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

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

Mercy Health Services-iowa Corp (NPI 1467537886)

Field	Value
Entity Type	Organization
Organization	Mercy Health Services-iowa Corp
Address	1000 4th St Sw
City	Mason City
State	IA
ZIP	50401
Taxonomy	Rural Acute Care Hospital
NPI Enumerated	October 25, 2006

Payer Source	Total Paid
Medicaid	$45.7M
Medicare	$0

Key Findings

MER CY HEALTH SERVICES-IOWA CORP has no Medicare billing on file and reports $45.7M in lifetime Medicaid revenue, making it effectively a single-payer (Medicaid) operation in the available claims data. This concentration means payer-mix analysis and any risk assessment should focus on Medicaid reimbursement policy and state-level program changes rather than Medicare dynamics.

Revenue is highly concentrated: the precomputed top three Medicaid codes account for 83.6% of the provider's total Medicaid revenue, with a single code, G0463, responsible for $30.2M or 67.9% of Medicaid receipts. That narrow revenue base indicates the provider’s financial exposure is closely tied to outpatient clinic visit reimbursement and utilization for the codes in that top-three group.

The code mix indicates this rural acute care hospital operates with a large hospital outpatient clinic and an active emergency department. G0463 (hospital outpatient clinic visit) dominance together with high volumes of ED E/M codes 99284 (19K claims, $3.9M, 8.9%) and 99283 (21.7K claims, $3.1M, 6.9%) point to significant ambulatory throughput plus steady ED case flow rather than inpatient-driven Medicaid revenue.

On competitive standing for outpatient clinic services, G0463 ranks #4 of 70 providers in-state (96th percentile), indicating the provider is a major statewide participant for hospital outpatient clinic visits and is notably above typical state volume for this code. That positional strength suggests regional market importance for ambulatory hospital services under Medicaid.

Emergency department activity is above typical for the state: 99284 ranks #28 of 275 providers (90th percentile) and 99283 ranks #21 of 305 providers (93th percentile, notably above typical state volume for this code). These ranks imply the ED is a significant access point for Medicaid patients, with especially high volume at the lower-to-moderate E/M levels.

Dental and anesthesia-associated outpatient procedures are a material secondary service line: D7140 (extraction) generates $899.1K (2.0% of Medicaid revenue) and G0330 (dental rehabilitation with monitored anesthesia) contributes $584K (1.3%). The presence and rank of G0330 (309 claims, ranks #2 of 8 providers, 86th percentile) and several dental codes indicate the hospital provides OR/monitored-anesthesia dental services for Medicaid beneficiaries.

This provider is an outlier in preventive and testing services for Medicaid: 90471 (vaccine administration) shows 15.7K claims and $707.6K in revenue and ranks #8 of 572 providers (99th percentile, extreme outlier); 87426 (SARS-CoV-2 immunoassay) ranks #3 of 124 (98th percentile, extreme outlier), and C9803 (COVID specimen collection) ranks #1 of 51 providers (100th percentile, extreme outlier). Those signals point to the hospital functioning as a local hub for vaccinations and high-volume COVID testing during the reporting period.

The provider's NPI tenure—enumerated on 2006-10-25 (~20 years ago)—indicates an established presence in the market. Given the long tenure combined with a Medicaid-dominant and highly concentrated revenue profile, downstream analyses should prioritize Medicaid policy sensitivity, outpatient clinic and ED capacity planning, and the implications of any state-level reimbursement or utilization shifts on this provider's financial stability.

Medicaid: Complete Services Breakdown

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

201 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
G0463	Hospital outpatient clinic visit for assessment and management of a patient	311,760	$100	$30.2M
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.	18,980	$210	$3.9M
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.	21,690	$140	$3.1M
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.	3,110	$290	$907K
D7140	Extraction, erupted tooth or exposed root (elevation and/or forceps removal)	530	$1,710	$899.1K
D2930	N/A	1,520	$530	$801.6K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	15,730	$50	$707.6K
G0330	Facility services for dental rehabilitation procedure(s) performed on a patient who requires monitored anesthesia (e.g., general, intravenous sedation (monitored anesthesia care) and use of an…	310	$1,890	$584K
92507	The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with…	7,690	$60	$492K
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	4,400	$110	$479.4K

Showing 1–10 of 201

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Iowa Distribution

Mercy Health Services-iowa Corp — 6 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Iowa

Full comparison — all codes billed, vs. Iowa median

201 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	4	70	1,440	$90	$2.8M
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.	28	280	850	$140	$801.8K
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.	50	180	340	$170	$722K
92507	The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with…	17	60	2,110	$70	$570.5K
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.	21	310	1,320	$100	$543.4K
G0330	Facility services for dental rehabilitation procedure(s) performed on a patient who requires monitored anesthesia (e.g., general, intravenous sedation (monitored anesthesia care) and use of an…	2	10	110	$2,080	$475.6K
90834	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	207	680	670	$70	$343.5K
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	21	90	320	$120	$327.7K
90853	Group psychotherapy is provided to a group of people who are normally not acquainted with each other but might be sharing similar kinds of psychological issues. The psychotherapist selects a group of…	48	120	980	$50	$230.3K
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…	17	50	130	$320	$224.4K

Showing 1–10 of 201

Related Providers

Other providers that share a Tax Identification Number (TIN) with Mercy Health Services-iowa Corp, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
North Iowa Mercy Clinics	IA	Emergency Medicine Physician	$0	$3.9M
North Iowa Mercy Clinics	IA	Cardiovascular Disease Physician	$0	$2.7M
North Iowa Mercy Clinics	IA	Pediatric Adolescent Medicine Physician	$0	$2.4M

Nearby Providers

Other providers in the same ZIP code as Mercy Health Services-iowa Corp, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Prairie Ridge Integrated Behavioral Healthcare	IA	Substance Abuse Rehabilitation Facility	$0	$24.2M
North Iowa Vocational Center	IA	Developmentally Disabled Services Day Training Agency	$0	$15.3M
Mason City Community School District	IA	Local Education Agency (LEA)	$0	$6.8M
Community Health Center Of Fort Dodge, Inc.	IA	Federally Qualified Health Center (FQHC)	$0	$6.4M
City Of Mason City	IA	Land Ambulance	$616.5K	$4.3M
Todd Hoeppner	IA	Pediatric Dentistry	$0	$4.8M
North Iowa Transition Center	IA	Community/Behavioral Health Agency	$0	$3.7M
Mason City Ambulatory Surgery Center, LLC	IA	Ambulatory Surgical Clinic/Center	$2.2M	$422.9K
Good Shepherd Geriatric Center, Inc.	IA	Assisted Living Facility	$0	$2.5M
Turning Leaf Counseling, Inc	IA	Mental Health Counselor	$0	$2.1M

Mercy Health Services-iowa Corp — Billing Profile & Reimbursement Data

Sign up for Mercy Health Services-iowa Corp — Billing Profile & Reimbursement Data policy alerts

Mercy Health Services-iowa Corp — Billing Profile & Reimbursement Data

Sign up for Mercy Health Services-iowa Corp — Billing Profile & Reimbursement Data policy alerts

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