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.

Baptist Healthcare System, Inc (NPI 1902865389)

Key Findings

Field	Value
Entity Type	Organization
Organization	Baptist Healthcare System, Inc
Address	1 Trillium Way
City	Corbin
State	KY
ZIP	40701
Taxonomy	General Acute Care Hospital
NPI Enumerated	March 22, 2006

Payer Source	Total Paid
Medicaid	$121.5M
Medicare	$0

This provider is effectively single‑payer at scale: there is no Medicare billing on file and all reported federal fee‑for‑service revenue is from Medicaid, with total Medicaid revenue of $121.5M. That concentration means payer negotiations, utilization patterns, and service mix will be interpreted primarily through a Medicaid lens rather than a mixed Medicare/Medicaid strategy.

Revenue concentration is materially driven by a small set of ED and cardiac imaging codes: the top three Medicaid codes (99283, 99284, 78452) together account for 36.8% of this provider’s Medicaid revenue. Individually those codes report $10.6M (13.7%) for 99283, $10.2M (13.2%) for 99284, and $7.7M (9.9%) for 78452, indicating a heavy share of revenue tied to emergency department E/M visits and cardiac SPECT imaging.

The code mix indicates a high‑throughput emergency department aligned with substantial inpatient/acute imaging capacity: high claim counts for ED E/M codes (99283: 74.8K claims; 99284: 46.2K claims; 99285: 15K claims) paired with elevated CT/IP imaging codes (74177, 74176, 70450) suggest the hospital operates as a regional acute care hub where ED evaluation drives downstream radiology utilization. This pattern is consistent with an organization that funnels large ED volume into advanced diagnostic imaging and short‑term observation services.

Baptist Healthcare System manifests regional dominance in multiple cardiac imaging and diagnostic modalities. 78452 ranks #1 of 131 providers in‑state (100th percentile) and is labeled an "extreme outlier, far above typical state volume," while 93017 also ranks #1 of 64 providers (100th percentile) with the same extreme‑outlier label; A9500 is likewise #1 of 51 providers (100th percentile). These rankings and labels point to unusually large nuclear cardiology and stress‑test capacity relative to in‑state peers.

The provider also shows strong in‑house laboratory and molecular testing capabilities: 0202U (BioFire RP2.1) reports 15.8K claims and $4.8M revenue (6.3% of Medicaid revenue) and ranks #3 of 27 providers in‑state (92nd percentile, "notably above typical state volume"); 87636 (SARS–CoV–2/flu multiplex) reports 21.8K claims and $1.5M revenue and ranks #3 of 68 providers (97th percentile, labeled "typical, unremarkable volume"). Coupled with 80053 (CMP) at 183.5K claims, the data imply substantial onsite lab throughput supporting both acute and diagnostic pathways.

Surgical and procedural throughput appears meaningful: 47562 (laparoscopic cholecystectomy) generates $2.1M (2.7% of Medicaid revenue) and ranks #1 of 37 providers in‑state (100th percentile, "notably above typical state volume"), indicating above‑typical general surgery volume for this service line. High rankings for endoscopy (43239) and CTA/CT codes (71275, 74177) further support consistent operative and radiologic procedural capacity.

Infusion and oncology services are also evident in the mix: infusion administration codes (96365, 96375, 96374) show very large claim volumes (33.9K, 29.4K, 52.7K claims respectively) and sit at high in‑state percentiles (96365 is #4 of 100, 97th percentile; 96374 is #5 of 107, 96th percentile). Chemotherapy administration (96413) contributes $1.5M (1.9% of Medicaid revenue) and indicates an active infusion/oncology service line, suggesting the hospital supports ongoing medical oncology treatments in addition to acute care.

The provider has been an enumerated NPI for approximately two decades (NPI enumerated 2006-03-22, ~20 years ago), giving it an established footprint in the region; combined with the code‑level dominance in nuclear cardiac imaging and certain surgical procedures, this tenure supports the interpretation that the facility is a long‑standing regional acute care center with concentrated Medicaid exposure.

Medicaid: Complete Services Breakdown

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

497 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.	74,800	$140	$10.6M
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.	46,200	$220	$10.2M
78452	In this procedure, the provider performs multiple SPECT studies of the heart to determine the areas of deficient blood flow. The goal of the procedure is to determine areas that have deficient blood…	24,320	$320	$7.7M
93306	The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent…	19,010	$380	$7.2M
0202U	This is a Proprietary Laboratory Analyses (PLA) code, meaning that the code applies to only one unique lab test made by a specific manufacturer or performed by a specific lab. Report 0202U for the…	15,840	$310	$4.8M
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.	12,600	$350	$4.4M
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.	15,010	$290	$4.3M
74176	The provider performs computed tomography of the abdomen and pelvis without contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	12,560	$300	$3.7M
93017	The provider records the electrical activity of the heart to examine for any abnormality in its functioning by obtaining blood pressure and electrocardiograph readings at regular intervals with the…	10,730	$260	$2.8M
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.	33,850	$70	$2.5M

Showing 1–10 of 497

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

Baptist Healthcare System, Inc — 12 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

497 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J9271	Injection, pembrolizumab, 1 mg	9	10	810	$7,760	$8.7M
97535	A healthcare provider is required to give proper instruction to a person especially in cases of recovery from acute disease.	269	310	830	$120	$3.7M
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.	26	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.	52	240	4,710	$150	$2.6M
H0035	Mental health partial hospitalization, treatment, less than 24 hours	39	60	3,270	$170	$2.2M
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…	45	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.	8	280	5,700	$120	$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.	20	180	1,870	$280	$1.5M
G0378	Hospital observation service, per hour	35	90	2,770	$190	$1.3M
0202U	This is a Proprietary Laboratory Analyses (PLA) code, meaning that the code applies to only one unique lab test made by a specific manufacturer or performed by a specific lab. Report 0202U for the…	3	30	2,320	$290	$1.2M

Showing 1–10 of 497

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Cumberland River Behavioral Health, Inc	KY	Community/Behavioral Health Agency	$0	$349.5M
Grace Community Health Center, Inc.	KY	Federally Qualified Health Center (FQHC)	$0	$21.1M
Barnhill Pediatric Dentistry, P.s.c.	KY	Pediatric Dentistry	$0	$13.8M
Bhg Xxxiv, LLC	KY	Substance Use Disorder Rehabilitation Clinic/Center	$156.1K	$6.3M
Cumberland Valley Surgical Center, LLC	KY	Ambulatory Surgical Clinic/Center	$1M	$5.2M
Sav-rite Home Care Inc	KY	Durable Medical Equipment & Medical Supplies	$0	$6.1M
Southeastern Medical Supply LLC	KY	Durable Medical Equipment & Medical Supplies	$0	$6M
Corbin Pediatric Associates Psc	KY	Rural Health Clinic/Center	$0	$4.2M
Green Meadows Wellness Center One, LLC	KY	Clinical Psychologist	$0	$3.3M
Martin Case Management	KY	Intellectual and/or Developmental Disabilities Residential Treatment Facility	$0	$3.1M

Baptist Healthcare System, Inc — 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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Baptist Healthcare System, Inc	KY	General Acute Care Hospital	$0	$98.1M
Baptist Healthcare System Inc	KY	General Acute Care Hospital	$0	$95.7M
Baptist Healthcare System, Inc	KY	General Acute Care Hospital	$0	$72.6M
Baptist Healthcare System Inc.	KY	General Acute Care Hospital	$0	$62.4M
Baptist Healthcare System, Inc.	KY	General Acute Care Hospital	$0	$58.5M
Hardin Memorial Hospital	KY	General Acute Care Hospital	$0	$37.2M
Baptist Healthcare System, Inc.	IN	General Acute Care Hospital	$0	$34.6M
Baptist Healthcare System, Inc.	KY	General Acute Care Hospital	$0	$16.1M
Baptist Healthcare System, Inc.	KY	Ambulatory Surgical Clinic/Center	$1.2M	$183.5K
Baptist Healthcare System Inc	KY	Land Ambulance	$424.7K	$47.4K