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

Why is the Medicaid comparison limited to Michigan 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. Michigan (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.

Bronson Methodist Hospital (NPI 1417961137)

Key Findings

Field	Value
Entity Type	Organization
Organization	Bronson Methodist Hospital
Address	601 John Street
City	Kalamazoo
State	MI
ZIP	49007
Taxonomy	Hospitalist Physician
NPI Enumerated	July 28, 2006

Payer Source	Total Paid
Medicaid	$64.8M
Medicare	$0

This provider reports no Medicare billing on file and concentrates its entire recorded fee-for-service scale in Medicaid, with total Medicaid revenue of $64.8M. In operational terms the practice is effectively single‑payer (Medicaid) in the claims dataset, which will shape contract and utilization analyses toward state Medicaid dynamics rather than Medicare trends.

Revenue concentration is high: the top 3 Medicaid codes (99214, 99213, 59409) account for 40.1% of this provider's total Medicaid revenue. Those top codes individually are 99214: 150.5K claims, $61 avg paid/claim, $9.2M revenue (18.0%); 99213: 178.3K claims, $41 avg paid/claim, $7.3M revenue (14.4%); and 59409: 5.2K claims, $746 avg paid/claim, $3.9M revenue (7.7%), indicating heavy dependence on a small set of services for a large share of dollars.

The code mix points to a dual emphasis on high-volume outpatient E/M and obstetrics. High-volume office visit codes 99214 and 99213 (combined 328.8K claims and $16.5M revenue) alongside major delivery codes such as 59409, 59426 (4.7K claims, $711 avg paid/claim, $3.3M revenue) and postpartum/outpatient delivery follow-up 59430 (3.9K claims, $163 avg paid/claim, $636.4K revenue) indicate an integrated hospital-based maternal and outpatient care footprint.

Inpatient and critical care services are also a material component of activity and revenue. Sub‑acute and inpatient E/M codes like 99232 (85.7K claims, $41 avg paid/claim, $3.5M revenue), 99233 (28.6K claims, $59 avg paid/claim, $1.7M revenue) and initial hospital care 99223 (15.4K claims, $106 avg paid/claim, $1.6M revenue) together with critical care 99291 (14.9K claims, $120 avg paid/claim, $1.8M revenue) show substantial hospital-based throughput and higher-acuity case mix.

Competitive standing within the state is dominant for many top codes: 99214 ranks #8 of 4380 providers in-state (100th percentile; extreme outlier) and 99213 ranks #6 of 4766 providers (100th percentile; extreme outlier). Obstetric codes are similarly concentrated—59426 ranks #1 of 155 providers in-state (100th percentile; extreme outlier) and 59409 ranks #2 of 132 providers (99th percentile; extreme outlier)—supporting characterization of the provider as a major, possibly regional, hub for maternity care in Michigan.

The provider reports very high volumes in newborn and preventive services, consistent with an active birthing center and associated follow-up care. Examples include 99460: 12.9K claims, $53 avg paid/claim, $681.9K revenue (1.3%) ranking #2 of 142 providers (99th percentile; extreme outlier), and preventive codes such as 99392 (14.2K claims, $61 avg paid/claim, $868.7K revenue) and 99395 (10.2K claims, $65 avg paid/claim, $664.9K revenue) that rank in the upper percentiles statewide.

There is also a meaningful share of high-complexity outpatient and initial visit work: 99215 (26.4K claims, $83 avg paid/claim, $2.2M revenue, 4.3%) and new-patient high-complexity 99205 (8.2K claims, $102 avg paid/claim, $833.1K revenue, 1.6%) indicate the provider manages complex ambulatory cases in addition to routine visits. This mix of high-acuity inpatient codes and high-volume office E/Ms suggests operational capacity across both acute inpatient services and robust outpatient clinics.

The NPI has been enumerated since 2006-07-28 (~20 years ago), indicating a long-established provider presence in the market. That tenure, combined with extreme outlier volumes across multiple code families, supports interpreting current patterns as sustained service lines rather than short-term spikes.

Medicaid: Complete Services Breakdown

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

327 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	150,520	$60	$9.2M
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…	178,280	$40	$7.3M
59409	In this procedure, the provider provides admission to the hospital for delivery, labor management, including induction of labor, fetal monitoring, use of low forceps, and episiotomy, vaginal delivery…	5,240	$750	$3.9M
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…	85,650	$40	$3.5M
59426	This service is considered a mini global code for the provider who provides seven or more antepartum visits. This can happen when the patient transfers out of the practice prior to delivery or the…	4,690	$710	$3.3M
99204	The provider sees a new 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 provider…	35,690	$80	$2.9M
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	26,390	$80	$2.2M
59514	The provider admits the patient to the hospital for delivery, delivers the fetus and placenta via an abdominal incision, and provides care immediately after delivery on the same date of service. This…	2,190	$840	$1.8M
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…	14,910	$120	$1.8M
99203	The provider sees a new 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 provider…	34,820	$50	$1.7M

Showing 1–10 of 327

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Michigan Distribution

Bronson Methodist Hospital — 23 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Michigan

Full comparison — all codes billed, vs. Michigan median

327 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.	322	480	1,350	$110	$1.7M
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.	310	450	1,540	$90	$1.3M
42820	The provider removes the tonsils and adenoids in a patient younger than 12 years old.	11	50	150	$1,300	$889.5K
99480	The provider directs the care of a recovering low birth weight infant, whose current weight is between 2501 and 5000 grams.	15	20	1,120	$100	$636.6K
59409	In this procedure, the provider provides admission to the hospital for delivery, labor management, including induction of labor, fetal monitoring, use of low forceps, and episiotomy, vaginal delivery…	2	130	200	$750	$636K
59514	The provider admits the patient to the hospital for delivery, delivers the fetus and placenta via an abdominal incision, and provides care immediately after delivery on the same date of service. This…	4	50	230	$760	$523.3K
59426	This service is considered a mini global code for the provider who provides seven or more antepartum visits. This can happen when the patient transfers out of the practice prior to delivery or the…	1	160	260	$820	$506.6K
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.	225	230	2,380	$90	$490K
59400	In this global service, the provider and nonphysician healthcare providers in the practice provide all of the antepartum care, admission to the hospital for delivery, labor management, including…	4	20	90	$2,020	$489.9K
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…	14	270	510	$140	$395.2K

Showing 1–10 of 327

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Bronson Methodist Hospital	MI	General Acute Care Hospital	$0	$109.1M
Flushing Hospital & Medical Center	NY	General Acute Care Hospital	$0	$52.8M
Bronson Battle Creek Hospital	MI	General Acute Care Hospital	$0	$43.9M
Advantage Health Saint Mary's Medical Group	MI	Multi-Specialty Clinic/Center	$0	$21.9M
Lakeland Medical Practices	MI	Internal Medicine Physician	$0	$20.9M
Advantage Health/saint Mary's Medical Group	MI	Multi-Specialty Clinic/Center	$0	$17M
Dlp Western Carolina Physician Practices LLC	NC	Internal Medicine Physician	$0	$14M
Sara Fleming	IL	Anatomic Pathology & Clinical Pathology Physician	$24.6K	$12.9M
Goshen Health System Inc	IN	Family Medicine Physician	$0	$12M
Ascension Medical Group Promed	MI	Internal Medicine Physician	$0	$10.6M

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Family Health Center Inc	MI	Federally Qualified Health Center (FQHC)	$0	$35.8M
Interact Of Michigan, Inc	MI	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$27.3M
Southwestern Michigan Emergency Services, PC	MI	Emergency Medical Services (Emergency Medicine) Physician	$0	$26.4M
Life Ems Of Kalamazoo, Inc	MI	Land Ambulance	$2.3M	$20.5M
Bethany House Recovery House	MI	Substance Abuse Rehabilitation Facility	$0	$15.5M
Forensic Fluids Laboratories Inc.	MI	Clinical Medical Laboratory	$928.6K	$10.2M
Southwestern Michigan Neonatology, P.C.	MI	Neonatal-Perinatal Medicine Physician	$0	$7.4M
Genemarkers LLC	MI	Clinical Medical Laboratory	$17.7K	$1.1M
Mazen Mislmani	MI	Radiation Oncology Physician	$472.8K	$0
West Michigan Air Care, Inc.	MI	Air Ambulance	$363.3K	$99.2K

Bronson Methodist Hospital — 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