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

Why is the Medicaid comparison limited to South Carolina 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. South Carolina (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.

Roper St. Francis Mount Pleasant Hospital (NPI 1255645644)

Field	Value
Entity Type	Organization
Organization	Roper St. Francis Mount Pleasant Hospital
Address	3500 Highway 17 Byp N
City	Mt Pleasant
State	SC
ZIP	29466
Taxonomy	General Acute Care Hospital
NPI Enumerated	July 28, 2010

Payer Source	Total Paid
Medicaid	$2.5M
Medicare	$0

Medicaid: Complete Services Breakdown

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

69 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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.	7,060	$70	$466.2K
80048	The lab analyst performs a basic metabolic pane (BMP) test in which he measures the blood level of eight chemicals including total calcium, sodium, potassium, chloride, carbon dioxide, glucose, blood…	3,760	$70	$251.9K
87636	The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, and influenza B using a multiplex amplified nucleic…	1,180	$170	$194.7K
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	2,720	$70	$193.4K
99282	The 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.	1,370	$130	$179.6K
81025	The lab analyst performs the pregnancy test on a urine specimen using a methodology or kit that the analyst can read visually for a direct readout.	2,720	$70	$179.2K
80053	The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel.	2,820	$60	$160.9K
81003	The lab analyst inserts a dip stick into a freshly collected urine specimen, removes the dipstick, and shakes off the excess urine. She places the stick onto a mechanical dip stick reader that will…	2,850	$50	$142.7K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	950	$90	$82.8K
96372	A therapeutic, prophylactic, or diagnostic substance (a fluid, a drug, etc.) is injected via intramuscular or subcutaneous route into the patient's body. The procedure is performed by the physician…	1,510	$50	$81.4K

Showing 1–10 of 69

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. South Carolina Distribution

Roper St. Francis Mount Pleasant Hospital — 0 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — South Carolina

Full comparison — all codes billed, vs. South Carolina median

69 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
80053	The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel.	95	210	1,470	$60	$615K
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.	93	340	110	$40	$450.5K
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.	108	350	100	$50	$446.9K
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.	90	200	1,680	$50	$443.2K
99282	The 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.	80	140	2,520	$90	$415.3K
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	282	290	2,600	$60	$414.4K
Q9967	Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml	69	110	1,880	$100	$414K
80048	The lab analyst performs a basic metabolic pane (BMP) test in which he measures the blood level of eight chemicals including total calcium, sodium, potassium, chloride, carbon dioxide, glucose, blood…	64	150	2,500	$50	$324.9K
J7050	Infusion, normal saline solution, 250 cc	48	50	1,140	$100	$309.2K
87636	The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, and influenza B using a multiplex amplified nucleic…	26	70	600	$130	$307.2K

Showing 1–10 of 69

Related Providers

Other providers that share a Tax Identification Number (TIN) with Roper St. Francis Mount Pleasant Hospital, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Jeffrey Rieder	SC	Interventional Cardiology Physician	$554.1K	$0
Troy Bunting	SC	Cardiovascular Disease Physician	$461.3K	$0
Matthew O'steen	SC	Interventional Cardiology Physician	$449.6K	$0
Lars Runquist	SC	Interventional Cardiology Physician	$412.2K	$0
Scott Woodfield	SC	Interventional Cardiology Physician	$383.3K	$0
Cary Hickman	SC	Internal Medicine Physician	$300.4K	$0
Geetha Pinto	SC	Cardiovascular Disease Physician	$280.4K	$0
Keith Lackey	SC	Internal Medicine Physician	$276.2K	$0
James Smith	SC	Cardiovascular Disease Physician	$273.6K	$0
Thomas Kaelin	SC	Pulmonary Disease Physician	$247.8K	$0

Nearby Providers

Other providers in the same ZIP code as Roper St. Francis Mount Pleasant Hospital, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
All On Board Speech, LLC	SC	Speech-Language Pathologist	$0	$3.6M
Mt. Pleasant Pediatric Speech Therapy, LLC	SC	Speech-Language Pathologist	$0	$1.9M
Spoken Word Speech Therapy, LLC	SC	Home Health Agency	$0	$1.6M
John Mccrosson	SC	Adult Reconstructive Orthopaedic Surgery Physician	$510.8K	$0
Kathleen Hogan	SC	Adult Reconstructive Orthopaedic Surgery Physician	$309.6K	$0
Palmetto Endoscopy Center - Mt Pleasant LLC	SC	Ambulatory Surgical Clinic/Center	$301K	$0
John Mart	SC	Physical Therapist	$272K	$0
Joseph Schriver	SC	Physical Therapist	$202.7K	$0
Collin Weyer	SC	Physical Therapist	$165.2K	$0
William Carroll	SC	Orthopaedic Surgery Physician	$148.6K	$0

Roper St. Francis Mount Pleasant Hospital — Billing Profile & Reimbursement Data

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Roper St. Francis Mount Pleasant Hospital — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References