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

Why is the Medicaid comparison limited to West Virginia 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. West Virginia (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.

West Virginia University Hospitals, Inc (NPI 1841271459)

Field	Value
Entity Type	Organization
Organization	West Virginia University Hospitals, Inc
Address	1 Medical Center Drive
City	Morgantown
State	WV
ZIP	26506
Taxonomy	General Acute Care Hospital
NPI Enumerated	November 10, 2005

Payer Source	Total Paid
Medicaid	$124.1M
Medicare	$0

Key Findings

WEST VIRGINIA UNIVERSITY HOSPITALS, INC is effectively a Medicaid-focused provider: there is no Medicare billing on file and its recorded lifetime Medicaid revenue is $124.1M. The absence of Medicare activity makes this organization functionally single‑payer (Medicaid) in the available claims dataset, concentrating analytical attention on Medicaid patterns.

Revenue concentration is notable: the precomputed top three Medicaid codes (99285, 99284, 99212) account for 31.2% of the provider's total Medicaid revenue. Individually those codes show substantial dollar contributions (99285: $6.9M; 99284: $5.7M; 99212: $4.3M), indicating a heavy reliance on emergency department and high-volume outpatient E/M services for overall Medicaid receipts.

The code mix points to a large emergency and outpatient operation. High-revenue E/M codes 99285 (18.8K claims, $370 avg, ranks #11 of 132, 92th percentile) and 99284 (34.4K claims, $167 avg, ranks #12 of 168, 93th percentile) together with 99283 and G0463 indicate substantial ED and hospital outpatient throughput, while 99212 (178.1K claims, $24 avg, ranks #1 of 536, 100th percentile) signals very high-volume, low-acuity outpatient encounters. This pattern is consistent with a general acute care hospital providing both ED care and high-volume clinic/office services.

The provider is a statewide leader on many outpatient and ancillary services. It ranks #1 of 536 for 99212 (100th percentile), #1 of 38 for G0463 (100th percentile), and #1 of 23 for J7120 (100th percentile), and it appears as an "extreme outlier" or top-percentile performer across multiple common lab and monitoring codes (e.g., 85025, 80048, 93005). These #1 ranks and extreme outlier labels indicate dominant in‑state scale for routine lab, infusion, and clinic visit volume.

At the same time the provider is not uniformly dominant across all high-cost therapies: J9271 (pembrolizumab) generates $4.2M and ranks #2 of 4 providers in-state (67th percentile), and J0585 (onabotulinumtoxina) ranks #2 of 4 (67th percentile), suggesting it offers specialty infusion and procedural services but shares those markets with a small set of peers. High-cost oncology and biologic injections contribute meaningfully to revenue but are concentrated in relatively few statewide providers.

Clinical support and observation services are substantial revenue drivers beyond E/Ms: sizable volumes are reported for intravenous fluids and observation (J7120: 30.3K claims, $54 avg, $1.6M revenue; G0378: 13.4K claims, $81 avg, $1.1M revenue), and laboratory testing is heavily used (85025: 153.6K claims, $2.8M; 80053: 70.5K claims, $2M; 80048: 67.7K claims, $1.6M). These patterns point to high inpatient/ED throughput with extensive lab and supportive care resource use, consistent with a major acute-care center handling complex and high-volume clinical work.

Operational tenure is long-standing: the NPI was enumerated 2005-11-10 (~21 years ago), indicating stable presence in the state’s provider landscape and sufficient time to develop the high-volume outpatient, ED, and ancillary service footprint observed in the Medicaid dataset. This longevity aligns with the provider’s frequent #1 rankings and extreme outlier volumes for many routine service lines.

From a payer/competitive perspective, the provider’s Medicaid billing profile shows both breadth and depth: it is a statewide volume leader on core outpatient, lab, and observation codes (multiple 100th percentile/#1 ranks and several "extreme outlier" labels), while it shares specialty infusion markets (e.g., J9271, J0585) with a handful of peers. For analysts assessing network leverage or contracting, the combination of dominant routine volumes and participation in high-cost drug/infusion segments suggests this hospital is a strategically important Medicaid provider in West Virginia.

Medicaid: Complete Services Breakdown

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

830 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.	18,760	$370	$6.9M
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.	34,390	$170	$5.7M
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,…	178,050	$20	$4.3M
J9271	Injection, pembrolizumab, 1 mg	790	$5,260	$4.2M
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.	29,730	$90	$2.8M
85025	A complete blood count (better known as a CBC) is a blood test request by a doctor that provides detailed information about various types of cells in a patient's blood. Usually a pathologist or a…	153,550	$20	$2.8M
J0585	Injection, onabotulinumtoxina, 1 unit	4,370	$470	$2M
80053	The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel.	70,540	$30	$2M
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.	8,110	$230	$1.8M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	94,770	$20	$1.8M

Showing 1–10 of 830

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. West Virginia Distribution

West Virginia University Hospitals, Inc — 16 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — West Virginia

Full comparison — all codes billed, vs. West Virginia median

830 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J9271	Injection, pembrolizumab, 1 mg	2	10	470	$4,910	$2.4M
J0178	Injection, aflibercept, 1 mg	2	10	220	$650	$2.1M
87801	The lab analyst performs a test for multiple infectious agents using amplified nucleic acid probe technique.	2	10	230	$40	$1.9M
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.	11	130	2,090	$210	$1.5M
87661	The lab analyst performs a test for Trichomonas vaginalis using nucleic acid amplified probe technique.	3	20	270	$20	$1.5M
41899	Use this code to report a procedure on the teeth and adjoining alveolar structures for which there is no specific code available.	6	10	580	$1,120	$1.3M
87491	The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique.	3	40	820	$30	$1.2M
87591	The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique.	3	40	820	$30	$1.2M
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.	12	170	3,350	$120	$1.1M
J0585	Injection, onabotulinumtoxina, 1 unit	2	10	2,680	$320	$1M

Showing 1–10 of 830

Related Providers

Other providers that share a Tax Identification Number (TIN) with West Virginia University Hospitals, Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
West Virginia University Medical Corporation	WV	Family Medicine Physician	$0	$162.1M
West Virginia University Hospitals, Inc.	WV	Substance Abuse Rehabilitation Facility	$0	$15.4M
West Virginia University Hospitals, Inc	WV	Emergency Medicine Physician	$0	$3M
Bethany Honce	WV	Physical Medicine & Rehabilitation Physician	$86K	$0
Brian Richardson	WV	Emergency Medicine Physician	$80K	$0
Joseph Nnadike	DC	Emergency Medicine Physician	$70.2K	$0
Brandon Wilson	WV	General Practice Physician	$62.3K	$6.4K
Chad Anderson	WV	Emergency Medicine Physician	$53.2K	$0
Makenzie Bartsch	WY	General Practice Physician	$40.5K	$0
Brittany Allen	WV	Family Nurse Practitioner	$31.2K	$0

Nearby Providers

Other providers in the same ZIP code as West Virginia University Hospitals, Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
West Virginia University Dental Corporation	WV	Dentist	$0	$5.9M
Heather Boo	WV	Neuroradiology Physician	$596.8K	$0
Arijit Chakravarty	WV	Nephrology Physician	$281K	$0
Adeem Akbar	WV	Nephrology Physician	$162.7K	$0
Robert Marsh	WV	Neurological Surgery Physician	$152.1K	$0
Mark Lisle	WV	Diagnostic Radiology Physician	$150.1K	$710
Brian Hamlin	WV	Adult Reconstructive Orthopaedic Surgery Physician	$148.2K	$0
David Tingler	WV	Cardiovascular Disease Physician	$145.7K	$0
Charles Moore	WV	Ophthalmology Physician	$145.3K	$0
Parvez Shaikh	WV	Radiation Oncology Physician	$137.8K	$0

West Virginia University Hospitals, Inc — Billing Profile & Reimbursement Data

Sign up for West Virginia University Hospitals, Inc — Billing Profile & Reimbursement Data policy alerts

West Virginia University Hospitals, Inc — Billing Profile & Reimbursement Data

Sign up for West Virginia University Hospitals, Inc — Billing Profile & Reimbursement Data policy alerts

Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References