Loading...
NPI 1225195340 · Muncie, IN · General Acute Care Hospital
Customize your policy alerts
Get alerted when relevant policies change without checking for updates manually.
Monitor payer policy activity
Indiana University Health Ball Memorial Hospital, Inc. is a general acute care hospital provider located in Muncie, Indiana. This profile covers 0 Medicare and 211 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.
Provider details (source: NPPES NPI Registry)
| Field | Value |
|---|---|
| Entity Type | Organization |
| Organization | Indiana University Health Ball Memorial Hospital, Inc. |
| Address | 2401 W University Ave |
| City | Muncie |
| State | IN |
| ZIP | 47303 |
| Taxonomy | General Acute Care Hospital |
| NPI Enumerated | January 2, 2007 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $44.5M |
| Medicare | $0 |
INDIANA UNIVERSITY HEALTH BALL MEMORIAL HOSPITAL, INC. is effectively a Medicaid-focused provider on file: there is no Medicare billing on file while Total Medicaid revenue is $44.5M, indicating the dataset reflects a single-payer (Medicaid) revenue footprint rather than a mixed Medicare/Medicaid profile. This concentration in a single payer should shape any payer-strategy analysis or risk adjustment assumptions for this facility.
Revenue concentration is high within a small set of emergency department E/M codes: the precomputed top 3 Medicaid codes account for 42.5% of this provider's total Medicaid revenue, and those top three individual codes are 99284 ($5.9M), 99283 ($5.8M), and 99285 ($5.4M). That level of concentration around a small number of ED visit codes indicates the emergency department is a primary revenue driver for the hospital's Medicaid business.
The code mix and top-revenue services profile this entity as a full-service acute hospital with heavy emergency care throughput and significant ancillary services: 99284, 99283, and 99285 (moderate/low/high ED E/M) dominate revenue, while procedural and diagnostic codes such as 11042 ($5M, debridement), 95810 ($3.5M, polysomnography), and 74177 ($1.3M, CT A/P with contrast) show a mix of surgical wound care, sleep-lab capability, and advanced imaging on-site. Together these codes suggest an operation handling high ED volume plus in-hospital procedural and diagnostic capacity rather than a narrowly focused specialty clinic.
Competitive standing in-state is mixed but strong in several service lines. For core ED codes the provider ranks in upper state percentiles (99284 ranks #37 of 382, 91st percentile; 99283 ranks #34 of 364, 91st percentile; 99285 ranks #18 of 325, 95th percentile) which places it among higher-volume Medicaid ED providers in Indiana even though the descriptor labels these volumes as "typical, unremarkable" for the codes. The hospital is a clear outlier or top-tier performer for several non-ED services: 11042 ranks #5 of 142 (97th percentile, described as notably above typical state volume), 96374 ranks #4 of 116 (97th percentile, notably above typical), and 96361 ranks #3 of 107 (98th percentile, notably above typical), marking it as a leading state provider for wound debridement and IV medication/infusion activity.
Laboratory and routine diagnostic throughput is also elevated relative to peers, supporting the picture of high inpatient/outpatient volume: 85025 (CBC) shows 90.2K claims and ranks #10 of 289 (97th percentile, notably above typical state volume), and 80053 (CMP) has 54.3K claims and ranks #12 of 211 (95th percentile, notably above typical). These high claim counts for common panels indicate sustained baseline inpatient/outpatient diagnostic work that complements the ED and procedural revenue streams.
Sleep medicine and polysomnography are meaningful specialty revenue contributors for Medicaid patients: 95810 accounts for $3.5M (8.7% of total Medicaid revenue) and ranks #7 of 58 (89th percentile, typical), while 95811 contributes $573.6K and ranks #7 of 34 (82nd percentile). The presence of multi-thousand-claim sleep-study billing suggests an established sleep lab program that adds material non-ED Medicaid revenue.
The provider has maintained an NPI since 2007-01-02 (~19 years ago), reflecting long tenure as a General Acute Care Hospital in MUNCIE, IN; this sustained presence, combined with the code mix, supports characterization as an established community hospital with robust ED, procedural, imaging, lab, infusion, and sleep services for Medicaid patients. Longevity strengthens the inference that current billing patterns reflect operational capacity rather than a transient programmatic change.
Operationally, the hospital shows both breadth and some concentrated specialties: while emergency E/M codes drive a large share of Medicaid revenue (top 3 = 42.5%), specific high-percentile codes (11042, 96374, 96361, 85025, 80053) indicate outsized state-level activity in wound debridement, IV therapy/infusions, and high-volume lab testing. For payer or network planning, these service-line concentrations and state ranking signals identify areas where the hospital is a likely referral or capacity center within Indiana's Medicaid network.
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
Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
211 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 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. | 41,400 | $140 | $5.9M |
| 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. | 38,520 | $150 | $5.8M |
| 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. | 41,740 | $130 | $5.4M |
| 11042 | The provider uses surgical instruments to remove the dead tissue in skin down to the subcutaneous layer and including the epidermis and dermis, up to the first 20 cm2. | 10,930 | $450 | $5M |
| 95810 | Polysomnography refers to the continuous and simultaneous monitoring and recording of various physiological and pathophysiological parameters of sleep for six or more hours with physician review,… | 1,770 | $1,990 | $3.5M |
| 71045 | In this diagnostic procedure, the provider performs a single radiological view of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and nearby… | 16,700 | $130 | $2.2M |
| 96374 | The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition. | 35,560 | $50 | $1.9M |
| 93005 | The provider records the electrical conduction of the heart to examine any abnormality in its functioning, based on signals from at least 12 leads, wires that connect the recording device to… | 28,290 | $60 | $1.8M |
| 74177 | The provider performs computed tomography of the abdomen and pelvis with contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs. | 4,000 | $330 | $1.3M |
| G0463 | Hospital outpatient clinic visit for assessment and management of a patient | 12,400 | $80 | $929.6K |
Showing 1–10 of 211
How this provider's Medicaid billing volume and revenue compare to other Indiana providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Indiana median
211 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 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. | 37 | 380 | 2,470 | $100 | $1.5M |
| 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. | 34 | 360 | 3,490 | $110 | $1.5M |
| 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. | 18 | 330 | 1,530 | $100 | $1.1M |
| G0463 | Hospital outpatient clinic visit for assessment and management of a patient | 22 | 100 | 2,210 | $70 | $926K |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 165 | 180 | 1,730 | $180 | $744.6K |
| 93005 | The provider records the electrical conduction of the heart to examine any abnormality in its functioning, based on signals from at least 12 leads, wires that connect the recording device to… | 13 | 130 | 3,770 | $60 | $617.7K |
| 43249 | The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum and dilates (widens) the esophagus with a balloon less than 30 mm in diameter. | 5 | 10 | 210 | $1,060 | $576.8K |
| 74177 | The provider performs computed tomography of the abdomen and pelvis with contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs. | 31 | 150 | 440 | $100 | $545.6K |
| 92507 | The 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… | 312 | 390 | 3,600 | $50 | $511.6K |
| 99214 | The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the… | 1,317 | 2,120 | 870 | $60 | $450.6K |
Showing 1–10 of 211
Other providers in the same ZIP code as Indiana University Health Ball Memorial Hospital, Inc., ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Hillcroft Services, Inc | IN | Social Worker | $0 | $26.1M |
| Indiana University Health Ball Memorial Physicians, Inc. | IN | Family Medicine Physician | $0 | $26M |
| Meridian Health Services Corp | IN | Psychiatric Hospital | $0 | $3.4M |
| Open Door Health Services, Inc. | IN | Federally Qualified Health Center (FQHC) | $0 | $3M |
| Ball Outpatient Surgery Center, LLC | IN | Ambulatory Surgical Clinic/Center | $1.2M | $1.7M |
| Henry Lee | IN | Radiation Oncology Physician | $868.5K | $0 |
| Drew Anderson | IN | Dermatology Physician | $788.5K | $0 |
| Brett Austin | IN | Dermatology Physician | $676.5K | $0 |
| Muhammad Sarfraz Nawaz | IN | Hematology & Oncology Physician | $420.1K | $0 |
| Elizabeth Peacock | IN | Dermatology Physician | $289.6K | $0 |
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.