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.

Rapid City Medical Center, LLP (NPI 1487602843)

Key Findings

Field	Value
Entity Type	Organization
Organization	Rapid City Medical Center, LLP
Address	2820 Mount Rushmore Rd
City	Rapid City
State	SD
ZIP	57701
Taxonomy	Multi-Specialty Clinic/Center
NPI Enumerated	May 5, 2006

Payer Source	Total Paid
Medicaid	$4.5M
Medicare	$0

This provider reports no Medicare billing on file and $4.5M in lifetime Medicaid revenue, making its fiscal footprint effectively single‑payer Medicaid in the available dataset. The absence of Medicare activity implies payer-concentration risk and that analyses of competitive standing or utilization should be evaluated primarily against Medicaid peers rather than a mixed payer panel.

Revenue concentration is high: the precomputed top three Medicaid codes (99213, 99214, 99204) account for 51.1% of the provider’s total Medicaid revenue. Individually those codes generate $860.5K (99213), $845.5K (99214), and $354.6K (99204), indicating that a small set of office‑visit E/M services dominates billing.

The code mix shows this is operating as a high-volume outpatient multi‑specialty clinic: the top revenue drivers are E/M office visit codes (99213, 99214, 99204), which are routine for ambulatory primary care and specialty follow-up visits. High claim counts for 99213 (25.3K claims) and 99214 (18K claims) point to substantial ambulatory throughput rather than a procedure-only or inpatient-focused practice.

Despite the E/M concentration, the provider maintains meaningful procedure lines in gastroenterology and pathology, with 43239 (EGD with biopsy) reporting $198.3K and 45385 (colonoscopy with snare polypectomy) reporting $143.8K. 45385 ranks #1 of 5 providers in-state (100th percentile; noted as notably above typical state volume), and 43239 ranks #2 of 14 (92th percentile), which supports in-house endoscopy capacity.

Surgical and obstetric procedural activity is evident and concentrated in a few high-ranked codes: 42820 (tonsil/adenoid removal in children) is $105.5K and ranks #1 of 10 in-state (100th percentile; notably above typical state volume), and 59409 (vaginal delivery) is $87.3K and also ranks #1 of 10 (100th percentile; notably above typical state volume). These ranks suggest the provider is a leading local provider for select ENT and delivery services.

For core E/M codes the provider shows a strong statewide presence: 99214 ranks #8 of 260 providers in-state (97th percentile; notably above typical state volume), while 99213 ranks #11 of 344 (97th percentile; described as typical, unremarkable volume). This pattern indicates particularly strong billing for moderate‑complexity established patient visits relative to peers.

Ancillary services and diversified revenue sources are present but secondary to E/M: allergy testing (95004, 95165), ophthalmology exams (92012), laboratory testing (87651, 85025, 80053), and pathology (88305) all appear in the top code list with measurable revenue. These codes show typical to modest percentile rankings, suggesting these lines supplement core ambulatory care rather than drive the practice.

The provider has a long tenure in the NPI file (enumerated 2006-05-05, ~20 years ago), indicating an established operation in the Rapid City market. Combined with the Medicaid-centric revenue profile and several state‑leading procedure ranks, this longevity supports the view of a stable, regionally significant multi‑specialty clinic with concentrated Medicaid exposure.

Medicaid: Complete Services Breakdown

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

134 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…	25,310	$30	$860.5K
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…	17,990	$50	$845.5K
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…	4,220	$80	$354.6K
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…	5,520	$60	$325.5K
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.	1,460	$140	$198.3K
W0037	N/A	5,470	$30	$158.7K
45385	The provider examines the colon and rectum using a colonoscope, a long, thin flexible tubular instrument with a light source and camera. He removes one or more tumors, polyps, or other lesions with a…	600	$240	$143.8K
88305	The physician, typically a pathologist, performs a level IV examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally…	2,220	$50	$115.6K
95004	The provider performs a percutaneous test with allergenic extracts to determine which substances (allergens) trigger an allergic reaction in the patient.	1,200	$90	$113K
42820	The provider removes the tonsils and adenoids in a patient younger than 12 years old.	380	$280	$105.5K

Showing 1–10 of 134

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

Rapid City Medical Center, LLP — 8 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

134 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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…	7	10	30	$1,280	$579.7K
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…	11	340	1,010	$100	$511K
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.	40	40	340	$90	$234.9K
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…	8	260	860	$80	$222.6K
43235	The provider inserts an endoscope through the mouth and down into the esophagus, stomach, and duodenum for diagnostic purposes; the provider may collect specimens by brushing or washing.	4	10	110	$390	$206.4K
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	28	40	1,100	$80	$181.3K
90832	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…	72	70	200	$80	$176.7K
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…	21	70	400	$40	$172.5K
99211	An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.	28	60	120	$210	$171.2K
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	156	190	430	$90	$154.1K

Showing 1–10 of 134

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Jennifer May	SD	Internal Medicine Physician	$1.9M	$0
Luke Hushagen	SD	Internal Medicine Physician	$1.4M	$0
Rebecca Linquist	SD	Ophthalmology Physician	$904.5K	$0
Gregory Wittenberg	SD	Dermatology Physician	$816K	$0
Robert Sage	SD	Dermatology Physician	$619.3K	$0
Tyler Ptacek	SD	Interventional Pain Medicine Physician	$507.9K	$0
Gail Bernard	SD	Ophthalmology Physician	$487.7K	$0
Jamie Schaeffer	SD	Family Medicine Physician	$326K	$0
Erika Toyoda	SD	Family Medicine Physician	$271.2K	$0
Julie Meyer	SD	Physician Assistant	$260.5K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Behavior Management Systems, Inc.	SD	Community/Behavioral Health Agency	$0	$19.8M
Monument Health Rapid City Hospital, Inc	SD	Multi-Specialty Clinic/Center	$0	$18.7M
Monument Health Rapid City Hospital, Inc.	SD	General Acute Care Hospital	$0	$11.5M
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

Rapid City Medical Center, LLP — Billing Profile & Reimbursement Data

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Rapid City Medical Center, LLP — 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