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Pikeville Medical Center INC

General Acute Care Hospital·Pikeville, KY·NPI: 1285621623Share

Compared to General Acute Care Hospital Peers

Total spending distribution among 156 providers in this specialty

P25MedianP75P90

This provider's total spending of $181.4M is at the 50th percentile among 156 General Acute Care Hospital providers.

Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$181.4M

$181,382,125

Total Claims

4.3M

Beneficiaries

3.1M

1.4 claims/patient

Avg Cost/Claim

$42

#525 of 618K providers by total spending(top <0.1%)

🔍 Analysis

Provider Overview

Pikeville Medical Center INC is a General Acute Care Hospital provider based in Pikeville, KY. From the 2018–2024 period, this provider received $181.4M in Medicaid payments across 4.3M claims.

Why This Matters

This provider received $181.4M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 22,672 Medicaid beneficiaries for a full year at average per-enrollee costs.

↑ 9% growthsince first billing year

Monthly Spending Trend

Yearly Spending

2018
$22.9M
+6%
2019
$24.3M
+8%
2020
$26.4M
+5%
2021
$27.7M
-6%
2022
$26.1M
+11%
2023
$28.9M
-14%
2024
$25.0M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 30 distinct procedure codes. The top code (G0463 (Hospital outpatient clinic visit)) accounts for 8% of total spending.

G0463Normal range

Hospital outpatient clinic visit

$14.0M

501K claims · 7.7%

Your Cost: $28.00/claim|Median: $26.41
1.1× median
99284Top 10%

Emergency dept visit, high complexity

$8.9M

48K claims · 4.9%

Your Cost: $185.11/claim|Median: $69.51
2.7× median
74177Top 5%

CT abdomen and pelvis with contrast

$8.6M

16K claims · 4.8%

Your Cost: $524.19/claim|Median: $65.76
8.0× median
99285Top 10%

Emergency dept visit, high/urgent complexity

$7.9M

36K claims · 4.4%

Your Cost: $217.64/claim|Median: $85.65
2.5× median
0202UTop 25%

Proprietary lab analysis, human genomic sequencing

$5.5M

19K claims · 3.0%

Your Cost: $294.95/claim|Median: $144.30
2.0× median
74176Top 5%

CT abdomen and pelvis without contrast

$5.4M

14K claims · 3.0%

Your Cost: $393.03/claim|Median: $60.19
6.5× median
99283Top 25%

Emergency dept visit, moderate complexity

$5.2M

42K claims · 2.9%

Your Cost: $125.28/claim|Median: $42.48
3.0× median
93306Top 5%

Echocardiography, transthoracic, complete, with Doppler

$3.5M

12K claims · 1.9%

Your Cost: $297.90/claim|Median: $54.68
5.5× median
70450Top 10%

CT head/brain without contrast

$2.9M

16K claims · 1.6%

Your Cost: $185.86/claim|Median: $45.53
4.1× median
G0378Normal range

Hospital observation service, per hour

$2.8M

18K claims · 1.5%

Your Cost: $152.69/claim|Median: $99.39
1.5× median
99212Top 25%

Office/outpatient visit, low complexity

$2.8M

69K claims · 1.5%

Your Cost: $40.01/claim|Median: $25.06
1.6× median
96372Top 5%

Therapeutic injection, subcutaneous/intramuscular

$2.7M

70K claims · 1.5%

Your Cost: $38.89/claim|Median: $9.56
4.1× median
71275Top 5%

CT angiography, chest, with contrast

$2.7M

6K claims · 1.5%

Your Cost: $441.82/claim|Median: $92.96
4.8× median
70553Top 25%

MRI brain without contrast, then with contrast

$2.3M

7K claims · 1.3%

Your Cost: $356.81/claim|Median: $133.68
2.7× median
96374Normal range

Therapeutic/prophylactic/diagnostic IV push, single substance

$2.2M

43K claims · 1.2%

Your Cost: $51.32/claim|Median: $21.76
2.4× median
96365Normal range

IV infusion, therapeutic/prophylactic/diagnostic, initial, up to 1 hour

$2.1M

32K claims · 1.2%

Your Cost: $66.42/claim|Median: $54.77
1.2× median
59025Top 5%

Fetal non-stress test

$2.0M

9K claims · 1.1%

Your Cost: $208.45/claim|Median: $26.45
7.9× median
20610Top 5%

Arthrocentesis, aspiration/injection, major joint

$1.9M

13K claims · 1.0%

Your Cost: $140.85/claim|Median: $29.03
4.8× median
87633Top 25%

Respiratory virus detection, 12-25 targets, nucleic acid

$1.7M

5K claims · 1.0%

Your Cost: $347.35/claim|Median: $169.17
2.0× median
41899Normal range

Unlisted procedure, dentoalveolar structures

$1.7M

2K claims · 1.0%

Your Cost: $768.82/claim|Median: $763.43
1.0× median
74178Top 5%

$1.7M

3K claims · 0.9%

Your Cost: $590.34/claim|Median: $122.85
4.8× median
43239Normal range

Upper GI endoscopy with biopsy

$1.7M

7K claims · 0.9%

Your Cost: $243.43/claim|Median: $151.68
1.6× median
72148Top 10%

MRI lumbar spine without contrast

$1.7M

5K claims · 0.9%

Your Cost: $342.38/claim|Median: $101.03
3.4× median
87502Top 25%

Influenza virus detection, reverse transcription, amplified probe

$1.7M

19K claims · 0.9%

Your Cost: $85.85/claim|Median: $65.64
1.3× median
93005Top 25%

Electrocardiogram, tracing only, without interpretation

$1.6M

57K claims · 0.9%

Your Cost: $27.24/claim|Median: $7.50
3.6× median
78452Top 25%

Myocardial perfusion imaging, SPECT, multiple studies

$1.6M

4K claims · 0.9%

Your Cost: $403.08/claim|Median: $106.14
3.8× median
96375Top 25%

Therapeutic/prophylactic/diagnostic IV push, each additional substance

$1.5M

43K claims · 0.8%

Your Cost: $34.36/claim|Median: $14.92
2.3× median
96361Normal range

IV infusion, hydration, each additional hour

$1.4M

43K claims · 0.8%

Your Cost: $32.50/claim|Median: $38.92
0.8× median
80053Top 25%

Comprehensive metabolic panel

$1.4M

115K claims · 0.8%

Your Cost: $11.92/claim|Median: $7.24
1.6× median
71045Top 10%

Chest X-ray, single view

$1.4M

40K claims · 0.7%

Your Cost: $33.70/claim|Median: $4.93
6.8× median

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