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    OpenPayerNPI Medicare & MedicaidSt Luke's Methodist Hospital
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    St Luke's Methodist Hospital — Billing Profile & Reimbursement Data

    NPI 1083708226 · Cedar Rapids, IA · General Acute Care Hospital

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    St Luke's Methodist Hospital is a general acute care hospital provider located in Cedar Rapids, Iowa. This profile covers 0 Medicare and 191 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

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    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeOrganization
    OrganizationSt Luke's Methodist Hospital
    Address1026 A Ave Ne
    CityCedar Rapids
    StateIA
    ZIP52402
    TaxonomyGeneral Acute Care Hospital
    NPI EnumeratedOctober 3, 2006

    Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)

    Payer SourceTotal Paid
    Medicaid$36.2M
    Medicare$0

    Key Findings

    This provider effectively operates as a Medicaid-focused facility: there is no Medicare billing on file while total Medicaid revenue is $36.2M, so the provider’s financial scale in available claims data is almost entirely driven by Medicaid reimbursements. That concentration creates a single-payer exposure in the claims dataset rather than a mixed Medicare/Medicaid profile.

    Revenue is highly concentrated in emergency department evaluation-and-management services: the top three Medicaid codes (99284, 99283, 99285) together account for 53.0% of the provider’s total Medicaid revenue. Individually these codes report $9.4M (27.0%), $5.7M (16.4%), and $3.3M (9.5%) respectively, indicating the ED is the primary revenue driver in the Medicaid population.

    The code mix indicates an acute care hospital with a busy emergency department and substantial outpatient procedural capability: high-revenue ED codes (99284/99283/99285) dominate, while procedural codes like 20610 ($2.5M, 7.2%) and G0260 ($2.4M, 6.8%) show frequent joint and sacroiliac injection services. Together these patterns point to combined emergency, ambulatory procedures, and interventional pain-management activity within the hospital’s outpatient offerings.

    On statewide competitive standing, the provider is a major outlier for several high-volume codes: 99283 ranks #6 of 305 providers in-state (98th percentile) and is labeled an "extreme outlier," while 99284 ranks #11 of 275 (96th percentile) indicating volumes well above typical state activity. Additionally, 99211 shows very high claim volume (97.4K claims, $1.2M revenue) and ranks #3 of 167 providers in-state (99th percentile), further demonstrating dominant outpatient/clinic throughput relative to peers.

    The hospital appears to offer unique or scarce services in-state: G0260 (sacroiliac joint injection) is reported as $2.4M in revenue and is the sole in-state provider listed (1 of 1 providers; no state peer volume comparison available), suggesting exclusive reporting for that procedure in the Medicaid dataset. This position could reflect a distinctive clinical capability or coding footprint for sacroiliac procedures within the state.

    Ancillary and post-acute services contribute materially to Medicaid revenue, indicating a broad service portfolio beyond ED care: S9123 (nursing care in the home) shows 26.4K claims and $2M revenue and ranks #1 of 11 providers in-state (100th percentile), while 92507 (speech/hearing services) reports 22.9K claims and $1.5M revenue (88th percentile). High volumes for infusion/IV medication administration (96374, $1.5M) and other therapy codes show the provider delivers significant outpatient and home-based clinical services.

    Several procedure codes are concentrated and extreme relative to peers, signaling focused clinical volumes in musculoskeletal and injection-based treatments: 20610 (14.3K claims, $2.5M revenue) ranks #2 of 39 providers in-state (97th percentile) and is described as an "extreme outlier," and J0585 (onabotulinumtoxina) contributes $1.1M (3.1%) and ranks #5 of 16 (73rd percentile). These procedural patterns reinforce a service-line emphasis on injections and specialty outpatient interventions.

    The provider has an established operating history in the NPI file, enumerated 2006-10-03 (~20 years ago), which aligns with the profile of a long-standing regional acute-care hospital with entrenched emergency and ambulatory procedural volumes. This tenure, combined with the Medicaid-centric revenue and multiple high-percentile code rankings, suggests a stable, regionally significant provider role in Iowa’s Medicaid ecosystem.

    Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

    Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.

    View: By Year1 / 3

    Medicaid: Complete Services Breakdown

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

    191 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    99284The 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.40,640$230$9.4M
    99283The 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.37,060$150$5.7M
    99285The 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.10,150$330$3.3M
    20610In this procedure, the provider inserts a needle through the skin of a patient and into a major joint or bursa and then uses the syringe attachment to the needle to remove fluid or he may inject a…14,300$180$2.5M
    G0260Injection procedure for sacroiliac joint; provision of anesthetic, steroid and/or other therapeutic agent, with or without arthrography9,710$240$2.4M
    S9123Nursing care, in the home; by registered nurse, per hour (use for general nursing care only, not to be used when cpt codes 99500-99602 can be used)26,430$80$2M
    96374The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.11,830$130$1.5M
    92507The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with…22,880$60$1.5M
    99211An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.97,380$10$1.2M
    J0585Injection, onabotulinumtoxina, 1 unit1,420$760$1.1M

    Showing 1–10 of 191

    • More pages

    Medicaid: Competitive Analysis & Benchmarks

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

    Full comparison — all codes billed, vs. Iowa median

    191 rows

    CPT/HCPCS CodeDescriptionRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    G0463Hospital outpatient clinic visit for assessment and management of a patient16701,440$90$2.8M
    G0260Injection procedure for sacroiliac joint; provision of anesthetic, steroid and/or other therapeutic agent, with or without arthrography1109,710$240$2.4M
    99284The 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.11280850$140$801.8K
    99285The 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.24180340$170$722K
    J0585Injection, onabotulinumtoxina, 1 unit520380$700$687.3K
    92507The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with…8602,110$70$570.5K
    99283The 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.63101,320$100$543.4K
    G0330Facility services for dental rehabilitation procedure(s) performed on a patient who requires monitored anesthesia (e.g., general, intravenous sedation (monitored anesthesia care) and use of an…710110$2,080$475.6K
    H0015Alcohol and/or drug services; intensive outpatient (treatment program that operates at least 3 hours/day and at least 3 days/week and is based on an individualized treatment plan), including…5202,150$80$334.3K
    S9123Nursing care, in the home; by registered nurse, per hour (use for general nursing care only, not to be used when cpt codes 99500-99602 can be used)110880$80$329.2K

    Showing 1–10 of 191

    • More pages

    Related Providers

    Other providers that share a Tax Identification Number (TIN) with St Luke's Methodist Hospital, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Unitypoint At HomeIADurable Medical Equipment & Medical Supplies$0$16.5M
    Unity HealthcareIAGeneral Acute Care Hospital$0$12.7M
    Trinity Regional Medical CenterIAGeneral Acute Care Hospital$0$12.3M
    Unitypoint At HomeIADurable Medical Equipment & Medical Supplies$0$5M
    Trinity Regional Medical CenterIAEmergency Medicine Physician$0$4.6M
    St. Luke's Methodist HospitalIACardiovascular Disease Physician$0$3.9M
    Unitypoint At HomeIADurable Medical Equipment & Medical Supplies$0$3.8M
    Unitypoint At HomeILHome Health Agency$0$3.5M
    Unitypoint At HomeIAHome Health Agency$0$3.3M
    Cass County Memorial HospitalIACritical Access Hospital$0$3.1M

    Nearby Providers

    Other providers in the same ZIP code as St Luke's Methodist Hospital, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Discovery Living, Inc.IAIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility$0$82M
    Prk Williams Inc.IAIn Home Supportive Care Agency$0$57.4M
    Life Connection, L.c.IAEarly Intervention Provider Agency$0$26.3M
    Medical Laboratories Of Eastern Iowa LcIAClinical Medical Laboratory$1.4M$14.4M
    East Central Iowa Acute Care, PLLCIAEmergency Medicine Physician$0$10.6M
    Covenant Family Solutions, LLCIACommunity/Behavioral Health Agency$0$8.5M
    Radiology Consultants Of Iowa, PlcIADiagnostic Radiology Physician$0$5.5M
    Weland Clinical Laboratories, P.C.IAClinical Medical Laboratory$1.2M$3.8M
    Comfort Care Medicare, IncIAHome Health Agency$0$3.9M
    Gentle Dental, P.C.IAGeneral Practice Dentistry$0$3.7M

    Frequently Asked Questions

    References

    1. 1.Medicare Physician & Other Practitioner by Provider and Service. CMS.gov.Provider-level Medicare Part B utilization and payment data.
    2. 2.NPPES NPI Registry. CMS.gov.National Provider Identifier registry used for provider enumeration and taxonomy metadata.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

    Medicaid Revenue by Year vs. Iowa Providers
    7 of 7 years billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Claims Volume vs. Iowa Distribution
    St Luke's Methodist Hospital — 6 of 25 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Iowa