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

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

St Marys Medical Center (NPI 1457393035)

Field	Value
Entity Type	Organization
Organization	St Marys Medical Center
Address	402 E 2nd St
City	Duluth
State	MN
ZIP	55805
Taxonomy	General Acute Care Hospital
NPI Enumerated	June 11, 2006

Payer Source	Total Paid
Medicaid	$21M
Medicare	$0

Medicaid: Complete Services Breakdown

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

142 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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.	51,120	$160	$8.2M
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.	52,160	$130	$6.8M
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.	31,630	$80	$2.6M
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	46,020	$10	$506.2K
95810	Polysomnography refers to the continuous and simultaneous monitoring and recording of various physiological and pathophysiological parameters of sleep for six or more hours with physician review,…	430	$650	$276K
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.	2,120	$110	$241.9K
43239	The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis.	1,050	$230	$241.9K
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…	2,860	$50	$148.9K
G0463	Hospital outpatient clinic visit for assessment and management of a patient	2,320	$60	$136.9K
80307	The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date.	4,450	$30	$133.4K

Showing 1–10 of 142

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Minnesota Distribution

St Marys Medical Center — 5 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Minnesota

Full comparison — all codes billed, vs. Minnesota median

142 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
G0463	Hospital outpatient clinic visit for assessment and management of a patient	53	80	6,550	$80	$4.4M
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.	7	160	580	$170	$1.8M
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.	10	210	980	$140	$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.	13	220	1,730	$120	$1.3M
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…	22	50	310	$130	$678K
80307	The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date.	24	100	510	$40	$560.8K
97530	The provider uses various activities during direct contact with the patient to improve the patient’s functional performance. Use this code for each 15 minutes of activity.	247	260	890	$60	$405.3K
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.	31	150	500	$110	$293.1K
G0378	Hospital observation service, per hour	6	20	400	$140	$266.4K
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…	45	270	550	$70	$254.7K

Showing 1–10 of 142

Related Providers

Other providers that share a Tax Identification Number (TIN) with St Marys Medical Center, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
The Duluth Clinic, Ltd	MN	Multi-Specialty Clinic/Center	$0	$51.7M
Smdc Medical Center	MN	General Acute Care Hospital	$0	$35.3M
St. Mary's Hospital Of Superior	WI	Critical Access Hospital	$0	$13.4M
St. Mary's Duluth Clinic Health System	MN	Clinical Medical Laboratory	$260.2K	$5M
John Thompson	MD	Ophthalmology Physician	$3.9M	$0
Kim Ogle	WI	Internal Medicine Physician	$211.8K	$0
Bryan Austin	WI	Cardiovascular Disease Physician	$131.4K	$0
Traci Rogers	MN	Family Nurse Practitioner	$130.1K	$0
Julia Montgomery	MN	Clinical Cardiac Electrophysiology Physician	$129K	$0
Brianne Sable	WI	Physician Assistant	$121.5K	$0

Nearby Providers

Other providers in the same ZIP code as St Marys Medical Center, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Rem Arrowhead, Inc.	MN	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$107.9M
Brightwater Health Dba Human Development Center	MN	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$50.4M
St. Luke's Hospital Of Duluth	MN	General Acute Care Hospital	$0	$26.6M
Lakewalk Surgery Center, Inc.	MN	Ambulatory Surgical Clinic/Center	$1.7M	$8.6M
Webmed Mental Health	MN	Mental Health Counselor	$0	$7.1M
St. Ann's Home	MN	Assisted Living Facility	$0	$5.1M
Hilary Reich	MN	Dermatology Physician	$294K	$0
Michael Wolz	MN	Dermatology Physician	$180.6K	$0
Center For Alcohol And Drug Treatment, Inc.	MN	Substance Use Disorder Rehabilitation Clinic/Center	$147.3K	$1.3K
Benjamin Jorgensen	MN	Vascular Surgery Physician	$119.4K	$0

St Marys Medical Center — Billing Profile & Reimbursement Data

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St Marys Medical Center — 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