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NPI 1780608216 · Portland, OR · General Acute Care Hospital
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Legacy Good Samaritan Hospital And Medical Center is a general acute care hospital provider located in Portland, Oregon. This profile covers 0 Medicare and 116 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.
Provider details (source: NPPES NPI Registry)
| Field | Value |
|---|---|
| Entity Type | Organization |
| Organization | Legacy Good Samaritan Hospital And Medical Center |
| Address | 1015 Nw 22nd Ave |
| City | Portland |
| State | OR |
| ZIP | 97210 |
| Taxonomy | General Acute Care Hospital |
| NPI Enumerated | July 27, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $18.3M |
| Medicare | $0 |
LEGACY GOOD SAMARITAN HOSPITAL AND MEDICAL CENTER reports $18.3M in lifetime Medicaid revenue and has no Medicare billing on file, making its public payer footprint effectively single-payer Medicaid in the available data. Its NPI was enumerated on 2006-07-27 (~20 years ago), indicating long-standing participation in public programs despite the absence of Medicare claims in this extract.
Revenue is heavily concentrated in emergency department evaluation & management codes: 99285 accounts for $6.5M (36.0% of Medicaid revenue; 21K claims), 99284 accounts for $4.5M (25.0%; 19.1K claims), and 99283 accounts for $3.1M (16.9%; 18.4K claims). Those top three codes together drive 77.9% of the provider’s reported Medicaid revenue, signaling that ED services are the primary revenue engine for this facility.
The ED-focused code mix implies an operational emphasis on high-volume, acute-care emergency services rather than elective inpatient surgery as the primary Medicaid revenue driver. High counts across 99285/99284/99283 (21K/19.1K/18.4K claims respectively) suggest sustained ED throughput and reliance on E/M reimbursement; this creates sensitivity to changes in ED policy or reimbursement for those codes.
State-level competitive standing on the top ED codes is moderate to strong but not dominant: 99285 ranks #22 of 129 providers in-state (84th percentile; typical, unremarkable volume for this code), while 99284 and 99283 rank in the mid-60s percentiles (99284: #51 of 145, 65th percentile; 99283: #50 of 137, 64th percentile). Those percentiles indicate the hospital is a meaningful regional ED player but not an extreme outlier in statewide ED utilization.
Beyond the ED, the provider bills a range of surgical, imaging, and specialty services that together comprise the remaining Medicaid revenue. Notable examples include breast reduction 19318 ($701K, 3.9% of Medicaid revenue; 152 claims, rank #1 of 3 providers in-state, 100th percentile), diagnostic LDCT 71271 ($63.1K, 0.3%; 1.3K claims, rank #2 of 23, 95th percentile and labeled notably above typical), cardiac echo 93306 ($138.7K, 0.8%; 2.9K claims), and breast removal 19303 ($178.1K, 1.0%; 39 claims). These codes show a mix of elective surgical and diagnostic capacity supplementing the dominant ED line.
Some codes show unusually high state percentile positioning even if their revenue share is modest: 71271 is ranked #2 of 23 providers in-state (95th percentile; notably above typical state volume for this code), and 19318 is ranked #1 of 3 providers in-state (100th percentile). Those observations point to pockets of above-typical service concentration (lung-cancer screening LDCT and certain breast procedures) that may reflect specialty programs or referral patterns despite their relatively small absolute revenue shares.
Many remaining top-25 Medicaid codes are described as typical or unremarkable in volume statewide, including infusion/IV administration codes (96374, 96375, 96361), common outpatient clinic visits (G0463, 99213, 99203, 99214), and routine imaging (71046, 70450, 74177). This pattern supports a profile of a general acute care hospital with a broad outpatient and diagnostic footprint that complements a dominant ED practice, rather than a narrow specialty center.
Operational and payer-mix implications: because 77.9% of Medicaid revenue is concentrated in three ED E/M codes, payer negotiations, ED case mix, and Medicaid policy changes affecting E/M valuation will have outsized effects on total Medicaid revenue. The absence of Medicare billing on file means Medicare-related revenue risk or diversification is not visible in this dataset; strategic or financial analyses should treat the provider as effectively Medicaid-driven based on the available claims data.
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
Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
116 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 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. | 21,010 | $310 | $6.5M |
| 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. | 19,150 | $240 | $4.5M |
| 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. | 18,430 | $170 | $3.1M |
| 96374 | The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition. | 7,700 | $120 | $923.9K |
| 19318 | Breast reduction is the removal of excess breast tissue which results from top scarring, calcification, or architectural distortion. | 150 | $4,610 | $701K |
| 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… | 11,600 | $50 | $626.5K |
| G0463 | Hospital outpatient clinic visit for assessment and management of a patient | 9,320 | $40 | $354K |
| 99203 | The provider sees a new 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 provider… | 3,130 | $80 | $259.9K |
| 92134 | The provider performs computerized diagnostic imaging of the retina in the posterior segment (back part) of the eye, interprets the data, and provides a report. The service may be on one or both eyes. | 8,880 | $20 | $186.5K |
| 19303 | The provider removes the entire breast, nipples, and skin surrounding the nipple–areolar complex but leaves the pectoralis major and minor muscles and axillary nodes in place. | 40 | $4,570 | $178.1K |
Showing 1–10 of 116
How this provider's Medicaid billing volume and revenue compare to other Oregon providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Oregon median
116 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 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. | 51 | 150 | 7,400 | $170 | $2.8M |
| 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. | 22 | 130 | 2,610 | $200 | $2.3M |
| 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. | 50 | 140 | 10,160 | $130 | $2.3M |
| G0463 | Hospital outpatient clinic visit for assessment and management of a patient | 15 | 40 | 3,200 | $60 | $1.5M |
| 96374 | The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition. | 23 | 60 | 3,620 | $90 | $623.7K |
| G0480 | Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but… | 38 | 60 | 420 | $60 | $405.1K |
| U0003 | Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high… | 30 | 60 | 460 | $40 | $327.4K |
| 99282 | The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making. | 65 | 80 | 1,130 | $90 | $327.2K |
| 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… | 679 | 1,500 | 650 | $70 | $312.4K |
| 80307 | The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date. | 49 | 80 | 1,210 | $40 | $294.3K |
Showing 1–10 of 116
Other providers in the same ZIP code as Legacy Good Samaritan Hospital And Medical Center, ranked by combined Medicare and Medicaid revenue.
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