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.

Black Hills Orthopedic & Spine Center, Inc. (NPI 1477523678)

Black Hills Orthopedic & Spine Center, Inc. is a multi-specialty clinic/center provider located in Rapid City, South Dakota. This profile covers 0 Medicare and 50 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Medicaid: Complete Services Breakdown

Field	Value
Entity Type	Organization
Organization	Black Hills Orthopedic & Spine Center, Inc.
Address	7220 Mount Rushmore Rd
City	Rapid City
State	SD
ZIP	57702
Taxonomy	Multi-Specialty Clinic/Center
NPI Enumerated	January 23, 2006

Payer Source	Total Paid
Medicaid	$1.7M
Medicare	$0

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

50 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	9,370	$30	$318.5K
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…	5,030	$60	$311.6K
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	8,350	$20	$158.6K
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…	1,240	$90	$110.4K
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…	2,280	$50	$109.5K
20610	In this procedure, the provider inserts a needle through the skin of a patient and into a major joint or bursa and then uses the syringe attachment to the needle to remove fluid or he may inject a…	2,850	$30	$94K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	3,220	$20	$77.3K
73110	The provider takes at least three X–ray images of a patient’s complete wrist to check for any fracture, swelling, or reason of pain in the wrist area.	3,090	$20	$71.1K
73610	In this procedure, the provider takes three or more X–ray images of the ankle joint to check for any fracture, swelling, or reason for pain in the ankle area.	1,630	$20	$35.8K
99243	The provider sees a patient for an office or other outpatient consultation involving evaluation and management (E/M). The E/M involves a low level of medical decision making or the provider spends at…	350	$100	$33.3K

Showing 1–10 of 50

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

Black Hills Orthopedic & Spine Center, Inc. — 4 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

50 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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…	48	340	1,010	$100	$511K
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…	71	260	860	$80	$222.6K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	14	160	210	$120	$97.4K
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.	23	50	400	$30	$76.4K
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	7	60	640	$20	$72K
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…	5	100	160	$60	$64.4K
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…	12	80	120	$80	$61.5K
97112	Neuromuscular reeducation is a therapeutic treatment (exercise) performed by a physician in an attempt to reduce impairments and restore function through the application of clinical skills and/or…	12	50	380	$30	$52K
95886	The provider assesses the electrical activity of a muscle in the extremity and related paraspinal areas. At the same session as a separately reportable nerve conduction study. He studies five or more…	5	10	470	$90	$49.6K
99243	The provider sees a patient for an office or other outpatient consultation involving evaluation and management (E/M). The E/M involves a low level of medical decision making or the provider spends at…	3	10	210	$90	$42.9K

Showing 1–10 of 50

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Rebecca Linquist	SD	Ophthalmology Physician	$904.5K	$0
Gregory Wittenberg	SD	Dermatology Physician	$816K	$0
Black Hills Surgical Hospital, LLC	SD	Urgent Care Clinic/Center	$0	$698.5K
Bradley Clark	MO	Diagnostic Radiology Physician	$570.8K	$0
Gail Bernard	SD	Ophthalmology Physician	$487.7K	$0
Ryan Berecky	OR	Diagnostic Radiology Physician	$250.2K	$0
Stephen Loos	NV	Diagnostic Radiology Physician	$247.8K	$0
Jeffrey Marrs	SD	Orthopaedic Surgery Physician	$247.5K	$0
Nathan Jaqua	SD	Gastroenterology Physician	$237.3K	$0
Daniel Kirkham	OR	Diagnostic Radiology Physician	$217.9K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Black Hills Works Inc	SD	Developmentally Disabled Services Day Training Agency	$0	$149.7M
Great Plains Tribal Chairmen's Health Board	SD	Pharmacy	$0	$36.4M
Black Hills Pediatric Dentistry	SD	Pediatric Dentistry	$0	$24.7M
Dakota Dental 4 Kids	SD	Dental Clinic/Center	$0	$7.1M
Oglala Sioux Tribe	SD	Obstetrics & Gynecology Physician	$0	$5.2M
Rushmore Ambulatory Surgery Center	SD	Ambulatory Surgical Clinic/Center	$0	$4.6M
Stay Graceful Inc	SD	In Home Supportive Care Agency	$0	$3.4M
Children's Care Hospital And School	SD	Rehabilitation Clinic/Center	$0	$2.1M
Rushmore Dental Products, Inc.	SD	Durable Medical Equipment & Medical Supplies	$0	$1.7M
Black Hills Caregiving, LLC	SD	Home Health Agency	$0	$1.1M

Black Hills Orthopedic & Spine Center, Inc. — Billing Profile & Reimbursement Data

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Black Hills Orthopedic & Spine Center, Inc. — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

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