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NPI 1790747491 · Livingston, NJ · Radiology Clinic/Center
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Saint Barnabas Outpatient Centers is a radiology clinic/center provider located in Livingston, New Jersey. This profile covers 122 Medicare and 53 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 | Saint Barnabas Outpatient Centers |
| Address | 200 S Orange Ave |
| City | Livingston |
| State | NJ |
| ZIP | 07039 |
| Taxonomy | Radiology Clinic/Center |
| NPI Enumerated | April 6, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $5.8M |
| Medicare | $3.1M |
SAINT BARNABAS OUTPATIENT CENTERS presents as a high-volume outpatient radiology clinic with a strong emphasis on breast imaging, advanced cross-sectional imaging, and PET services. Medicare top codes include 77067, 78815, and 76641 (combined = 49.1% of Medicare revenue) and Medicaid top codes include 70553, 70551, and 77067 (combined = 46.8% of Medicaid revenue), indicating the site offers mammography/tomosynthesis, breast ultrasound, MRI brain, and PET/CT as core services.
Medicare revenue is $3.1M while Medicaid revenue is $5.8M, so this provider bills materially more to Medicaid than to Medicare and is not effectively single-payer. The larger Medicaid volume suggests the center’s patient mix and payer exposure are skewed toward state-plan beneficiaries, which has implications for contracting, reimbursement risk, and access planning.
Revenue concentration is notable: Medicare top 3 codes account for 49.1% of Medicare revenue, led by 77067 ($565.5K, 21.8% of Medicare revenue), 78815 ($543.5K, 21.0% of Medicare revenue), and 76641 ($164.4K, 6.3% of Medicare revenue). These three codes together dominate Medicare receipts and imply the business relies heavily on mammography/tomosynthesis, PET/CT, and breast ultrasound services.
On the Medicaid side, the top 3 codes account for 46.8% of Medicaid revenue and are led by 70553 ($1.6M, 28.3% of Medicaid revenue), 70551 ($515.7K, 9.4% of Medicaid revenue), and 77067 ($503.2K, 9.2% of Medicaid revenue). This concentration shows MRI brain (70553/70551) and screening mammography (77067) are the primary Medicaid drivers, with 70553 alone contributing nearly a third of Medicaid revenue.
The provider’s competitive standing is strong in breast imaging and several MRI/CT areas when benchmarked against peers. For Medicare, 77067 ranks #11 of 15198 (100th percentile; extreme outlier) and 76641 ranks #2 of 4011 (100th percentile; extreme outlier), while 77049 ranks #1 of 3140 (100th percentile; extreme outlier), signaling national-scale volume for mammography and breast MRI workflows. For Medicaid within New Jersey, leading MRI and mammography codes sit in middle-to-upper state percentiles (for example, 70553 ranks #15 of 87, 84th percentile; 77067 ranks #38 of 181, 79th percentile), indicating the provider is a meaningful local competitor for MRI and breast services but not uniformly dominant across every modality.
Modality breadth is wide: the Medicare list includes PET/CT (78815 $543.5K; 78816 $70.6K; A9552 $38.9K), multiple MRI codes (70551 $64.2K, 70553 $62.3K, 72148 $60.6K), CT abd/pelvis (74177 $103.8K, 74183 $93.9K) and DXA (77080 $94.5K). Medicaid volumes mirror that mix with high-value MRI brain (70553 $1.6M) and substantial mammography/ultrasound throughput, supporting a true multi-modality outpatient imaging platform rather than a single-service clinic.
The vendor has long tenure on file (NPI enumerated 2006-04-06 (~20 years ago)), which, combined with repeated “extreme outlier” and high-percentile ranks across breast imaging and MRI codes, suggests an established operation with sustained referral flows. The persistence of high ranks across multiple years of claims would be relevant when assessing network inclusion, capacity planning, or utilization management.
Multiple Medicare codes are flagged as statistical outliers versus national peers (labels include “extreme outlier” or “notably above typical” for many breast and MRI codes), which should trigger focused review for contracting and utilization discussions rather than implying any improper behavior. Examples include 77067 (100th percentile; extreme outlier), 76641 (100th percentile; extreme outlier), and 77049 (100th percentile; extreme outlier) — these indicate unusually high relative volume in breast imaging that payers and provider analysts should treat as a material operational characteristic when benchmarking and negotiating.] }}</katamari_response> PMID:0.1284.9? PMID? Apologies. Continuous. Would remove extraneous trailing. I must ensure output only JSON, no extra tokens. The assistant included a stray trailing text
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
122 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 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… | 5,240 | $110 | $565.5K |
| 78815 | PET and CT scans are both standard imaging tools that allow doctors to evaluate the location and metabolic actions of tumors or cancer inside the body before beginning an active treatment regimen.… | 400 | $1,380 | $543.5K |
| 76641 | In this procedure, the provider performs a complete ultrasound of one breast. The procedure includes documentation of the images. | 1,870 | $90 | $164.4K |
| 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… | 5,180 | $30 | $145K |
| 77049 | The provider obtains images of both breasts by applying an external magnetic field and radiofrequency waves to create three–dimensional images, with and without contrast; he may also perform… | 440 | $300 | $132K |
| 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. | 500 | $210 | $103.8K |
| 77080 | The provider performs an imaging procedure, called dual–energy X–ray absorptiometry (DXA), of one or more bony areas on the trunk to determine the bone mineral density (BMD) and whether the patient… | 2,780 | $30 | $94.5K |
| 74183 | The provider performs magnetic resonance imaging of the structures and organs of the abdomen, initially without control and then with additional sequences after injection of contrast. | 400 | $230 | $93.9K |
| 78816 | The patient is injected with a radiopharmaceutical tracer called FDG (fluoro–deoxyglucose, a radioactive substance containing glucose) about one hour before the imaging is scheduled to begin. The… | 50 | $1,390 | $70.6K |
| 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. | 540 | $120 | $64.2K |
Showing 1–10 of 122
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 122 CPT/HCPCS codes.
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Full comparison — all codes billed, vs. state median
122 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| 78815 | 8 | 160 | 60 | $720 | $83K |
| 77067 | 1 | 410 | 250 | $100 | $40.2K |
| 78816 | 10 | 50 | 30 | $720 | $24.4K |
| 77063 | 1 | 400 | 260 | $50 | $18.5K |
| A9552 | 5 | 80 | 60 | $140 | $15.5K |
| 72148 | 9 | 350 | 70 | $130 | $14.7K |
| 70553 | 5 | 270 | 60 | $170 | $14.5K |
| 74177 | 15 | 610 | 100 | $100 | $14.4K |
| 73721 | 47 | 230 | 50 | $140 | $13.9K |
| 72197 | 6 | 120 | 40 | $220 | $13.5K |
Showing 1–10 of 122
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.
53 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | 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… | 1,930 | $800 | $1.6M |
| 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. | 1,170 | $440 | $515.7K |
| 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… | 6,210 | $80 | $503.2K |
| 78815 | PET and CT scans are both standard imaging tools that allow doctors to evaluate the location and metabolic actions of tumors or cancer inside the body before beginning an active treatment regimen.… | 460 | $1,040 | $476.7K |
| 76700 | An abdominal ultrasound is a noninvasive procedure used to assess the body parts within the abdomen (i.e. liver, gallbladder, pancreas, bile ducts, spleen, and abdominal aorta). This particular code… | 1,850 | $140 | $249.9K |
| 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. | 830 | $300 | $248.9K |
| 76641 | In this procedure, the provider performs a complete ultrasound of one breast. The procedure includes documentation of the images. | 2,050 | $110 | $219.1K |
| 76856 | A pelvic ultrasound is a noninvasive procedure used to assess body parts such as the bladder, ovaries, uterus, cervix, and fallopian tubes in females and the bladder, prostate gland, and seminal… | 1,890 | $110 | $213.7K |
| 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. | 1,490 | $120 | $177.1K |
| 73721 | In this diagnostic procedure, the provider performs magnetic resonance imaging of a lower extremity joint without using contrast material. | 270 | $530 | $142.3K |
Showing 1–10 of 53
How this provider's Medicaid billing volume and revenue compare to other New Jersey providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. New Jersey median
53 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average 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. | 101 | 170 | 2,330 | $110 | $578.8K |
| OP272 | N/A | 77 | 80 | 8,420 | $40 | $447.7K |
| 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… | 15 | 90 | 190 | $430 | $429.3K |
| 93005 | The provider records the electrical conduction of the heart to examine any abnormality in its functioning, based on signals from at least 12 leads, wires that connect the recording device to… | 78 | 90 | 15,540 | $20 | $425.8K |
| OP250 | N/A | 155 | 170 | 15,310 | $10 | $424.7K |
| 78815 | PET and CT scans are both standard imaging tools that allow doctors to evaluate the location and metabolic actions of tumors or cancer inside the body before beginning an active treatment regimen.… | 14 | 40 | 190 | $710 | $324K |
| 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… | 38 | 180 | 1,610 | $70 | $284.3K |
| 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. | 32 | 120 | 240 | $210 | $198.1K |
| 73721 | In this diagnostic procedure, the provider performs magnetic resonance imaging of a lower extremity joint without using contrast material. | 27 | 70 | 160 | $290 | $191.2K |
| 74183 | The provider performs magnetic resonance imaging of the structures and organs of the abdomen, initially without control and then with additional sequences after injection of contrast. | 15 | 30 | 190 | $360 | $180K |
Showing 1–10 of 53
Other providers in the same ZIP code as Saint Barnabas Outpatient Centers, ranked by combined Medicare and Medicaid revenue.
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