Spartanburg Medical Center
Rate Outlier
Billing above the 90th percentile across multiple procedure codes simultaneously.
Billing above the 90th percentile for 158 procedure codes: 80053 at 14.0× median, Q9967 at 98.5× median.
Statistical flags are not proof of wrongdoing. Some entities (government agencies, home care programs) may legitimately bill at high rates. Hospitals, government entities, and large care organizations may legitimately bill at higher rates due to patient acuity, overhead costs, or specialized services. Read our methodology.
Red Flags Explained
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Each flag represents a statistical test that identified unusual billing patterns. Here's what each flag on this provider means in plain English:
Rate Outlier
Rate Outlier means this provider charges above the 90th percentile for multiple different procedure codes simultaneously. While one high-cost code could reflect specialization, consistently high rates across many codes may indicate systematic overbilling.
These flags are statistical indicators only. Many flagged providers have legitimate explanations for their billing patterns. Learn more about our methodology.
Risk Assessment
Bills $101.27 per claim for 80053 (Comprehensive metabolic panel) — 14.0× the national median of $7.24.
Bills $336.94 per claim for Q9967 (Low osmolar contrast material, 300-399 mg iodine/ml, per ml) — 98.5× the national median of $3.42.
Bills $482.00 per claim for J7040 (Normal saline solution infusion, 500 cc) — 434.2× the national median of $1.11.
Billing in the top 1% nationally for 10 procedure codes: Q9967, J7040, J7030.
This is a statistical summary, not an accusation. See our methodology.
Compared to Ambulance Peers
Total spending distribution among 12 providers in this specialty
This provider's total spending of $187.8M is at the 50th percentile among 12 Ambulance providers.
Total Paid
$187.8M
$187,762,034
Total Claims
3.8M
Beneficiaries
3.0M
1.2 claims/patient
Avg Cost/Claim
$49
#499 of 618K providers by total spending(top <0.1%)
🔍 Analysis
Provider Overview
Spartanburg Medical Center is a Ambulance provider based in Spartanburg, SC. From the 2018–2024 period, this provider received $187.8M in Medicaid payments across 3.8M claims.
Why This Matters
This provider received $187.8M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 23,470 Medicaid beneficiaries for a full year at average per-enrollee costs.
Monthly Spending Trend
Yearly Spending
Procedure Breakdown
Cost per claim compared to national benchmarks
This provider bills for 30 distinct procedure codes. The top code (80053 (Comprehensive metabolic panel)) accounts for 9% of total spending.
Comprehensive metabolic panel
$16.6M
164K claims · 8.8%
$9.8M
29K claims
$336.94
$3.42
Low osmolar contrast material, 300-399 mg iodine/ml, per ml
$9.8M
29K claims · 5.2%
$9.0M
19K claims
$482.00
$1.11
Normal saline solution infusion, 500 cc
$9.0M
19K claims · 4.8%
$8.3M
47K claims
$177.89
$1.53
Normal saline solution infusion, 1000 cc
$8.3M
47K claims · 4.4%
$7.8M
111K claims
$70.67
$37.81
Office/outpatient visit, est. patient, low-mod complexity
$7.8M
111K claims · 4.2%
$7.3M
128K claims
$57.10
$42.48
Emergency dept visit, moderate complexity
$7.3M
128K claims · 3.9%
$6.1M
12K claims
$499.03
$0.82
Normal saline solution infusion, 250 cc
$6.1M
12K claims · 3.3%
$6.0M
58K claims
$103.48
$1.57
Collection of venous blood by venipuncture
$6.0M
58K claims · 3.2%
$5.9M
105K claims
$56.29
$2.03
Urinalysis, automated, with microscopy
$5.9M
105K claims · 3.2%
$5.7M
21K claims
$272.72
$1.51
Ringer's lactate infusion, up to 1000 cc
$5.7M
21K claims · 3.0%
$5.4M
24K claims
$230.80
$9.56
Therapeutic injection, subcutaneous/intramuscular
$5.4M
24K claims · 2.9%
Therapeutic exercises, each 15 min
$5.2M
94K claims · 2.8%
Therapeutic activities, each 15 min
$4.6M
59K claims · 2.5%
Urine pregnancy test
$4.4M
52K claims · 2.3%
$4.3M
79K claims
$54.52
$49.45
Speech/hearing/language treatment
$4.3M
79K claims · 2.3%
$3.9M
30K claims
$130.54
$97.61
Respiratory virus detection, 6-11 targets, nucleic acid
$3.9M
30K claims · 2.1%
Basic metabolic panel
$3.5M
43K claims · 1.9%
$3.3M
22K claims
$148.08
$164.22
Ambulance, ALS emergency transport Level 1
$3.3M
22K claims · 1.8%
$3.0M
64K claims
$46.79
$53.41
Office/outpatient visit, est. patient, mod-high complexity
$3.0M
64K claims · 1.6%
$3.0M
37K claims
$80.22
$138.19
Ambulance, BLS emergency transport
$3.0M
37K claims · 1.6%
$2.3M
31K claims
$75.55
$69.35
Preventive medicine, established patient, infant (under 1)
$2.3M
31K claims · 1.3%
Emergency dept visit, low complexity
$2.3M
15K claims · 1.3%
$2.2M
2K claims · 1.2%
$1.6M
21K claims
$75.79
$12.93
Office/outpatient visit, minimal complexity
$1.6M
21K claims · 0.9%
$1.6M
17K claims
$92.57
$63.08
Infectious disease detection (COVID-19)
$1.6M
17K claims · 0.8%
$1.5M
1K claims · 0.8%
$1.5M
2K claims · 0.8%
$1.4M
25K claims
$55.29
$24.95
Chlamydia detection, nucleic acid, amplified probe
$1.4M
25K claims · 0.7%
$1.3M
3K claims
$485.94
$133.68
MRI brain without contrast, then with contrast
$1.3M
3K claims · 0.7%
$1.3M
15K claims
$89.33
$54.77
IV infusion, therapeutic/prophylactic/diagnostic, initial, up to 1 hour
$1.3M
15K claims · 0.7%
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