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

Why is the Medicaid comparison limited to North Carolina 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. North Carolina (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.

Wakemed (NPI 1972579837)

Field	Value
Entity Type	Organization
Organization	Wakemed
Address	3000 New Bern Ave
City	Raleigh
State	NC
ZIP	27610
Taxonomy	General Acute Care Hospital
NPI Enumerated	February 28, 2006

Payer Source	Total Paid
Medicaid	$140.8M
Medicare	$0

Key Findings

WAKEMED is effectively a single-payer Medicaid hospital in this dataset: it has Total Medicare revenue: none (no Medicare billing on file) while reporting Total Medicaid revenue: $140.8M. This concentration means all available claims-level analysis and competitive comparisons should be framed against Medicaid volumes and in-state peers rather than Medicare benchmarks.

Revenue concentration is extreme and ED-centric: the precomputed top 3 Medicaid codes account for 75.7% of WAKEMED’s total Medicaid revenue, driven by 99284 ($65.6M, 183.8K claims, $357 avg paid/claim — 48.9% of Medicaid revenue), 99283 ($29.7M, 166.9K claims, $178 avg paid/claim — 22.1%), and 99282 ($6.2M, 64K claims, $97 avg paid/claim — 4.6%). This makes the provider highly dependent on emergency department evaluation-and-management activity for its Medicaid revenue.

Operational profile: the top codes by revenue and volume are emergency department E/M services (99284, 99283, 99282), indicating WAKEMED functions as a high-throughput acute care hospital with heavy ED reliance and high-acuity capacity. Additional procedure and observation codes present in the top list (G0378, 99285, multiple infusion and lab codes) further support a model oriented around acute ED care, observation stays, IV treatments, and on-site diagnostics.

Competitive standing within North Carolina is dominant for core ED activity: 99283 ranks #2 of 316 providers in-state (100th percentile, labeled an extreme outlier) and 99284 ranks #6 of 325 providers (98th percentile, extreme outlier). Several other codes tied to ED throughput and diagnostics also rank at or near the top statewide (e.g., 0241U #1 of 136, 0240U #1 of 24, 96374 #1 of 118), signaling WAKEMED is a major in-state ED and hospital-based diagnostics provider rather than a modest participant.

Multiple codes are explicitly flagged as statistical outliers in-state, reinforcing atypically high throughput: beyond 99283 and 99284 being extreme outliers, codes such as 0241U, 0240U, 96374, 93005, 87631, and 84703 are also described as extreme outliers or near that level. These outlier labels indicate volumes far above typical state peers for a variety of ED, lab, and point-of-care diagnostic services rather than isolated pricing differences.

Service-line nuance: high volumes of ancillary ED and diagnostic services are visible in the top 25 Medicaid codes — for example, 96374 (47.3K claims, $37 avg paid/claim, $1.7M), 93005 (44K claims, $35 avg paid/claim, $1.5M), 85025 (140.8K claims, $9 avg paid/claim, $1.3M), and U0003 (15.9K claims, $86 avg paid/claim, $1.4M). This mix suggests the hospital pairs large-scale ED visits with high-frequency laboratory and point-of-care testing, consistent with a busy urban/suburban acute-care ED.

Tenure and stability: WAKEMED’s NPI was enumerated on 2006-02-28 (~20 years ago), indicating long-standing participation in the billing ecosystem and a sustained presence in the state market. Given the long tenure plus the concentrated Medicaid revenue base, analysts should expect established operational workflows driving the large ED and diagnostic volumes reported here.

Risk for payers and network planning: because nearly half of Medicaid revenue is tied to one code (99284 at $65.6M, 48.9% of Medicaid revenue) and the top three codes collectively account for 75.7% of Medicaid revenue, WAKEMED represents a concentrated utilization pattern for Medicaid populations. Payers should consider this concentration when modeling utilization, negotiating ED reimbursement, or planning care-delivery interventions focused on emergency and observation services.

Medicaid: Complete Services Breakdown

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

266 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.	183,810	$360	$65.6M
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.	166,860	$180	$29.7M
99282	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making.	64,000	$100	$6.2M
0241U	N/A	30,060	$180	$5.4M
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.	13,750	$380	$5.3M
0240U	N/A	24,170	$170	$4M
41899	Use this code to report a procedure on the teeth and adjoining alveolar structures for which there is no specific code available.	2,150	$1,110	$2.4M
G0378	Hospital observation service, per hour	10,550	$190	$2M
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	47,270	$40	$1.7M
93005	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…	44,010	$40	$1.5M

Showing 1–10 of 266

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. North Carolina Distribution

Wakemed — 14 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — North Carolina

Full comparison — all codes billed, vs. North Carolina median

266 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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.	6	330	6,130	$130	$2.7M
U0003	Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high…	17	160	840	$70	$2.3M
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.	2	320	6,160	$120	$2.1M
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.	69	280	2,690	$130	$1.6M
A0427	Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency)	161	170	2,470	$140	$1.2M
87661	The lab analyst performs a test for Trichomonas vaginalis using nucleic acid amplified probe technique.	34	70	280	$20	$896.7K
41899	Use this code to report a procedure on the teeth and adjoining alveolar structures for which there is no specific code available.	3	40	420	$1,080	$841K
80307	The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date.	123	360	1,830	$40	$819.8K
97530	The provider uses various activities during direct contact with the patient to improve the patient’s functional performance. Use this code for each 15 minutes of activity.	516	520	2,870	$70	$721.7K
87491	The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique.	23	190	530	$20	$635.1K

Showing 1–10 of 266

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Capital City Surgery Center, LLC	NC	Ambulatory Surgical Clinic/Center	$3.1M	$62.4K
Medical Foundation, Inc.	MS	Geriatric Medicine (Family Medicine) Physician	$0	$1.8M
Reema Munir	CA	Diagnostic Radiology Physician	$949.4K	$0
Patrick O'brien	NC	Physical Medicine & Rehabilitation Physician	$910.2K	$0
Holly Springs Surgery Center, LLC	NC	Ambulatory Surgical Clinic/Center	$641.8K	$0
Gregory Bortoff	NC	Diagnostic Radiology Physician	$587.7K	$0
Pavlo Netrebko	NC	Clinical Cardiac Electrophysiology Physician	$497.1K	$0
Thomas Sullivan	NC	Diagnostic Radiology Physician	$18.9K	$393.7K
Rama Garimella	NC	Cardiovascular Disease Physician	$396K	$0
Rajesh Vakani	NC	Cardiovascular Disease Physician	$373.1K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Carolina Outreach, LLC	NC	Community/Behavioral Health Agency	$0	$38M
County Of Wake	NC	State or Local Public Health Clinic/Center	$0	$26.4M
Southlight Healthcare	NC	Community/Behavioral Health Agency	$124.4K	$24.4M
Wake Emergency Physicians PA	NC	Emergency Medicine Physician	$0	$24.3M
Wake Specialty Physicians, LLC	NC	Surgery Physician	$0	$14.8M
Surgical Center For Dental Professionals Of Nc LLC	NC	Ambulatory Surgical Clinic/Center	$0	$11M
Advance Community Health, Inc	NC	Federally Qualified Health Center (FQHC)	$0	$10.8M
Advance Community Health, Inc	NC	Federally Qualified Health Center (FQHC)	$0	$10.7M
Family First Personal Care	NC	In Home Supportive Care Agency	$0	$9.5M
Southeastern Healthcare Of North Carolina, Inc.	NC	Community/Behavioral Health Agency	$0	$8.2M

Wakemed — Billing Profile & Reimbursement Data

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Wakemed — 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