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

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

University Medical Center, Inc (NPI 1861554438)

Field	Value
Entity Type	Organization
Organization	University Medical Center, Inc
Address	530 S Jackson St
City	Louisville
State	KY
ZIP	40202
Taxonomy	General Acute Care Hospital
NPI Enumerated	December 13, 2006

Payer Source	Total Paid
Medicaid	$179.5M
Medicare	$0

Key Findings

This provider effectively operates as a Medicaid-centric hospital: there is no Medicare billing on file while total Medicaid revenue is $179.5M, so the organization is highly exposed to Medicaid reimbursement policy and payer contracting dynamics rather than Medicare flows. The absence of Medicare claims indicates a single-payer concentration that should shape risk and network-management analysis for payers and competitors alike.

Revenue concentration is high: the top 3 Medicaid codes by revenue account for 47.3% of this provider's total Medicaid revenue. Those top drivers are 99285 ($27.9M, 22.2%), J9271 ($19.2M, 15.3%), and 99284 ($12.2M, 9.7%), showing the hospital relies heavily on a small set of high-revenue services.

Emergency department services are a central service line. Multiple high-acuity E/M codes appear near the top of the Medicaid revenue list—99285 (59.4K claims, $470 avg, $27.9M, 22.2%), 99284 (55.5K claims, $219 avg, $12.2M, 9.7%), 99283 (65.4K claims, $131 avg, $8.6M, 6.8%) and 99282 (34.2K claims, $93 avg, $3.2M, 2.5%)—which together indicate heavy ED throughput and material revenue tied to emergency care intensity.

The provider shows a substantial oncology and infusion footprint. High-cost oncology drug billing is led by J9271 (pembrolizumab, $19.2M, 15.3%) which ranks #2 of 9 in-state and is described as notably above typical state volume, and chemotherapy administration codes such as 96413 ($6.1M, 4.9%) rank #3 of 48 (96th percentile; notably above typical), supporting a large infusion oncology program driving nontrivial Medicaid spend.

Advanced imaging, radiation, and procedural services contribute meaningfully to revenue and suggest substantial capitalized service lines. CT and MRI codes (74177 $6.2M, 4.9%; 70450 $2.9M, 2.3%; 71260 $2.7M, 2.1%) and IMRT delivery 77386 ($2.7M, 2.1%) are in the top billers, and several of these imaging/RAD codes rank at or near top statewide percentiles, indicating concentrated volume in diagnostic and therapeutic technology.

Hospital observation and ancillary services are unusually prominent in state comparisons. G0378 (hospital observation service) shows 42.7K claims and $2M revenue (1.6%) and ranks #3 of 87 in-state (98th percentile; labeled an extreme outlier), while observation-adjacent codes like G0463 (59.8K claims, $2.3M, 1.9%) also appear high, suggesting the facility relies heavily on observation-level care and throughput management as part of its payer mix.

Competitive standing is mixed but strong in several specialist areas: the provider is an extreme or high outlier in multiple statewide metrics (for example, 71260 and 72125 both rank in the 98th percentile and are called extreme outliers), while it is also notably above typical volume on oncology administration codes (96413 at the 96th percentile). These rank patterns imply the hospital is a major state-level player for imaging, certain procedural services, and oncology infusions, even if some common codes are labeled "typical, unremarkable" despite high percentiles.

The provider has an established operational tenure, with an NPI enumerated on 2006-12-13 (~20 years ago). This two-decade presence combined with concentrated Medicaid revenue profiles and specialist service-line strengths (ED, oncology infusion, imaging, observation services) frames it as an entrenched Medicaid-focused acute-care facility that payers should evaluate for contracting leverage, referral patterns, and capacity in these high-volume areas.

Medicaid: Complete Services Breakdown

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

492 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.	59,380	$470	$27.9M
J9271	Injection, pembrolizumab, 1 mg	2,930	$6,570	$19.2M
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.	55,500	$220	$12.2M
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.	65,420	$130	$8.6M
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.	15,500	$400	$6.2M
96413	Chemotherapy is a therapeutic procedure used for the treatment of cancer via the use of chemical agents. These chemical agents (drugs) work on the cancerous cells of the body to destroy them. These…	16,750	$360	$6.1M
J9299	Injection, nivolumab, 1 mg	980	$4,240	$4.2M
96375	Following the administration of a drug or other substance via intravenous, or IV, push, the provider sequentially infuses a different medication or medications, also via IV push. He administers the…	28,090	$120	$3.4M
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.	34,240	$90	$3.2M
96365	The provider administers the initial intravenous infusion of a medication or other substance for a period up to one hour to prevent, treat, or diagnose a condition or disease.	16,200	$180	$2.9M

Showing 1–10 of 492

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Kentucky Distribution

University Medical Center, Inc — 7 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Kentucky

Full comparison — all codes billed, vs. Kentucky median

492 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J9271	Injection, pembrolizumab, 1 mg	2	10	810	$7,760	$8.7M
J9299	Injection, nivolumab, 1 mg	2	10	540	$6,390	$4M
97535	A healthcare provider is required to give proper instruction to a person especially in cases of recovery from acute disease.	126	310	830	$120	$3.7M
77386	Intensity modulated radiation treatment delivery (IMRT), includes guidance and tracking, when performed; complex	4	10	4,350	$560	$3.3M
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.	16	280	7,150	$150	$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.	11	240	4,710	$150	$2.6M
J1745	Injection, infliximab, excludes biosimilar, 10 mg	4	10	140	$3,650	$2.5M
G0483	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…	36	70	1,650	$100	$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.	12	280	5,700	$120	$2M
41899	Use this code to report a procedure on the teeth and adjoining alveolar structures for which there is no specific code available.	37	40	740	$1,170	$1.7M

Showing 1–10 of 492

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Norton Hospitals Inc	KY	General Acute Care Hospital	$0	$419.8M
Norton Hospitals, Inc	KY	General Acute Care Hospital	$0	$299.3M
Uofl Health-louisville Inc	KY	General Acute Care Hospital	$0	$283.3M
Verralab Ja LLC	KY	Clinical Medical Laboratory	$304.7K	$38.8M
University Medical Associates	KY	Internal Medicine Physician	$0	$17.3M
Ocean Behavioral Healthcare LLC	KY	Clinical Social Worker	$0	$11.9M
University Emergency Medicine Associates P.s.c.	KY	Emergency Medicine Physician	$0	$11.8M
Recovery Chestnut, LLC	KY	Addiction (Substance Use Disorder) Counselor	$0	$10.9M
Green House Recovery And Rehabilitation Center	KY	Multi-Specialty Clinic/Center	$0	$10.6M
University Of Louisville	KY	General Practice Dentistry	$0	$8.3M

University Medical Center, Inc — Billing Profile & Reimbursement Data

Sign up for University Medical Center, Inc — Billing Profile & Reimbursement Data policy alerts

University Medical Center, Inc — Billing Profile & Reimbursement Data

Sign up for University Medical Center, 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

Nearby Providers

Frequently Asked Questions

References