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 Magee-womens Hospital (NPI 1952311508)

Field	Value
Entity Type	Organization
Organization	Upmc Magee-womens Hospital
Address	300 Halket St
City	Pittsburgh
State	PA
ZIP	15213
Taxonomy	General Acute Care Hospital
NPI Enumerated	August 8, 2006

Payer Source	Total Paid
Medicaid	$43M
Medicare	$0

Key Findings

UPMC MAGEE-WOMENS HOSPITAL shows no Medicare billing on file and is effectively a single-payer Medicaid provider in the available dataset, with Total Medicaid revenue reported as $43M. The absence of Medicare revenue implies analyses of payer mix should treat this facility as Medicaid-dominant for the period covered rather than a mixed Medicare/Medicaid operator.

Revenue concentration in Medicaid is high: the precomputed top 3 Medicaid codes account for 42.5% of the provider's total Medicaid revenue. This indicates a relatively narrow set of services generates a large share of payment, increasing sensitivity of overall Medicaid revenue to volume or reimbursement changes for those leading codes.

The code mix points to a combined emergency, women’s health, and oncology/infusion service-line profile. High-volume ED codes 99284 (32.2K claims, $6.2M revenue) and 99283/99285 volumes reflect substantial emergency department throughput, while maternity code 59410 (497 claims, $657K) and high volumes of lab and screening codes (87661, 87491, 87591) align with a large obstetrics/gynecology and outpatient testing footprint.

Oncology and specialty infusion services are a prominent revenue driver: J9271 (pembrolizumab, $2.7M), J9312 (rituximab, $1.2M), J2323 (natalizumab, $1.2M), J9299 (nivolumab, $1.1M), and multiple other high-cost biologic codes rank at or near the top in-state. Several of these drugs are marked as extreme outlier or 100th percentile, signaling that the facility is a primary regional site for oncology and specialty infusions within Pennsylvania.

Competitive standing in-state is strong for multiple high-revenue codes: T1015 ranks #22 of 1691 (99th percentile; extreme outlier) and J9271 ranks #1 of 24 providers in-state (100th percentile; extreme outlier), indicating the hospital is a dominant provider for clinic encounters and pembrolizumab infusion among Pennsylvania Medicaid providers. ED code 99284 ranks #37 of 1604 (98th percentile), showing emergency services volume is also well above typical state peers.

Several high-cost drug codes where the hospital ranks #1 of few providers (e.g., J9312, J2323, J9299, J9173, J9306) suggest specialization in infusion therapies with limited peer competition statewide. Where the dataset notes no state peer volume comparison (0th percentile entries), these codes still contribute materially to Medicaid revenue and reflect service lines that are concentrated at this facility rather than broadly distributed across many institutions.

Operational implications include dependency on high-volume clinic/encounter and ED throughput plus specialized infusion oncology services; T1015 (99.2K claims, $3.6M) and ED codes together drive significant patient volume and revenue. Payers and network managers should view this facility as a high-capacity site for ambulatory encounters and complex infusion care that could be critical for Medicaid member access to oncology and women’s health services.

Provider tenure is long: the NPI was enumerated ~2006-08-08 (~20 years ago), indicating an established presence in the market which can support scale in the high-volume codes noted. That tenure, combined with top-state ranks on multiple codes, suggests entrenched referral relationships and infrastructure for the service lines observed.

Medicaid: Complete Services Breakdown

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

485 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.	32,250	$190	$6.2M
T1015	Clinic visit/encounter, all-inclusive	99,190	$40	$3.6M
J9271	Injection, pembrolizumab, 1 mg	3,890	$700	$2.7M
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…	15,770	$90	$1.4M
J9312	Injection, rituximab, 10 mg	830	$1,490	$1.2M
J2323	Injection, natalizumab, 1 mg	1,960	$610	$1.2M
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.	9,930	$120	$1.2M
J9299	Injection, nivolumab, 1 mg	1,140	$930	$1.1M
J9173	Injection, durvalumab, 10 mg	580	$1,690	$973.4K
J9306	Injection, pertuzumab, 1 mg	1,160	$830	$964.8K

Showing 1–10 of 485

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 Magee-womens Hospital — 16 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

485 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J1561	Injection, immune globulin, (gamunex-c/gammaked), non-lyophilized (e.g., liquid), 500 mg	3	10	1,490	$2,430	$3.8M
J1569	Injection, immune globulin, (gammagard liquid), non-lyophilized, (e.g., liquid), 500 mg	2	10	1,120	$1,340	$2.5M
J0490	Injection, belimumab, 10 mg	2	10	690	$3,540	$2.4M
J2350	Injection, ocrelizumab, 1 mg	3	10	170	$6,410	$1.9M
J1745	Injection, infliximab, excludes biosimilar, 10 mg	9	20	350	$1,720	$1.6M
G0378	Hospital observation service, per hour	35	150	510	$870	$1.4M
J2323	Injection, natalizumab, 1 mg	1	10	240	$2,130	$1.2M
T1015	Clinic visit/encounter, all-inclusive	22	1,690	760	$170	$1.2M
J9173	Injection, durvalumab, 10 mg	1	10	580	$1,690	$973.4K
J9306	Injection, pertuzumab, 1 mg	1	10	1,160	$830	$965K

Showing 1–10 of 485

Related Providers

Other providers that share a Tax Identification Number (TIN) with Upmc Magee-womens Hospital, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Paul Demjanenko	PA	Cardiovascular Disease Physician	$165.6K	$116.6K
James Cirbus	NY	Cardiovascular Disease Physician	$232.6K	$32.8K
David Strasser	PA	Cardiovascular Disease Physician	$164.7K	$85.6K
Anthony Bartholomew	NY	Internal Medicine Physician	$223.1K	$140
Antonio Roman	NY	Cardiovascular Disease Physician	$178.2K	$30.9K
George So	NY	Cardiovascular Disease Physician	$163.5K	$36.7K
Kelly Hayes	PA	Clinical Cardiac Electrophysiology Physician	$182.6K	$9.3K
Jean Moubarak	PA	Clinical Cardiac Electrophysiology Physician	$172.8K	$9.3K
James Campion	NY	Gastroenterology Physician	$157K	$6.6K
Christopher Good	PA	Cardiovascular Disease Physician	$85K	$37.6K

Nearby Providers

Other providers in the same ZIP code as Upmc Magee-womens Hospital, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Upmc Presbyterian Shadyside	PA	General Acute Care Hospital	$0	$125.5M
University Of Pittsburgh Physicians	PA	Psychiatry Physician	$0	$26.4M
University Of Pittsburgh Physicians	PA	Specialist	$0	$23.6M
Upmc Presbyterian Shadyside	PA	Methadone Clinic	$165.7K	$5.9M
Shyam Kodati	PA	Ophthalmology Physician	$1.1M	$0
Sandeep Sharma	PA	Nephrology Physician	$900.7K	$0
Badreddine Bencherif	PA	Specialist	$560.6K	$0
Ashima Lall	PA	Diagnostic Radiology Physician	$518.1K	$41.5K
Andrew Eller	PA	Specialist	$509.8K	$290
S. Kreps	PA	Child & Adolescent Psychiatry Physician	$39.8K	$462.6K

Upmc Magee-womens Hospital — Billing Profile & Reimbursement Data

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Upmc Magee-womens 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