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

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

St Mary Medical Center (NPI 1780686931)

Field	Value
Entity Type	Organization
Organization	St Mary Medical Center
Address	1201 Langhorne-newtown Rd
City	Langhorne
State	PA
ZIP	19047
Taxonomy	General Acute Care Hospital
NPI Enumerated	June 1, 2005

Payer Source	Total Paid
Medicaid	$10.8M
Medicare	$0

Medicaid: Complete Services Breakdown

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

179 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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.	13,980	$270	$3.8M
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.	8,550	$280	$2.4M
G0378	Hospital observation service, per hour	720	$1,770	$1.3M
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.	3,520	$280	$979.1K
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.	2,620	$250	$665.5K
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	3,180	$80	$248.2K
76815	The provider performs a limited examination of the fetus using ultrasound. The provider performs the examination of certain parameters for one or more fetuses.	1,880	$70	$137.4K
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…	670	$140	$91.4K
59025	In this procedure, the provider measures the fetal heart rate of the fetus in response to its own movements.	2,120	$40	$78.4K
76811	The provider performs an ultrasound study using a transabdominal approach to examine the fetus and mother, along with additional examination of the fetal anatomy, such as the heart rate, amniotic…	430	$170	$71.2K

Showing 1–10 of 179

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Pennsylvania Distribution

St Mary Medical Center — 0 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Pennsylvania

Full comparison — all codes billed, vs. Pennsylvania median

179 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
G0378	Hospital observation service, per hour	64	150	510	$870	$1.4M
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.	156	210	730	$40	$689.7K
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…	156	200	990	$70	$517.5K
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.	142	1,600	270	$120	$409.7K
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.	73	1,060	150	$130	$405.4K
0202U	This 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…	21	60	430	$200	$354.2K
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.	131	1,230	250	$130	$284K
G0463	Hospital outpatient clinic visit for assessment and management of a patient	33	100	330	$40	$166K
87633	The lab analyst performs a test to identify a respiratory virus using amplified nucleic acid probe technique. He may also use a multiplex reverse transcription technique. The provider does this for…	22	60	110	$220	$151.2K
99211	An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.	759	980	310	$50	$136.6K

Showing 1–10 of 179

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Bmg Circle Of Life, LLC	PA	Home Health Agency	$0	$15.3M
Family Service Association Of Bucks County	PA	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$11.9M
Penndel Mental Health Center, Inc.	PA	Community/Behavioral Health Agency	$0	$11M
Penndel Mental Health Center	PA	Community/Behavioral Health Agency	$0	$10.7M
Woods Services Inc	PA	Emotionally Disturbed Childrens' Residential Treatment Facility	$0	$10.6M
Emergency Care Services Of Pennsylvania, P.C.	PA	Emergency Medicine Physician	$0	$9.2M
Pyramid Healthcare Inc.	PA	Substance Abuse Rehabilitation Facility	$0	$8.6M
Woods Services, Inc	PA	Emotionally Disturbed Childrens' Residential Treatment Facility	$0	$5.8M
Woods Services, Inc	PA	Emotionally Disturbed Childrens' Residential Treatment Facility	$0	$5.6M
Pain Management Centers Of America, LLC	PA	Pain Clinic/Center	$4.6M	$74.2K

St Mary Medical Center — Billing Profile & Reimbursement Data

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St Mary 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

Nearby Providers

Frequently Asked Questions

References