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

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

Fairview Health Services (NPI 1013994359)

Field	Value
Entity Type	Organization
Organization	Fairview Health Services
Address	2450 Riverside Ave
City	Minneapolis
State	MN
ZIP	55454
Taxonomy	General Acute Care Hospital
NPI Enumerated	December 28, 2005

Payer Source	Total Paid
Medicaid	$90.4M
Medicare	$0

Key Findings

FAIRVIEW HEALTH SERVICES shows no Medicare billing on file and all reported public-payer activity is Medicaid-only, with total Medicaid revenue of $90.4M. In practical terms this profile functions as effectively single‑payer (Medicaid) in the available datasets, so analyses of public-program volume and competition should focus on Medicaid flows and state-level peers rather than Medicare comparisons.

The provider has a long-standing NPI: enumerated 2005-12-28 (~21 years ago), indicating stable operational tenure in the market and a history long enough to establish broad service lines and referral patterns in the region. This longevity supports interpreting high-volume code patterns as institutional capabilities rather than short-term anomalies.

Revenue is highly concentrated in a small set of outpatient and behavioral-health codes: the precomputed top three Medicaid codes (99285, G0463, H2035) account for 56.8% of the provider’s total Medicaid revenue. Individually those top three are 99285 $18.4M (21.8%), G0463 $16.2M (19.2%), and H2035 $13.3M (15.7%), which together dominate the payer revenue mix.

The operational footprint is consistent with a high-volume emergency department plus large hospital outpatient clinic presence: 99285 has 51.2K claims ($359 avg paid/claim) and $18.4M revenue, while related ED codes 99284 (46.5K claims, $9.7M) and 99283 (55.5K claims, $9.7M) further underline substantial ED throughput. At the same time G0463 shows extremely high outpatient clinic volume (192.9K claims, $16.2M), signaling that ambulatory hospital clinic visits are a major revenue driver alongside ED care.

Behavioral health and substance-use treatment are material service lines: H2035 (72.4K claims, $13.3M) is a top revenue driver and the dataset also shows 90853 group psychotherapy (26.2K claims, $2.1M) labeled an “extreme outlier” in-state, and 90791 psychiatric evaluation (10.4K claims, $1.2M) at the 98th percentile. Medication-assisted treatment is present via Q9991 and Q9992 (Sublocade) with $1.4M and $1.1M respectively and rank #1 of 2 providers in-state, indicating the provider is among the very few in the state billing these long‑acting buprenorphine products.

The provider is a statewide outlier in several throughput and procedural categories: 96361 (IV fluids, additional hour) is rank #1 of 68 with 9.9K claims and $859.6K revenue and labeled an “extreme outlier,” while 80053 (CMP) is also rank #1 of 302 with 40.5K claims and $647.9K revenue (100th percentile). High-volume diagnostics such as 87637 (multiplex SARS–CoV–2/flu/RSV testing; 7.5K claims, $1M) are likewise described as an “extreme outlier,” signaling dominant lab and infusion throughput relative to in-state peers.

Competitive standing is mixed by service line: for core emergency and clinic visit codes the provider sits near the top but not uniquely dominant (e.g., 99285 ranks #6 of 160, 97th percentile; G0463 ranks #7 of 81, 93th percentile), indicating major but not exclusive market share for ED and outpatient clinic care. Conversely, several specialty and ancillary codes show near-maximum in-state concentration (e.g., 90853 at the 98th percentile labeled an “extreme outlier,” 96361 and 80053 at the 100th percentile), suggesting market leadership in selected behavioral-health, infusion, and lab services.

Service breadth extends beyond ED and behavioral health into ancillary areas that support a broad Medicaid patient base: dental extractions D7140 ($1.4M, 1.2K claims), interpreter services T1013 (16.1K claims, $692.2K), ECT 90870 (1.5K claims, $388.8K), and obstetric/fetal ultrasound follow-up 76816 (4.4K claims, $386.3K) are all represented in the top 25. This mix indicates the provider operates a wide array of clinical programs—acute, behavioral, procedural, dental, diagnostic, and supportive services—consistent with a comprehensive general acute care hospital serving Medicaid populations.

Medicaid: Complete Services Breakdown

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

297 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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.	51,220	$360	$18.4M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	192,870	$80	$16.2M
H2035	Alcohol and/or other drug treatment program, per hour	72,450	$180	$13.3M
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.	46,540	$210	$9.7M
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.	55,480	$170	$9.7M
90853	Group psychotherapy is provided to a group of people who are normally not acquainted with each other but might be sharing similar kinds of psychological issues. The psychotherapist selects a group of…	26,170	$80	$2.1M
Q9991	Injection, buprenorphine extended-release (sublocade), less than or equal to 100 mg	1,010	$1,390	$1.4M
D7140	Extraction, erupted tooth or exposed root (elevation and/or forceps removal)	1,230	$1,140	$1.4M
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	10,410	$120	$1.2M
Q9992	Injection, buprenorphine extended-release (sublocade), greater than 100 mg	800	$1,360	$1.1M

Showing 1–10 of 297

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Minnesota Distribution

Fairview Health Services — 10 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Minnesota

Full comparison — all codes billed, vs. Minnesota median

297 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
G0463	Hospital outpatient clinic visit for assessment and management of a patient	7	80	6,550	$80	$4.4M
H2012	Behavioral health day treatment, per hour	24	40	6,530	$140	$3.7M
H2035	Alcohol and/or other drug treatment program, per hour	19	280	5,980	$120	$3M
H0035	Mental health partial hospitalization, treatment, less than 24 hours	9	10	1,690	$300	$2.4M
S5100	Day care services, adult; per 15 minutes	69	70	16,370	$70	$2M
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.	6	160	580	$170	$1.8M
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.	12	210	980	$140	$1.7M
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.	9	220	1,730	$120	$1.3M
41899	Use this code to report a procedure on the teeth and adjoining alveolar structures for which there is no specific code available.	6	10	280	$2,150	$1M
S5102	Day care services, adult; per diem	34	40	10,700	$80	$1M

Showing 1–10 of 297

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
North Memorial Health Care	MN	Ambulance	$0	$112.8M
Fairview Health Services	MN	Land Ambulance	$2.3M	$48.5M
Regions Hospital	MN	General Acute Care Hospital	$0	$44.4M
Fairview Express Care	MN	Specialist	$0	$33.1M
North Memorial Health Care	MN	General Acute Care Hospital	$0	$32.5M
Fairview Health Services	MN	General Acute Care Hospital	$0	$30M
Fairview Health Services	MN	Emergency Medicine Physician	$0	$26.6M
Fairview Pharmacy Services LLC	MN	Home Infusion Therapy Pharmacy	$72.8K	$20M
Fairview Health Services	MN	General Acute Care Hospital	$0	$17.2M
University Of Minnesota Health Clinics And Surgery Center, Inc.	MN	Clinic/Center	$0	$16.3M

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Kalkaal Home Care, Inc	MN	Home Health Agency	$0	$18.3M
Cedar Riverside People's Center	MN	Federally Qualified Health Center (FQHC)	$0	$15.3M
Loving Arms Adult Care	MN	Community/Behavioral Health Agency	$0	$7.9M
Mgm Home Care, Inc.	MN	Home Health Agency	$0	$7.1M
Smart Choice Adult Day Care LLC	MN	Community/Behavioral Health Agency	$0	$7M
University Of Minnesota Pediatric Dental Clinic	MN	Dentist	$0	$4.7M
Justin Miles	MN	Psychiatry Physician	$134.3K	$0
Daniel Popa	MN	Emergency Medicine Physician	$27.1K	$100.7K
Brian Johns	MN	Psychiatry Physician	$124.5K	$0
Daniel Miller	MN	Dermatology Physician	$123.1K	$0

Fairview Health Services — Billing Profile & Reimbursement Data

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Fairview Health Services — 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