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    OpenPayerNPI Medicare & MedicaidSpencer Municipal Hospital
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    Spencer Municipal Hospital — Billing Profile & Reimbursement Data

    NPI 1255328621 · Spencer, IA · Rural Acute Care Hospital

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    Spencer Municipal Hospital is a rural acute care hospital provider located in Spencer, Iowa. This profile covers 0 Medicare and 64 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
    OrganizationSpencer Municipal Hospital
    Address1200 1st Ave E
    CitySpencer
    StateIA
    ZIP51301
    TaxonomyRural Acute Care Hospital
    NPI EnumeratedSeptember 30, 2005

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

    Payer SourceTotal Paid
    Medicaid$3.2M
    Medicare$0

    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.

    64 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    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.11,180$80$916.7K
    42820The provider removes the tonsils and adenoids in a patient younger than 12 years old.130$4,390$566.1K
    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.3,750$130$480.4K
    G0463Hospital outpatient clinic visit for assessment and management of a patient10,630$40$372K
    A0999Unlisted ambulance service320$870$276.4K
    69436This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia.210$700$144.6K
    99282The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making.2,410$60$139.9K
    99232The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…1,510$40$54.4K
    99223The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…290$110$30K
    99239The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends more than 30 minutes on the service on the…450$60$24.9K

    Showing 1–10 of 64

    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

    64 rows

    CPT/HCPCS CodeDescriptionRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    G0463Hospital outpatient clinic visit for assessment and management of a patient15701,440$90$2.8M
    A0999Unlisted ambulance service3460600$990$2.5M
    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.66280850$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.166180340$170$722K
    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.453101,320$100$543.4K
    96374The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.6890320$120$327.7K
    90853Group 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…112120980$50$230.3K
    A0427Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency)7590570$80$180.2K
    99232The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…561201,100$30$162.6K
    99214The 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…5141,060480$40$154.5K

    Showing 1–10 of 64

    Related Providers

    Other providers that share a Tax Identification Number (TIN) with Spencer Municipal Hospital, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Spencer Municipal HospitalIAFamily Medicine Physician$0$3.1M
    John WagenerSDInterventional Cardiology Physician$352.5K$0
    Michael MarksALRadiation Oncology Physician$321.4K$0
    Jason HoughIAOrthopaedic Surgery Physician$297.8K$0
    Herbert HartmanNECardiovascular Disease Physician$249.4K$0
    Dung NguyenOHRadiation Oncology Physician$231.7K$0
    Tarek MahrousSDInterventional Cardiology Physician$210.6K$0
    Jonathon AdamsSDClinical Cardiac Electrophysiology Physician$203.1K$0
    Paul OlsonSDClinical Cardiac Electrophysiology Physician$203K$0
    Thomas WaterburySDInterventional Cardiology Physician$196.1K$0

    Nearby Providers

    Other providers in the same ZIP code as Spencer Municipal Hospital, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Northwest Iowa Mental Health CenterIAMental Health Clinic/Center (Including Community Mental Health Center)$0$16.6M
    Regional Transit AuthorityIABus$0$2.2M
    Spencer C.s.d.IALocal Education Agency (LEA)$0$1.3M
    Drs. Jones & Geyer, PCIAOrthodontics and Dentofacial Orthopedics Dentistry$0$1.1M
    Bridgette SchmidtIAPediatric Dentistry$0$1.1M
    Stephen FoxIAOphthalmology Physician$765.6K$0
    Bobbi HonkompIANurse Practitioner$339.2K$0
    Hy-vee IncIACommunity/Retail Pharmacy$142.8K$22.9K
    Christopher RiersonIAOrthopaedic Surgery Physician$165.4K$0
    White Drug Enterprises IncIACommunity/Retail Pharmacy$127.5K$1.9K

    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
    0 of 7 years billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Claims Volume vs. Iowa Distribution
    Spencer Municipal Hospital — 0 of 25 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Iowa