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

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

Sunrise Hospital And Medical Center, LLC (NPI 1861439952)

Key Findings

Field	Value
Entity Type	Organization
Organization	Sunrise Hospital And Medical Center, LLC
Address	3186 S Maryland Pkwy
City	Las Vegas
State	NV
ZIP	89109
Taxonomy	General Acute Care Hospital
NPI Enumerated	May 31, 2006

Payer Source	Total Paid
Medicaid	$85.9M
Medicare	$0

SUNRISE HOSPITAL AND MEDICAL CENTER, LLC shows no Medicare billing on file and is effectively a single-payer Medicaid-revenue provider with Total Medicaid revenue of $85.9M. The absence of Medicare activity alongside substantial Medicaid receipts indicates the provider’s financial scale and payer exposure are driven almost entirely by Medicaid contracts and utilization.

Revenue is highly concentrated in a small set of emergency and observation services: the precomputed top three Medicaid codes account for 56.2% of Medicaid revenue, comprised of 99283 ($17.4M, 25.1%), 99284 ($13.9M, 20.0%), and G0378 ($7.7M, 11.0%). This concentration means a majority of dollars flow from a narrow set of ED/observation activities rather than a broad mix of inpatient or elective procedures.

The procedure mix strongly indicates an emergency-department and observation-focused operating model. High-volume ED E/M codes (99283 with 191.7K claims and 99284 with 135.2K claims) and supplemental treatment codes such as 96374 (63.2K claims, $2.5M) and 96361 (52.9K claims, $1M) point to frequent acute-care encounters with rapid IV medication and fluid administration. The presence of G0378 (38.1K claims, $7.7M) as a top revenue source further underscores substantial observation-hour throughput.

SUNRISE is a dominant statewide performer on several Medicaid ED codes: 99283 ranks #1 of 390 providers in-state (100th percentile; extreme outlier) and 99284 ranks #2 of 398 providers (100th percentile; extreme outlier), while 99282 also ranks #1 of 90 providers (100th percentile; extreme outlier). G0378 ranks #3 of 38 providers (95th percentile; notably above typical state volume) and several other codes (e.g., 96374 rank #2 of 79, 96361 rank #1 of 58) are in very high percentiles, indicating the facility runs far above typical state volumes for core ED and ancillary care items.

Diagnostic imaging and lab services support the ED/observation load: CT abdomen/pelvis 74177 (18.4K claims, $2.3M), CT head 70450 (23.8K claims, $1M), and CTA chest 71275 (4.9K claims, $675K) are all material revenue contributors and rank notably above typical state volumes. Similarly, definitive drug testing G0480 (35.3K claims, $1.4M) and presumptive testing 80307 (32.9K claims, $790.5K) indicate high lab throughput tied to ED presentations.

The provider’s tenure (NPI enumerated 2006-05-31, ~20 years ago) suggests an established presence in the market, which aligns with its outsized statewide rankings on multiple ED-related codes. Longevity combined with extreme-volume status for core codes implies an entrenched operational footprint for acute and observation services in Las Vegas/NV.

This profile presents concentration and payer-risk considerations: with $85.9M entirely in Medicaid and 56.2% of that revenue coming from three ED/observation codes (99283, 99284, G0378), SUNRISE’s revenue stream is sensitive to shifts in Medicaid policy, reimbursement, or shifts in ED utilization patterns. Analysts and contracting teams should prioritize monitoring Medicaid reimbursement trends for ED E/M and observation-hour codes and assess capacity/throughput drivers behind the very large claim volumes reported for these codes.

Medicaid: Complete Services Breakdown

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

372 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.	191,680	$90	$17.4M
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.	135,190	$100	$13.9M
G0378	Hospital observation service, per hour	38,140	$200	$7.7M
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.	43,830	$110	$4.9M
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.	46,960	$80	$3.9M
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	63,240	$40	$2.5M
93975	The provider performs a complete study of the abdominal, pelvic, scrotal, and or retroperitoneal organs using duplex ultrasound. He performs the procedure to examine the vascular supply to the organs…	15,160	$160	$2.4M
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.	18,450	$130	$2.3M
54161	The provider excises the foreskin of a patient older than 28 days; the provider uses a technique other than a clamp, other devices, or dorsal slit.	2,890	$590	$1.7M
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…	35,310	$40	$1.4M

Showing 1–10 of 372

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Nevada Distribution

Sunrise Hospital And Medical Center, LLC — 17 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Nevada

Full comparison — all codes billed, vs. Nevada median

372 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
A0429	Ambulance service, basic life support, emergency transport (bls-emergency)	27	30	660	$210	$2.3M
41899	Use this code to report a procedure on the teeth and adjoining alveolar structures for which there is no specific code available.	12	20	470	$640	$1.5M
G0378	Hospital observation service, per hour	3	40	4,770	$110	$1.2M
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.	15	350	240	$110	$685.4K
92507	The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with…	37	150	1,060	$50	$482K
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.	2	400	200	$90	$442.5K
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.	6	140	210	$140	$421K
97530	The provider uses various activities during direct contact with the patient to improve the patient’s functional performance. Use this code for each 15 minutes of activity.	29	310	680	$50	$373.3K
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.	1	390	200	$60	$289.8K
87798	The lab analyst performs a test for an infectious agent not specified in another code using an amplified nucleic acid probe technique. Use this code if you know the laboratory technique is amplified…	5	30	290	$60	$260.3K

Showing 1–10 of 372

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Laboratory Corporation Of America Holdings	NC	Clinical Medical Laboratory	$214.6M	$1.4B
Laboratory Corporation Of America Holdings	NJ	Clinical Medical Laboratory	$143.3M	$717.5M
Natera, Inc.	CA	Clinical Medical Laboratory	$133.1M	$641.5M
Unilab Corporation	CA	Clinical Medical Laboratory	$94M	$668.5M
Bioreference Health, LLC	NJ	Clinical Medical Laboratory	$66.8M	$620.1M
Laboratory Corporation Of America Holdings	OH	Clinical Medical Laboratory	$56.9M	$617M
Millennium Health, LLC	CA	Clinical Medical Laboratory	$20.4M	$579.3M
Exact Sciences Laboratories, LLC	WI	Clinical Medical Laboratory	$299.3M	$276.5M
Aeroflow Inc.	NC	Durable Medical Equipment & Medical Supplies	$0	$571.9M
Zoll Services LLC	PA	Durable Medical Equipment & Medical Supplies	$0	$503.8M

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Fremont Emergency Services Scherr Ltd	NV	Emergency Medicine Physician	$0	$20.9M
Sunrise Hospital And Medical Center, LLC	NV	General Acute Care Hospital	$0	$17.1M
Sanjay Kandoth Md PC	NV	Pediatrics Physician	$0	$14.6M
Sdmi, LLC	NV	Diagnostic Radiology Physician	$0	$14.3M
Harold Zilberman M D Chtd	NV	Pediatrics Physician	$0	$14.3M
Radiology Specialists Ltd Marasso-miller	NV	Diagnostic Radiology Physician	$0	$13.9M
1st Love & Life Caregivers, LLC	NV	In Home Supportive Care Agency	$0	$10.8M
Childrens Lung Specialists	NV	Pediatric Pulmonology Physician	$0	$8.6M
Jlk Home Care, Inc	NV	In Home Supportive Care Agency	$0	$5.1M
Elsa Home Care Inc	NV	In Home Supportive Care Agency	$0	$4.8M

Sunrise Hospital And Medical Center, LLC — Billing Profile & Reimbursement Data

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Sunrise Hospital And Medical Center, LLC — Billing Profile & Reimbursement Data

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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