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

Why is the Medicaid comparison limited to New York 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. New York (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.

Mount Sinai Hospital (NPI 1932103413)

Field	Value
Entity Type	Organization
Organization	Mount Sinai Hospital
Address	1 Gustave L Levy Pl
City	New York
State	NY
ZIP	10029
Taxonomy	General Acute Care Hospital
NPI Enumerated	June 13, 2005

Payer Source	Total Paid
Medicaid	$278.8M
Medicare	$0

Key Findings

MOUNT SINAI HOSPITAL bills almost exclusively to Medicaid at scale: lifetime Medicaid revenue is $278.8M and there is no Medicare billing on file. This makes the provider effectively single‑payer (Medicaid) in the supplied claims data and means Medicaid reimbursement patterns will dominate any revenue or utilization analysis for this entity.

Revenue is concentrated in a small set of high-volume outpatient evaluation-and-management and high-cost drug codes: the top three Medicaid codes (99213, 99214, J2350) together account for 34.7% of the provider's total Medicaid revenue. Individually these top drivers are 99213 ($24.2M, 13.6%), 99214 ($23.7M, 13.3%), and J2350 ($13.9M, 7.8%), indicating a mix of high outpatient clinic visits plus expensive specialty drug administration.

The outpatient clinic footprint is exceptionally large: 99213 has 224.2K claims ($24.2M) and is reported as an extreme outlier (rank #38 of 19110, 100th percentile), while 99214 has 221.4K claims ($23.7M) and is also an extreme outlier (rank #12 of 16554, 100th percentile). High concurrent volume in 99215 (53.6K claims, $7.4M; rank #6 of 2046, 100th percentile) further supports a dense ambulatory practice pattern with substantial higher-complexity visits.

Emergency and acute-care throughput is also elevated: ED E/M codes 99283 (50.6K claims, $8.2M; rank #45 of 1423, 97th percentile), 99284 (32.9K claims, $5.3M; rank #66 of 2210, 97th percentile), and 99285 (38.8K claims, $6M; rank #24 of 2333, 99th percentile) are all notably above typical state volume or extreme outliers. These volumes suggest a busy emergency department handling a wide spectrum of acuity levels and contributing materially to Medicaid revenue.

The provider is a significant site for oncology and specialty infusions: J2350 (ocrelizumab) appears as a top revenue driver (483 claims, $13.9M; rank #2 of 6, 80th percentile), and other high‑cost oncology/immunotherapy drugs such as J9271 (1.4K claims, $12.3M), J1745 (3.6K claims, $11.7M), J9144 (1.5K claims, $6.3M; rank #1 of 7, 100th percentile), and J9299 (678 claims, $6M) show meaningful revenue. The mix of these codes, plus high volumes in chemotherapy administration add‑ons (96415, 10K claims, $3.6M; rank #1 of 93, 100th percentile) and infusion-related supportive drugs (J2505, J1561), indicates substantial infusion center and oncology service-line capacity.

High diagnostic and procedural throughput appears concentrated in specific advanced services: routine phlebotomy 36415 has 495.2K claims ($5.4M) and ranks #1 of 5089 providers in-state (100th percentile, extreme outlier), nuclear cardiology 78452 has 11.4K claims ($2M) and ranks #1 of 341 (100th percentile, extreme outlier), and coronary angiography imaging 93458 (2.4K claims, $3.6M) ranks #2 of 77 (99th percentile). Together these data points signal large volumes in lab services, cardiac imaging/cath lab support, and other high-intensity diagnostics.

Behavioral health and observation services are nontrivial components of activity: psychotherapy codes 90834 (32.5K claims, $4.6M) and 90832 (23.7K claims, $2.9M) appear with high claim counts and are reported as typical or above-typical volumes, while hospital observation G0378 (4.7K claims, $5.2M) is an established contributor (rank #19 of 131, 86th percentile). This suggests the facility maintains both outpatient mental health capacity and structured short-term observation workflows.

Competitive standing and tenure reinforce a dominant in-state Medicaid presence: multiple codes are labeled as extreme outliers or sit at the 100th percentile in-state (including 99213, 99214, 99215, 36415, 96415, 78452), indicating MOUNT SINAI HOSPITAL is a major Medicaid provider across several service lines in New York. The NPI was enumerated 2005-06-13 (~21 years ago), signaling a long-standing operational presence in the market that aligns with the breadth and depth of reported claims activity.

Medicaid: Complete Services Breakdown

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

933 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	224,180	$110	$24.2M
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…	221,360	$110	$23.7M
J2350	Injection, ocrelizumab, 1 mg	480	$28,740	$13.9M
J9271	Injection, pembrolizumab, 1 mg	1,390	$8,850	$12.3M
J1745	Injection, infliximab, excludes biosimilar, 10 mg	3,610	$3,250	$11.7M
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.	50,570	$160	$8.2M
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	53,590	$140	$7.4M
J9144	Injection, daratumumab, 10 mg and hyaluronidase‑fihj	1,510	$4,150	$6.3M
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.	38,830	$160	$6M
J9299	Injection, nivolumab, 1 mg	680	$8,870	$6M

Showing 1–10 of 933

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. New York Distribution

Mount Sinai Hospital — 14 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — New York

Full comparison — all codes billed, vs. New York median

933 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2022	Case management, per month	26	80	360	$550	$11.6M
J2350	Injection, ocrelizumab, 1 mg	2	10	210	$26,790	$10.9M
J9271	Injection, pembrolizumab, 1 mg	6	20	750	$8,890	$8.1M
J1745	Injection, infliximab, excludes biosimilar, 10 mg	2	20	730	$2,870	$3.5M
J9299	Injection, nivolumab, 1 mg	2	10	360	$6,430	$3M
J2323	Injection, natalizumab, 1 mg	5	10	360	$4,710	$2.5M
J9144	Injection, daratumumab, 10 mg and hyaluronidase‑fihj	1	10	300	$4,540	$2.5M
17380	The provider uses short wave diathermy current to destroy and remove unwanted hair and prevent further hair growth.	3	10	2,680	$280	$2.2M
J3380	Injection, vedolizumab, intravenous, 1 mg	3	20	120	$5,050	$1.9M
J2505	Injection, pegfilgrastim, 6 mg	3	10	490	$2,730	$1.5M

Showing 1–10 of 933

Related Providers

Other providers that share a Tax Identification Number (TIN) with Mount Sinai Hospital, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mount Sinai Hospital	NY	General Acute Care Hospital	$0	$91.8M
Icahn School Of Medicine At Mount Sinai	NY	Cardiovascular Disease Physician	$0	$21.7M
Mount Sinai Medical Center Of Florida, Inc	FL	General Acute Care Hospital	$0	$18.3M
Karthik Gujja	NY	Cardiovascular Disease Physician	$2.9M	$394.9K
Nimesh Patel	NY	Legal Medicine	$671.3K	$2M
Concord Hospital, Inc.	NH	Emergency Medicine Physician	$0	$2.5M
Jessica Lee	NY	Ophthalmology Physician	$1.9M	$120.9K
Shane Meehan	NY	Dermatopathology (Pathology) Physician	$1.9M	$4.1K
David Pinhas	NY	Ophthalmology Physician	$1.4M	$330.5K
Windsor Ting	NY	Vascular Surgery Physician	$36.3K	$1.6M

Nearby Providers

Other providers in the same ZIP code as Mount Sinai Hospital, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Helping U Homecare, Inc.	NY	Home Health Agency	$0	$143.8M
New York City Health And Hospitals Corporation	NY	General Acute Care Hospital	$0	$100.7M
Fpa Hospital Based	NY	Emergency Medicine Physician	$0	$71M
Center For Comprehensive Health Practice Inc	NY	Multi-Specialty Clinic/Center	$125.5K	$11.9M
Ron Rosen	NY	Nuclear Medicine Physician	$2.4M	$8.9K
Carnegie Hill Endoscopy LLC	NY	Ambulatory Surgical Clinic/Center	$1.6M	$177.4K
Joseph Shams	NY	Vascular & Interventional Radiology Physician	$1.5M	$142.3K
Su Jung Lee	NY	Family Nurse Practitioner	$931.2K	$0
Ignatius Lau	NY	Vascular Surgery Physician	$853.5K	$0
David Mobley	NY	Vascular & Interventional Radiology Physician	$826.1K	$7.5K

Mount Sinai Hospital — 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