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

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

Emerson Hospital (NPI 1922103357)

Emerson Hospital is a general acute care hospital provider located in Concord, Massachusetts. This profile covers 0 Medicare and 267 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	Emerson Hospital
Address	133 Old Road To 9 Acre Cor
City	Concord
State	MA
ZIP	01742
Taxonomy	General Acute Care Hospital
NPI Enumerated	September 13, 2006

Payer Source	Total Paid
Medicaid	$18.6M
Medicare	$0

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

267 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
96361	The provider administers intravenous, or IV, fluids with electrolytes through an already established intravenous route for each additional hour to treat more severe dehydration.	6,050	$320	$1.9M
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.	12,710	$140	$1.8M
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.	10,810	$140	$1.5M
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.	9,910	$150	$1.5M
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	24,540	$60	$1.4M
U0004	2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc, making use of high throughput technologies as described by…	19,270	$60	$1.2M
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.	4,040	$130	$508.8K
99214	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…	3,810	$120	$468.6K
97112	Neuromuscular reeducation is a therapeutic treatment (exercise) performed by a physician in an attempt to reduce impairments and restore function through the application of clinical skills and/or…	9,530	$40	$400.3K
59025	In this procedure, the provider measures the fetal heart rate of the fetus in response to its own movements.	1,530	$260	$398K

Showing 1–10 of 267

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Massachusetts Distribution

Emerson Hospital — 1 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Massachusetts

Full comparison — all codes billed, vs. Massachusetts median

267 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
96361	The provider administers intravenous, or IV, fluids with electrolytes through an already established intravenous route for each additional hour to treat more severe dehydration.	47	90	7,560	$350	$4.2M
S9485	Crisis intervention mental health services, per diem	86	110	1,250	$540	$3.2M
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…	36	50	1,870	$210	$1.4M
G0378	Hospital observation service, per hour	53	70	7,250	$100	$1.3M
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.	46	80	4,380	$140	$1.1M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	45	110	5,660	$30	$1.1M
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.	80	520	120	$130	$1M
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.	71	550	110	$120	$865.5K
99211	An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.	101	410	140	$110	$742.2K
87633	The lab analyst performs a test to identify a respiratory virus using amplified nucleic acid probe technique. He may also use a multiplex reverse transcription technique. The provider does this for…	26	30	270	$290	$731.4K

Showing 1–10 of 267

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Joseph Lee	MD	Clinical Cardiac Electrophysiology Physician	$726.5K	$0
Piotr Sobieszczyk	MA	Interventional Cardiology Physician	$169K	$0
Anju Nohria	MA	Cardiovascular Disease Physician	$86.8K	$0
Connie Tsao	MA	Cardiovascular Disease Physician	$54.3K	$670
David Lautz	MA	Surgery Physician	$35.1K	$7.6K
Charles Hardin	MA	Internal Medicine Physician	$35.5K	$0
Michael Muto	MA	Gynecologic Oncology Physician	$32.1K	$0
Colleen Feltmate	MA	Gynecologic Oncology Physician	$30.9K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Eliot Community Human Services	MA	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$36.9M
Anew Health LLC	MA	Adult Day Care Clinic/Center	$0	$17M
Minute Man Arc For Human Services, Inc.	MA	In Home Supportive Care Agency	$0	$10M
Minute Man Arc For Human Services, Inc.	MA	Developmental Disabilities Clinic/Center	$0	$9.6M
Matthew Zipoli	MA	MOHS-Micrographic Surgery Physician	$1.1M	$0
Jennifer Toyohara	MA	Dermatology Physician	$859.1K	$0
Margo Moskos	MA	Diagnostic Radiology Physician	$717.3K	$137.9K
Shields Pet-ct At Emerson Hospital LLC	MA	Mobile Radiology Clinic/Center	$590.3K	$0
Town Of Concord	MA	Land Ambulance	$346.6K	$100.9K
Paul D'ambrosio	MA	Internal Medicine Physician	$253.6K	$107.5K

Emerson Hospital — Billing Profile & Reimbursement Data

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Emerson Hospital — 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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