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.

Charleston Hospital Inc. (NPI 1891732889)

Charleston Hospital Inc. is a general acute care hospital provider located in Charleston, West Virginia. This profile covers 0 Medicare and 116 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Medicaid: Complete Services Breakdown

Field	Value
Entity Type	Organization
Organization	Charleston Hospital Inc.
Address	333 Laidley St
City	Charleston
State	WV
ZIP	25301
Taxonomy	General Acute Care Hospital
NPI Enumerated	May 31, 2006

Payer Source	Total Paid
Medicaid	$3.5M
Medicare	$0

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

116 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
11042	The provider uses surgical instruments to remove the dead tissue in skin down to the subcutaneous layer and including the epidermis and dermis, up to the first 20 cm2.	4,840	$100	$469K
43239	The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis.	850	$180	$151.1K
64494	In this add–on procedure, the provider injects a diagnostic or therapeutic substance into a single lumbar or sacral paravertebral facet (zygapophyseal) joint, or into the nerves that supply that…	380	$370	$139.1K
64495	In this add–on procedure, the provider injects a diagnostic or therapeutic substance into a lumbar or sacral paravertebral facet (zygapophyseal) joint, or into the nerves that supply that joint,…	290	$470	$138K
11043	The provider uses surgical instruments to remove the dead tissue in muscle and/or fascia, including any debridement of the epidermis, dermis, and subcutaneous tissue, for the first or only 20 cm2 or…	940	$140	$134.9K
88305	The physician, typically a pathologist, performs a level IV examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally…	1,580	$80	$130.9K
69436	This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia.	210	$580	$121K
64493	The provider injects a diagnostic or therapeutic substance into a single lumbar or sacral paravertebral facet (zygapophyseal) joint, or into the nerves that supply that joint, using imaging guidance…	340	$360	$120.7K
G0463	Hospital outpatient clinic visit for assessment and management of a patient	9,650	$10	$106.2K
J2250	Injection, midazolam hydrochloride, per 1 mg	940	$100	$92.1K

Showing 1–10 of 116

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

Charleston Hospital Inc. — 2 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

116 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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.	59	110	2,080	$50	$537.1K
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…	21	50	800	$70	$504.4K
G0481	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…	17	20	690	$80	$346.6K
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.	78	110	5,530	$20	$344.8K
C1713	Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable)	9	10	160	$660	$344.5K
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.	86	90	1,380	$60	$273.2K
80047	The lab analyst performs a basic metabolic panel (BMP) test in which he measures the blood level of eight chemicals identified in the descriptor including ionized calcium, sodium, potassium,…	6	10	160	$20	$255.3K
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	59	60	2,600	$40	$245.3K
99213	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…	483	1,270	1,240	$30	$245K
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…	82	140	3,080	$20	$243.1K

Showing 1–10 of 116

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Charleston Area Medical Center Inc	WV	General Acute Care Hospital	$0	$200.1M
Wv Birth To Three	WV	Early Intervention Provider Agency	$0	$59.9M
Charleston Area Medical Center, Inc.	WV	General Acute Care Hospital	$0	$50.9M
Children's Home Society Of West Virginia	WV	Emotionally Disturbed Childrens' Residential Treatment Facility	$0	$44.1M
Kanawha County Emergency Ambulance Authority	WV	Land Ambulance	$2.3M	$31.9M
Maxim Healthcare Services, Inc.	WV	Home Health Agency	$0	$19.9M
All-aid Services, Inc.	WV	Home Health Agency	$0	$16.3M
The Arc Of The Three Rivers, Inc.	WV	Case Management Agency	$0	$15.6M
Retina Consultants, PLLC	WV	Retina Specialist (Ophthalmology) Physician	$0	$13.6M
Dolan & Kalaskey Ltd	WV	Orthodontics and Dentofacial Orthopedics Dentistry	$0	$8.3M

Charleston Hospital Inc. — Billing Profile & Reimbursement Data

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Charleston Hospital Inc. — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

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