii, LLC	SC	Substance Use Disorder Rehabilitation Clinic/Center	$264.8K	$3.5M

Upstate Carolina Radiology PA — Billing Profile & Reimbursement Data

Sign up for Upstate Carolina Radiology PA — Billing Profile & Reimbursement Data policy alerts

Upstate Carolina Radiology PA — Billing Profile & Reimbursement Data

Sign up for Upstate Carolina Radiology PA — Billing Profile & Reimbursement Data policy alerts

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
Riverside Radiology And Interventional Associates Inc	OH	Diagnostic Radiology Physician	$0	$30.3M
Bryce Hansen	NE	Diagnostic Radiology Physician	$206.7K	$0
Stetson Bickley	SC	Diagnostic Radiology Physician	$177.4K	$0
Janet Terlouw	SC	Diagnostic Radiology Physician	$174.2K	$0
William Joyce	SC	Diagnostic Radiology Physician	$167.1K	$120
Stephan Haas	SC	Diagnostic Radiology Physician	$161.3K	$0
Todd Kihne	SC	Diagnostic Radiology Physician	$156.1K	$0
Benjamin Cooper	CO	Diagnostic Radiology Physician	$129.6K	$20.8K
Matthew Chaney	SC	Diagnostic Radiology Physician	$149.1K	$0
David Pelino	SC	Diagnostic Radiology Physician	$148.7K	$0