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 1437122009)

Field	Value
Entity Type	Organization
Organization	Monument Health Rapid City Hospital, Inc.
Address	353 Fairmont Blvd
City	Rapid City
State	SD
ZIP	57701
Taxonomy	General Acute Care Hospital
NPI Enumerated	February 13, 2006

Payer Source	Total Paid
Medicaid	$11.5M
Medicare	$0

Key Findings

This facility has no Medicare billing on file and is effectively a Medicaid-centric operator: total Medicaid revenue on file is $11.5M and there is explicitly "none below" for Medicare codes. For analysts, that means competitive and utilization assessments should be framed against Medicaid flows rather than dual-payer dynamics.

Revenue is highly concentrated in a small set of outpatient/ED and lab codes: the top three Medicaid codes (36415, 99283, 99284) together account for 56.6% of the provider's total Medicaid revenue. Individually these are 36415 ($4.4M, 38.7%), 99283 ($1.4M, 12.4%), and 99284 ($622.5K, 5.5%), indicating a small number of services drive the majority of reimbursement.

The code mix points to a high-throughput emergency department and outpatient diagnostic operation: 99283 (20.4K claims), 99284 (19.5K claims), and 99282 (4.5K claims) are all prominent, and the presence of G0378 (43.1K claims) and G0463 (20.5K claims) reinforces substantial observation and outpatient clinic activity. These volumes suggest the provider functions as a regional ED and observation hub rather than primarily as an inpatient surgical center.

Phlebotomy and diagnostic testing are major service lines: 36415 (16.7K claims, $4.4M) is the single largest revenue source and ranks #2 of 105 providers in-state with a "typical, unremarkable volume" label despite its revenue share. High claim counts for 93005 (34.3K claims, $411.8K, 97th percentile) and molecular/respiratory codes such as U0003 (2.9K claims, $270.6K) and 0202U (257 claims, $127K) further indicate substantial lab and diagnostic throughput.

Infusion and IV-related services also contribute meaningfully to Medicaid revenue and show above-typical statewide standing: J7120 (2K claims, $496.9K) and J7030 (1K claims, $374.5K) both rank #1 in-state with 100th-percentile labels, and 96361 (828 claims, $410.7K) is likewise ranked #1 with a 100th-percentile label. Together these codes imply routine administration of fluids and infusions in the ED or short-stay setting, supporting the broader impression of high-acuity outpatient care.

Several codes are statistical outliers in the state and underscore the provider’s dominant role for specific services: 99283 is an "extreme outlier, far above typical state volume" (rank #1 of 66), A9270 is an "extreme outlier" (rank #1 of 27), and J3301 is an "extreme outlier" as well (rank #1 of 18). These extreme and high-percentile rankings indicate the provider is a leading statewide deliverer for particular ED, supply, and drug administration services.

High claim volumes for a small set of codes suggest operational throughput is a defining characteristic: examples include G0378 (43.1K claims), 93005 (34.3K claims), and A9270 (36.3K claims), which together with the dominant top-3 revenue drivers point to concentrated resource needs around ED, observation, and lab capacity. For payer contracting and network planning, this profile implies capacity and utilization pressures typical of a busy acute-care outpatient hub.

The provider has long-standing active enrollment: the NPI was enumerated on 2006-02-13 (~20 years ago), indicating sustained operations and an established presence in the Rapid City market. That tenure, combined with the high statewide ranks on multiple Medicaid codes, supports the conclusion that this hospital is an entrenched regional provider for ED, observation, diagnostic, and infusion services.

Medicaid: Complete Services Breakdown

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

88 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	16,720	$260	$4.4M
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.	20,410	$70	$1.4M
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.	19,450	$30	$622.5K
Q9967	Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml	1,670	$330	$557.1K
J7120	Ringers lactate infusion, up to 1000 cc	2,020	$250	$496.9K
G0378	Hospital observation service, per hour	43,090	$10	$474K
G0463	Hospital outpatient clinic visit for assessment and management of a patient	20,480	$20	$430K
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…	34,320	$10	$411.8K
96361	The provider administers intravenous, or IV, fluids with electrolytes through an already established intravenous route for each additional hour to treat more severe dehydration.	830	$500	$410.7K
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.	4,470	$90	$388.5K

Showing 1–10 of 88

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. — 14 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

88 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J3490	Unclassified drugs	19	20	1,200	$170	$1M
41899	Use this code to report a procedure on the teeth and adjoining alveolar structures for which there is no specific code available.	4	10	150	$400	$440.3K
00170	The provider performs anesthesia services for a patient undergoing an intraoral procedure, including biopsy.	17	20	130	$150	$248.6K
0202U	This is a Proprietary Laboratory Analyses (PLA) code, meaning that the code applies to only one unique lab test made by a specific manufacturer or performed by a specific lab. Report 0202U for the…	3	10	170	$360	$236.6K
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	40	340	$90	$234.9K
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.	5	60	680	$60	$205.7K
J0585	Injection, onabotulinumtoxina, 1 unit	8	10	230	$420	$201.7K
G0378	Hospital observation service, per hour	1	10	3,790	$10	$178.2K
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.	1	70	1,150	$50	$155.9K
U0003	Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high…	2	30	270	$70	$138.6K

Showing 1–10 of 88

Related Providers

Other providers that share a Tax Identification Number (TIN) with Monument Health Rapid City Hospital, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Monument Health Rapid City Hospital, Inc	SD	Multi-Specialty Clinic/Center	$0	$18.7M
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
Monument Health Rapid City Hospital, Inc.	SD	Urgent Care Clinic/Center	$0	$1.3M

Nearby Providers

Other providers in the same ZIP code as Monument Health Rapid City Hospital, Inc., ranked by combined Medicare and Medicaid revenue.

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
Rapid City Emergency Services PA	SD	Emergency Medicine Physician	$0	$8.2M
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

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