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

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

Monument Health Rapid City Hospital, Inc (NPI 1275553463)

Key Findings

Field	Value
Entity Type	Organization
Organization	Monument Health Rapid City Hospital, Inc
Address	353 Fairmont Blvd
City	Rapid City
State	SD
ZIP	57701
Taxonomy	Multi-Specialty Clinic/Center
NPI Enumerated	July 20, 2006

Payer Source	Total Paid
Medicaid	$18.7M
Medicare	$0

MONUMENT HEALTH RAPID CITY HOSPITAL, INC has no Medicare billing on file and is effectively a single-payer Medicaid provider in the datasets provided, with Total Medicaid revenue of $18.7M. The absence of Medicare revenue means analyses of Medicare mix, risk adjustment, and inpatient/outpatient splits must rely on other data sources or peer benchmarking rather than this provider's own Medicare claims.

Revenue concentration within Medicaid is high: the top 3 Medicaid codes by revenue account for 40.0% of the provider's total Medicaid revenue. This level of concentration indicates that a relatively small set of inpatient and critical-care services are primary drivers of the facility's Medicaid business.

The provider’s Medicaid activity is dominated by inpatient and critical care evaluation & management codes: 99232 ($3.3M, 19.8%), 99233 ($1.7M, 10.2%), and 99291 ($1.7M, 10.0%). Together these top codes point to a service mix focused on ongoing inpatient management and high-acuity critical care, suggesting the facility operates substantial hospital inpatient, observation, and ICU-level services.

Competitive standing in-state is exceptionally strong for multiple high-value inpatient codes: MONUMENT HEALTH ranks #1 for 99232 (100th percentile, described as an extreme outlier), #1 for 99233 (100th percentile, extreme outlier), and #1 for 99291 (100th percentile, notably above typical). These ranks indicate the provider is a dominant source of Medicaid billing for subsequent inpatient and critical care services in South Dakota.

Beyond the top three, the provider also posts very high in-state volumes across other inpatient and E/M codes: 99223 ($1.5M) ranks #1 (100th percentile, extreme outlier) and 99239 ($994.2K) ranks #1 (100th percentile, extreme outlier). This reinforces the characterization of MONUMENT HEALTH as a major inpatient and discharge-management center for Medicaid patients across the state, not just for isolated critical care events.

The provider shows notable outpatient and diagnostic service volume as well: high-ranking Medicaid codes include office/outpatient E/M codes 99213 (rank #9 of 344, 98th percentile) and 99214 (rank #5 of 260, 98th percentile), as well as diagnostic procedures like 93306 (echocardiography, $506.6K, rank #2 of 22, 95th percentile). This suggests the organization maintains substantial ambulatory and diagnostic capacity in addition to its inpatient focus.

Procedure mix includes specialized, high-cost injectable and cardiac imaging services such as J0585 (onabotulinumtoxina, $648K, rank #2 of 8, 86th percentile) and 78452 (SPECT cardiac studies, $244.1K, rank #1 of 4, 100th percentile). While these are smaller contributors to total Medicaid revenue, their presence indicates ancillary specialty services supporting the hospital’s broader clinical footprint.

The NPI was enumerated ~2006-07-20 (about 20 years ago), indicating over a decade of enrollment and suggesting an established presence in the market; this tenure aligns with the facility-level volumes and top-state rankings observed across multiple inpatient and specialty codes.

Medicaid: Complete Services Breakdown

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

167 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99232	The 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…	87,490	$40	$3.3M
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	31,010	$60	$1.7M
99291	Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is…	11,090	$150	$1.7M
99223	The 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…	15,050	$100	$1.5M
99213	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…	32,130	$40	$1.2M
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…	23,380	$50	$1.1M
99239	The 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…	16,300	$60	$994.2K
J0585	Injection, onabotulinumtoxina, 1 unit	940	$690	$648K
93306	The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent…	7,680	$70	$506.6K
99222	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	6,740	$80	$505.5K

Showing 1–10 of 167

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. South Dakota Distribution

Monument Health Rapid City Hospital, Inc — 17 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — South Dakota

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

167 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J3490	Unclassified drugs	23	20	1,200	$170	$1M
99469	The provider evaluates and manages the subsequent care of a newborn or infant less than 28 days of age in a neonatal critical care setting, after the first day.	4	10	2,010	$410	$839.2K
99480	The provider directs the care of a recovering low birth weight infant, whose current weight is between 2501 and 5000 grams.	4	10	3,630	$180	$789.6K
99213	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…	9	340	1,010	$100	$511K
99291	Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is…	1	10	240	$140	$472K
99479	The provider directs the care of a recovering low birth weight infant, whose current weight is between 1500 and 2500 grams.	3	10	2,410	$130	$344.9K
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…	5	260	860	$80	$222.6K
J0585	Injection, onabotulinumtoxina, 1 unit	2	10	230	$420	$201.7K
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	10	40	1,100	$80	$181.3K
99232	The 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	70	400	$40	$172.5K

Showing 1–10 of 167

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Monument Health Rapid City Hospital, Inc.	SD	General Acute Care Hospital	$0	$11.5M
Rapid City Emergency Services PA	SD	Emergency Medicine Physician	$0	$8.2M
Monument Health Rapid City Hospital, Inc.	SD	Multi-Specialty Clinic/Center	$0	$5.2M
Richard White	AR	Hematology & Oncology Physician	$2.2M	$0
Monument Health Network, Inc.	SD	Multi-Specialty Clinic/Center	$0	$2M
Jennifer May	SD	Internal Medicine Physician	$1.9M	$0
Monument Health Network, Inc.	SD	Multi-Specialty Clinic/Center	$0	$1.8M
Monument Health Rapid City Hospital, Inc.	SD	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$1.6M
Luke Hushagen	SD	Internal Medicine Physician	$1.4M	$0
Don Wynn	TX	Pulmonary Disease Physician	$1.4M	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Behavior Management Systems, Inc.	SD	Community/Behavioral Health Agency	$0	$19.8M
Community Health Center Of The Black Hills Inc	SD	Federally Qualified Health Center (FQHC)	$0	$10.2M
Jrk Services, Inc	SD	Home Health Agency	$0	$10.1M
Black Hills Pediatrics, LLP	SD	Pediatrics Physician	$0	$9.7M
Wellspring Inc.	SD	Psychiatry Physician	$0	$7.4M
Prema Abraham	SD	Retina Specialist (Ophthalmology) Physician	$7.1M	$0
Radiology Associates Prof, LLC	SD	Diagnostic Radiology Physician	$0	$5.3M
City Of Rapid City	SD	Ambulance	$1.4M	$3.7M
Rapid City Medical Center, LLP	SD	Multi-Specialty Clinic/Center	$0	$4.5M
Black Hills Oral & Maxillofacial Surgery PC	SD	Oral and Maxillofacial Pathology Dentistry	$0	$3.2M

Monument Health Rapid City Hospital, Inc — Billing Profile & Reimbursement Data

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Monument Health Rapid City Hospital, Inc — 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