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.

Upmc Mercy (NPI 1881695146)

Field	Value
Entity Type	Organization
Organization	Upmc Mercy
Address	1400 Locust St
City	Pittsburgh
State	PA
ZIP	15219
Taxonomy	General Acute Care Hospital
NPI Enumerated	August 9, 2005

Payer Source	Total Paid
Medicaid	$16.7M
Medicare	$0

Medicaid: Complete Services Breakdown

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

324 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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.	37,030	$160	$6M
G0378	Hospital observation service, per hour	8,390	$270	$2.3M
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.	19,760	$100	$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.	11,560	$170	$2M
T1015	Clinic visit/encounter, all-inclusive	14,400	$30	$403.2K
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	18,160	$20	$326.8K
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.	2,390	$120	$279.7K
70450	The provider performed computed tomography, or CT scanning, of the head or brain, without contrast. He performs the procedure to diagnose any brain or intracranial abnormalities.	4,310	$50	$202.4K
66984	The provider inserts an artificial lens after removing an extracapsular cataract by aspiration or use of ultrasonic waves. This procedure is done without the use of an endoscopic laser probe to…	210	$860	$180.2K
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.	3,780	$40	$166.5K

Showing 1–10 of 324

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

Upmc Mercy — 8 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

324 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
G0378	Hospital observation service, per hour	5	150	510	$870	$1.4M
T1015	Clinic visit/encounter, all-inclusive	181	1,690	760	$170	$1.2M
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…	101	130	310	$60	$769.3K
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.	33	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…	88	200	990	$70	$517.5K
J0475	Injection, baclofen, 10 mg	3	10	330	$200	$443K
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.	31	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.	40	1,060	150	$130	$405.4K
A4351	Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each	21	20	590	$100	$332.8K
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.	54	1,230	250	$130	$284K

Showing 1–10 of 324

Nearby Providers

Other providers in the same ZIP code as Upmc Mercy, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Maxim Healthcare Services, Inc.	PA	Home Health Agency	$0	$54.9M
Renewl, Inc.	PA	Substance Abuse Rehabilitation Facility	$0	$29.7M
Passages To Recovery, Inc.	PA	Substance Abuse Rehabilitation Facility	$0	$9.9M
Every Child Inc	PA	Public Health or Welfare Agency	$0	$6M
Pamela Rath	PA	Ophthalmology Physician	$1.7M	$17.7K
Srinivas Kondapalli	PA	Ophthalmology Physician	$1.7M	$46.6K
Pinchas Rosenberg	PA	Ophthalmology Physician	$1.2M	$17.5K
Ravikumar Alagar	PA	Pulmonary Disease Physician	$373K	$0
Vivek Joshi	PA	Diagnostic Radiology Physician	$294.4K	$4.5K
Margaret Miller	PA	Diagnostic Radiology Physician	$51.6K	$176.9K

Upmc Mercy — Billing Profile & Reimbursement Data

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Upmc Mercy — 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