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

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

Pinnacle Regional Hospital, Inc. (NPI 1952629370)

Field	Value
Entity Type	Organization
Organization	Pinnacle Regional Hospital, Inc.
Address	12850 Metcalf Ave
City	Overland Park
State	KS
ZIP	66213
Taxonomy	General Acute Care Hospital
NPI Enumerated	May 10, 2010

Payer Source	Total Paid
Medicaid	$12.8M
Medicare	$0

Medicaid: Complete Services Breakdown

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

25 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
Y7506	N/A	1,590	$3,230	$5.1M
X4006	N/A	950	$5,340	$5.1M
X4003	N/A	2,980	$840	$2.5M
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…	1,590	$50	$79.4K
J3490	Unclassified drugs	620	$30	$17.9K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	430	$30	$13.3K
72148	In this diagnostic procedure, the provider performs magnetic resonance imaging (MRI) of the lumbar spinal canal and contents without using contrast.	90	$130	$11K
G0463	Hospital outpatient clinic visit for assessment and management of a patient	450	$10	$5.4K
72114	In this diagnostic service, the provider performs a complete radiological study of the lumbar spine. He performs a minimum of six views that include the bending views of the spine.	110	$50	$5K
43775	Using laparoscopic technique, the provider reduces the size of the stomach by removing the bulk of the stomach in a vertical fashion. This procedure leaves a long, cylindrical stomach without the…	20	$50	$1K

Showing 1–10 of 25

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Kansas Distribution

Pinnacle Regional Hospital, Inc. — 1 of 14 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Kansas

Full comparison — all codes billed, vs. Kansas median

25 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
Y7506	N/A	2	10	1,030	$6,380	$10.6M
X4006	N/A	2	10	950	$3,250	$4M
X4003	N/A	3	10	3,320	$230	$1M
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…	355	1,050	560	$80	$266.8K
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…	336	880	400	$60	$136K
G0463	Hospital outpatient clinic visit for assessment and management of a patient	30	50	510	$10	$66.5K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	82	340	100	$100	$43.3K
99204	The provider sees a new 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 provider…	66	170	70	$90	$43.2K
99203	The provider sees a new 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 provider…	208	240	70	$70	$37.1K
93000	The provider records the electrical conduction of the heart to examine any abnormality in its functioning, based on signals from at least 12 leads, wires that connect the recording device to…	26	30	330	$10	$22.2K

Showing 1–10 of 25

Nearby Providers

Other providers in the same ZIP code as Pinnacle Regional Hospital, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Rose Estates	KS	Assisted Living Facility	$0	$4.4M
Christopher Koenig	KS	Rheumatology Physician	$2.3M	$0
Deer Creek Surgery Center, LLC	KS	Ambulatory Surgical Clinic/Center	$1.8M	$0
Saint Lukes South Hospital, Inc.	KS	General Acute Care Hospital	$0	$1.6M
Keith Warren	KS	Ophthalmology Physician	$1.1M	$8.4K
Mep Kansas LLC	KS	Emergency Medicine Physician	$0	$1.1M
Clare Roewe	KS	Family Nurse Practitioner	$952.9K	$0
Saint Lukes South Surgery Center LLC	KS	Ambulatory Surgical Clinic/Center	$949.8K	$0
Advanced Radiology Consultants Of Kansas City, PA	KS	Diagnostic Radiology Physician	$0	$840.3K
Aruna Baratham	KS	Rheumatology Physician	$768.3K	$0

Pinnacle Regional Hospital, Inc. — Billing Profile & Reimbursement Data

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Pinnacle Regional Hospital, Inc. — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References