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.

Spartanburg Medical Center (NPI 1760637904)

Spartanburg Medical Center is a obstetrics & gynecology physician provider located in Spartanburg, South Carolina. This profile covers 0 Medicare and 29 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	Spartanburg Medical Center
Address	1686 Skylyn Dr
City	Spartanburg
State	SC
ZIP	29307
Taxonomy	Obstetrics & Gynecology Physician
NPI Enumerated	December 1, 2008

Payer Source	Total Paid
Medicaid	$3.3M
Medicare	$0

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

29 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…	17,550	$90	$1.6M
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…	20,600	$60	$1.3M
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…	740	$120	$87.8K
81002	The lab analyst inserts a dip stick into a freshly collected urine specimen, removes the dip stick, and shakes off the excess urine. Alternatively, the analyst may place drops of the urine specimen…	23,320	$1	$70K
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	600	$90	$51.9K
76819	The provider performs a biophysical profile test to measure the health of the baby during pregnancy using only ultrasound and not a nonstress test.	670	$70	$44.8K
81025	The lab analyst performs the pregnancy test on a urine specimen using a methodology or kit that the analyst can read visually for a direct readout.	3,940	$10	$31.5K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	7,500	$1	$22.5K
85018	The lab analyst measures the hemoglobin in a whole blood sample. Hemoglobin is the red pigmented iron compound contained in the red blood cell that combines with oxygen needed by the body tissue.	9,990	$1	$20K
76820	The provider performs Doppler ultrasonography for fetal surveillance to determine the velocity of blood flow through the umbilical artery. This test determines the timing of labor induction and when…	540	$40	$19.3K

Showing 1–10 of 29

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

Spartanburg Medical Center — 4 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

29 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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…	128	2,770	210	$60	$254.5K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	87	710	350	$60	$247.2K
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…	86	2,480	350	$80	$246K
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	37	100	240	$100	$187.3K
76819	The provider performs a biophysical profile test to measure the health of the baby during pregnancy using only ultrasound and not a nonstress test.	22	70	150	$70	$156.2K
96372	A therapeutic, prophylactic, or diagnostic substance (a fluid, a drug, etc.) is injected via intramuscular or subcutaneous route into the patient's body. The procedure is performed by the physician…	299	410	330	$50	$152.6K
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,…	410	610	190	$50	$98.4K
76820	The provider performs Doppler ultrasonography for fetal surveillance to determine the velocity of blood flow through the umbilical artery. This test determines the timing of labor induction and when…	13	20	670	$30	$93.1K
81025	The lab analyst performs the pregnancy test on a urine specimen using a methodology or kit that the analyst can read visually for a direct readout.	81	380	660	$30	$90K
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…	59	360	100	$100	$76.9K

Showing 1–10 of 29

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
The Charles Lea Center Inc.	SC	In Home Supportive Care Agency	$0	$70.3M
Spartanburg School District 7	SC	Local Education Agency (LEA)	$0	$9.2M
Elite Home Care	SC	In Home Supportive Care Agency	$0	$6.9M
Spartanburg Medical Center	SC	Urgent Care Clinic/Center	$0	$4.2M
Circle Of Angels Home Health Care	SC	Home Health Agency	$0	$3M
Spartanburg Pediatric Dentistry	SC	Pediatric Dentistry	$0	$2.7M
Mary Black Health System LLC	SC	General Acute Care Hospital	$0	$2.3M
Allergy Partners, PLLC	SC	Allergy & Immunology Physician	$0	$2.2M
Lincare Inc.	SC	Durable Medical Equipment & Medical Supplies	$0	$2M
The Forrester Center For Behavioral Health, Inc.	SC	Substance Use Disorder Rehabilitation Clinic/Center	$0	$1.9M

Spartanburg Medical Center — Billing Profile & Reimbursement Data

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Spartanburg Medical Center — Billing Profile & Reimbursement Data

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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
Spartanburg Medical Center	SC	General Acute Care Hospital	$0	$187.7M
Spartanburg Medical Center	SC	Emergency Medicine Physician	$0	$17.2M
Spartanburg Medical Center	SC	Family Medicine Physician	$0	$17M
Cherokee Medical Center	SC	General Acute Care Hospital	$0	$15.4M
Pelham Medical Center	SC	General Acute Care Hospital	$0	$13.8M
Spartanburg Medical Center	SC	Maternal & Fetal Medicine Physician	$0	$11.5M
Union Medical Center	SC	General Acute Care Hospital	$0	$10.7M
Spartanburg Medical Center	SC	Community Based Hospice Care Agency	$0	$8.9M
Spartanburg Medical Center	SC	Urgent Care Clinic/Center	$0	$6.3M
Spartanburg Medical Center	SC	Pediatrics Physician	$0	$4.8M