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 Area Medical Center Inc (NPI 1952390239)

Field	Value
Entity Type	Organization
Organization	Charleston Area Medical Center Inc
Address	501 Morris St
City	Charleston
State	WV
ZIP	25301
Taxonomy	General Acute Care Hospital
NPI Enumerated	October 19, 2005

Payer Source	Total Paid
Medicaid	$200.1M
Medicare	$0

Key Findings

CHARLESTON AREA MEDICAL CENTER INC is effectively a single‑payer Medicaid provider: it reports no Medicare billing on file and records $200.1M in lifetime Medicaid revenue, indicating the organization’s measurable public‑payer footprint is concentrated in Medicaid rather than Medicare. This payer mix suggests reliance on state Medicaid volumes for the bulk of its reimbursed activity.

Revenue is heavily concentrated in a small set of emergency department E/M codes: the top three Medicaid codes (99285, 99284, 99283) account for 48.2% of the provider’s total Medicaid revenue, with individual contributions of $24.9M (23.0%), $18.2M (16.8%), and $9.1M (8.4%) respectively. This concentration points to ED encounters as the principal revenue driver for the organization.

The code mix and volumes identify this facility as a high‑throughput acute care hospital with a dominant emergency department presence — 99284 ranks #1 of 168 providers in-state (100th percentile; extreme outlier) and 99283 ranks #1 of 163 (100th percentile; extreme outlier), while 99285 is also an extreme outlier at $24.9M revenue and ranks #3 of 132 (98th percentile). Multiple ED- and observation-related codes (including G0378 at $2.7M) and large token counts for ED E/M and related drug administrations indicate significant unscheduled/urgent care throughput.

CHARLESTON demonstrates comprehensive diagnostic and monitoring capacity: large volumes and high state ranks appear across imaging and laboratory codes such as 74177 ($4.1M, ranks #6 of 76; typical, unremarkable volume), 70450 ($1.7M, ranks #6 of 90; notably above typical), and high-volume lab panels 85025 ($3.9M, ranks #1 of 138; extreme outlier), 80047 ($2.2M, ranks #1 of 10; 100th percentile) and 80053 ($1.9M, ranks #2 of 111; 99th percentile). These patterns are consistent with a large hospital handling both ED and inpatient/outpatient diagnostic workflows at scale.

The provider also supports specialty infusion and oncology services: J9271 (pembrolizumab) generated $5M and ranks #1 of 4 providers in-state (100th percentile; typical, unremarkable volume), J1745 (infliximab) produced $1.6M and ranks #1 of 4 (100th percentile), and chemotherapy administration 96413 generated $1.8M (ranks #2 of 20; 95th percentile). These entries show a staffed infusion/oncology capability contributing materially to Medicaid revenue alongside ED and diagnostic services.

Procedural and interventional capabilities are evident in higher‑unit‑price codes: 93458 (coronary angiography imaging) produced $1.5M and ranks #1 of 25 providers (100th percentile; extreme outlier), and implantable device C1713 generated $1.8M (ranks #2 of 9; 88th percentile; notably above typical). The presence and ranking of these codes support that the hospital performs advanced cardiology and surgical procedures beyond routine ED care.

Across a broad set of codes the provider is frequently a statewide leader: many codes are ranked #1 or in the top few and are described as "extreme outlier" or at the 100th percentile (examples include 99284, 99283, 85025, 93005, J2704, J3010, J1100 and others). This consistent top‑state ranking across ED, lab, imaging and drug administration codes indicates dominant market share within West Virginia for several high‑volume service lines.

The provider’s NPI tenure (enumerated 2005-10-19, ~21 years ago) confirms it is an established hospital entity; combined with the $200.1M Medicaid lifetime revenue and the pronounced code‑level dominance, the data characterize CHARLESTON AREA MEDICAL CENTER INC as a long‑standing regional acute care hub with outsized Medicaid‑funded ED, diagnostic, infusion, and procedural activity.

Medicaid: Complete Services Breakdown

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

736 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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.	58,240	$430	$24.9M
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.	104,240	$180	$18.2M
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.	95,000	$100	$9.1M
41899	Use this code to report a procedure on the teeth and adjoining alveolar structures for which there is no specific code available.	6,370	$1,140	$7.3M
J9271	Injection, pembrolizumab, 1 mg	910	$5,480	$5M
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.	15,620	$260	$4.1M
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…	257,050	$20	$3.9M
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	144,020	$20	$2.9M
G0378	Hospital observation service, per hour	6,930	$380	$2.7M
J3010	Injection, fentanyl citrate, 0.1 mg	40,750	$60	$2.6M

Showing 1–10 of 736

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 Area Medical Center Inc — 19 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

736 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J9271	Injection, pembrolizumab, 1 mg	1	10	470	$4,910	$2.4M
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.	3	130	2,090	$210	$1.5M
41899	Use this code to report a procedure on the teeth and adjoining alveolar structures for which there is no specific code available.	1	10	580	$1,120	$1.3M
87491	The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique.	2	40	820	$30	$1.2M
87591	The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique.	2	40	820	$30	$1.2M
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.	1	170	3,350	$120	$1.1M
J0585	Injection, onabotulinumtoxina, 1 unit	4	10	2,680	$320	$1M
88175	The lab analyst performs the technical lab test to analyze a cervical or vaginal cytopathology specimen that a clinician collected in preservative fluid. The test uses automated thin layer…	4	20	70	$20	$832.7K
87798	The lab analyst performs a test for an infectious agent not specified in another code using an amplified nucleic acid probe technique. Use this code if you know the laboratory technique is amplified…	23	30	180	$40	$773.3K
87624	The lab analyst performs a test to determine the presence of human papillomavirus, or HPV. The provider uses nucleic acid detection for high–risk types and produces a pooled result.	3	20	720	$20	$721.7K

Showing 1–10 of 736

Related Providers

Other providers that share a Tax Identification Number (TIN) with Charleston Area Medical Center Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Charleston Area Medical Center, Inc.	WV	General Acute Care Hospital	$0	$50.9M
Columbus Radiology Corp	OH	Diagnostic Radiology Physician	$0	$49.9M
Somc Medical Care Foundation, Inc.	OH	Family Medicine Physician	$0	$25.3M
Rainelle Medical Center Inc	WV	Federally Qualified Health Center (FQHC)	$0	$14.3M
Mark Le	FL	Diagnostic Radiology Physician	$10.7M	$0
Rajiv Khanna	WV	Medical Oncology Physician	$2M	$0
Charleston Area Medical Center, Inc.	WV	Hospitalist Physician	$0	$1.4M
Mayez El-harake	WV	Medical Oncology Physician	$1.1M	$0
Linda Armstrong	GA	Diagnostic Radiology Physician	$643.9K	$175.1K
Robert Fried	KY	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	$719.4K	$0

Nearby Providers

Other providers in the same ZIP code as Charleston Area Medical Center Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Wv Birth To Three	WV	Early Intervention Provider Agency	$0	$59.9M
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
Mindoula Health Inc.	WV	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$6.7M
Kanawha Valley Center Inc	WV	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$6M

Charleston Area Medical Center 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