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Carilion Medical Center

General Acute Care Hospital·Roanoke, VA·NPI: 1033102942Share

Compared to General Acute Care Hospital Peers

Total spending distribution among 156 providers in this specialty

P25MedianP75P90

This provider's total spending of $124.9M is at the below 25th percentile among 156 General Acute Care Hospital providers.

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

Total Paid

$124.9M

$124,861,359

Total Claims

2.9M

Beneficiaries

2.1M

1.4 claims/patient

Avg Cost/Claim

$43

#948 of 618K providers by total spending(top 0.2%)

🔍 Analysis

Provider Overview

Carilion Medical Center is a General Acute Care Hospital provider based in Roanoke, VA. From the 2018–2024 period, this provider received $124.9M in Medicaid payments across 2.9M claims.

Why This Matters

This provider received $124.9M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 15,607 Medicaid beneficiaries for a full year at average per-enrollee costs.

↑ 80% growthsince first billing year

Monthly Spending Trend

Yearly Spending

2018
$10.9M
+54%
2019
$16.8M
-5%
2020
$16.1M
+18%
2021
$18.9M
+5%
2022
$19.8M
+14%
2023
$22.7M
-13%
2024
$19.7M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 30 distinct procedure codes. The top code (99284 (Emergency dept visit, high complexity)) accounts for 8% of total spending.

99284Top 10%

Emergency dept visit, high complexity

$10.3M

59K claims · 8.3%

Your Cost: $176.09/claim|Median: $69.51
2.5× median
99283Top 10%

Emergency dept visit, moderate complexity

$10.2M

58K claims · 8.2%

Your Cost: $175.84/claim|Median: $42.48
4.1× median
99285Top 25%

Emergency dept visit, high/urgent complexity

$8.4M

48K claims · 6.8%

Your Cost: $176.24/claim|Median: $85.65
2.1× median
96361Top 10%

IV infusion, hydration, each additional hour

$7.2M

25K claims · 5.8%

Your Cost: $292.21/claim|Median: $38.92
7.5× median
41899Normal range

Unlisted procedure, dentoalveolar structures

$4.2M

3,373 claims · 3.4%

Your Cost: $1,252.55/claim|Median: $763.43
1.6× median
43239Top 10%

Upper GI endoscopy with biopsy

$3.2M

5,709 claims · 2.5%

Your Cost: $555.44/claim|Median: $151.68
3.7× median
74177Top 25%

CT abdomen and pelvis with contrast

$2.8M

13K claims · 2.2%

Your Cost: $212.05/claim|Median: $65.76
3.2× median
97110Top 25%

Therapeutic exercises, each 15 min

$2.7M

50K claims · 2.1%

Your Cost: $53.60/claim|Median: $24.49
2.2× median
99282Top 10%

Emergency dept visit, low complexity

$2.5M

15K claims · 2.0%

Your Cost: $163.44/claim|Median: $37.72
4.3× median
93306Top 5%

Echocardiography, transthoracic, complete, with Doppler

$2.3M

7,245 claims · 1.9%

Your Cost: $319.32/claim|Median: $54.68
5.8× median
59899Top 1%

$2.3M

2,669 claims · 1.8%

Your Cost: $849.63/claim|Median: $86.86
9.8× median
70450Top 25%

CT head/brain without contrast

$2.2M

14K claims · 1.8%

Your Cost: $165.09/claim|Median: $45.53
3.6× median
92507Top 5%

Speech/hearing/language treatment

$2.2M

19K claims · 1.8%

Your Cost: $120.78/claim|Median: $49.45
2.4× median
64493Top 5%

$1.8M

1,969 claims · 1.5%

Your Cost: $936.49/claim|Median: $103.44
9.1× median
70553Top 25%

MRI brain without contrast, then with contrast

$1.8M

5,390 claims · 1.4%

Your Cost: $335.26/claim|Median: $133.68
2.5× median
77386Top 25%

Intensity modulated radiation treatment delivery, complex

$1.7M

3,309 claims · 1.3%

Your Cost: $508.69/claim|Median: $260.56
2.0× median
96366Top 5%

IV infusion, therapeutic/prophylactic/diagnostic, each additional hour

$1.6M

5,872 claims · 1.3%

Your Cost: $270.87/claim|Median: $40.12
6.8× median
99213Top 5%

Office/outpatient visit, est. patient, low-mod complexity

$1.6M

11K claims · 1.3%

Your Cost: $148.47/claim|Median: $37.81
3.9× median
99220Normal range

$1.4M

29K claims · 1.1%

Your Cost: $47.53/claim|Median: $73.56
0.6× median
64483Top 5%

$1.4M

1,826 claims · 1.1%

Your Cost: $751.90/claim|Median: $124.24
6.1× median
97530Top 25%

Therapeutic activities, each 15 min

$1.3M

21K claims · 1.0%

Your Cost: $63.55/claim|Median: $33.11
1.9× median
45385Top 10%

Colonoscopy with polyp removal, snare technique

$1.3M

2,016 claims · 1.0%

Your Cost: $637.33/claim|Median: $255.17
2.5× median
95810Top 25%

Polysomnography, sleep study, 6+ hours

$1.3M

2,040 claims · 1.0%

Your Cost: $624.87/claim|Median: $233.73
2.7× median
62323Top 5%

Epidural injection of diagnostic or therapeutic substance, lumbar

$1.3M

2,528 claims · 1.0%

Your Cost: $501.53/claim|Median: $111.02
4.5× median
78815Top 25%

PET imaging for limited area

$1.3M

1,612 claims · 1.0%

Your Cost: $784.15/claim|Median: $325.10
2.4× median
0241UNormal range

Proprietary lab analysis, genomic sequencing

$1.2M

16K claims · 1.0%

Your Cost: $77.48/claim|Median: $91.47
0.8× median
45380Top 25%

Colonoscopy with biopsy

$1.2M

2,236 claims · 1.0%

Your Cost: $545.18/claim|Median: $200.68
2.7× median
96360Top 25%

IV infusion, hydration, initial, 31 minutes to 1 hour

$1.2M

8,853 claims · 1.0%

Your Cost: $136.96/claim|Median: $61.57
2.2× median
71275Top 25%

CT angiography, chest, with contrast

$1.1M

5,911 claims · 0.9%

Your Cost: $180.13/claim|Median: $92.96
1.9× median
76705Top 10%

Ultrasound, abdominal, limited

$944K

9,660 claims · 0.8%

Your Cost: $97.72/claim|Median: $23.81
4.1× median

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