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

Why is the Medicaid comparison limited to New Mexico 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. New Mexico (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.

Presbyterian Healthcare Services (NPI 1558347708)

Field	Value
Entity Type	Organization
Organization	Presbyterian Healthcare Services
Address	211 Sudderth Dr
City	Ruidoso
State	NM
ZIP	88345
Taxonomy	Critical Access Hospital
NPI Enumerated	December 20, 2005

Payer Source	Total Paid
Medicaid	$33.1M
Medicare	$0

Key Findings

This entity is effectively a single-payer facility in the available data — there is no Medicare billing on file while its lifetime Medicaid revenue is $33.1M, indicating Medicaid is the primary (and only recorded) public payer revenue source for this provider. Analysts should treat comparisons to Medicare peers as not applicable for this facility since Top 25 Medicare CPT/HCPCS is listed as "none below."

Revenue is highly concentrated in a small set of emergency department E/M codes: the top three Medicaid codes (99283, 99284, 99285) together account for 57.2% of this provider's total Medicaid revenue. This concentration signals that emergency and acute evaluation services are the primary revenue drivers rather than elective inpatient or outpatient specialty procedures.

The specific code mix (large volumes of 99283, 99284, 99285) and meaningful revenue from ambulance transport codes (A0427, A0425, A0429) indicate this Critical Access Hospital operates as a front-line emergency destination and a regional stabilizer for urgent care; the presence of high-acuity 99285 volume paired with advanced life-support ambulance billing underscores a significant emergency services footprint. Imaging and diagnostics such as 74177 and 70450 also contribute, supporting on-site acute diagnostic capability.

Despite the high absolute revenue contribution of ED E/M codes, the provider's state-level competitive standing on these codes is modest to typical. For example, 99283 ranks #16 of 84 providers (82nd percentile), 99284 ranks #23 of 76 (71st percentile), and 99285 ranks #21 of 71 (71st percentile), which together indicate the hospital has solid but not dominant share of in-state ED Medicaid volume relative to peers.

Several ancillary service lines show notable activity but not outlier status: PCR/multiplex testing codes (87636, 0241U, U0003, 87631) and common lab panels (80053, 85025) appear in the top codes with typical, unremarkable volume, implying an on-site laboratory handling both infectious disease diagnostics and routine testing. These lab revenues are meaningful in aggregate but do not approach the concentration seen in ED E/M codes.

Ambulance and EMS-related revenue is a material secondary revenue stream — A0427 ($1.1M, 3.9% of Medicaid revenue) and A0425 ($1.1M, 3.8%) both appear among the top Medicaid codes and rank in mid-to-upper state percentiles (75th and 70th respectively). This supports the characterization of the hospital as part of regional emergency transport networks, likely receiving a steady inflow of Medicaid patients via EMS.

Operationally, the presence of high counts for basic ED-level services (99282–99285 in aggregate) plus high-volume ancillary codes for IV infusions (96365, 96374, 96375) and oxygen therapy (94640) suggests the provider manages a range of acuity from straightforward to complex ED treatments without relying on Medicare patient volume. These patterns are consistent with a Critical Access Hospital serving a Medicaid-heavy local population.

The provider has a long tenure in the NPI registry, enumerated since 2005-12-20 (~21 years ago), which signals established operations and likely sustained relationships with state Medicaid plans. Combined with the single-payer billing picture, this tenure supports expecting continued Medicaid-focused service delivery unless payer mix changes externally.

Across most listed Medicaid codes the facility's state-level ranks sit in the middle-to-upper percentiles but rarely at the top (examples include ranks in roughly the 36th–83rd percentiles), indicating it is a meaningful regional participant rather than a statewide leader for most services. Analysts should interpret the profile as an emergency-focused Critical Access Hospital with concentrated Medicaid revenue and stable, typical competitive positioning in New Mexico.

Medicaid: Complete Services Breakdown

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

207 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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.	30,350	$190	$5.8M
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.	26,850	$210	$5.7M
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.	13,650	$320	$4.4M
87636	The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, and influenza B using a multiplex amplified nucleic…	6,460	$210	$1.3M
A0427	Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency)	3,640	$300	$1.1M
A0425	Ground mileage, per statute mile	4,920	$220	$1.1M
74177	The provider performs computed tomography of the abdomen and pelvis with contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	1,700	$610	$1M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	10,370	$80	$777.5K
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…	5,960	$110	$649.6K
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…	7,920	$80	$633.3K

Showing 1–10 of 207

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. New Mexico Distribution

Presbyterian Healthcare Services — 0 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — New Mexico

Full comparison — all codes billed, vs. New Mexico median

207 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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.	23	80	12,050	$160	$3.9M
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.	21	70	6,920	$210	$3.5M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	15	40	3,670	$80	$3.2M
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.	16	80	10,650	$130	$2.4M
A0427	Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency)	14	50	1,320	$270	$2M
74177	The provider performs computed tomography of the abdomen and pelvis with contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	34	60	3,070	$210	$1.4M
A0429	Ambulance service, basic life support, emergency transport (bls-emergency)	29	60	1,850	$260	$1.2M
G0378	Hospital observation service, per hour	30	40	1,000	$400	$1M
87636	The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, and influenza B using a multiplex amplified nucleic…	9	30	3,760	$120	$900.7K
70450	The provider performed computed tomography, or CT scanning, of the head or brain, without contrast. He performs the procedure to diagnose any brain or intracranial abnormalities.	36	60	2,820	$110	$799.5K

Showing 1–10 of 207

Related Providers

Other providers that share a Tax Identification Number (TIN) with Presbyterian Healthcare Services, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Presbyterian Healthcare Services	NM	General Acute Care Hospital	$0	$345.3M
Presbyterian Healthcare Services	NM	Internal Medicine Physician	$0	$240.8M
Centra Medical Group, LLC	VA	Family Medicine Physician	$0	$60.1M
Presbyterian Healthcare Services	NM	Rural Acute Care Hospital	$0	$47.6M
Presbyterian Healthcare Services	NM	Rural Acute Care Hospital	$0	$40.9M
Presbyterian Healthcare Services	NM	General Acute Care Hospital	$0	$21.6M
Presbyterian Healthcare Services	NM	Critical Access Hospital	$0	$20.6M
Presbyterian Healthcare Services	NM	Critical Access Hospital	$0	$8.5M
Christopher Roybal	NM	Ophthalmology Physician	$3.8M	$0
Presbyterian Healthcare Services	NM	Home Health Agency	$0	$3.3M

Nearby Providers

Other providers in the same ZIP code as Presbyterian Healthcare Services, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Shuttle Ruidoso, LLC	NM	Non-emergency Medical Transport (VAN)	$0	$23.7M
Region Ix Developmental Services	NM	Home Health Agency	$0	$2.3M
Health Care Solutions PA	NM	Family Medicine Physician	$0	$1.9M
Kenneth W Childress Dds PC	NM	General Practice Dentistry	$0	$1.8M
Patrick Connor	NM	Emergency Medicine Physician	$48.3K	$765.9K
Abhinav Singh	NM	Internal Medicine Physician	$302.6K	$0
Elizabeth Dosch	NM	Optometrist	$139.9K	$0
Edward Regalado	NM	Physical Therapist	$138.7K	$0
Paul Gulbas	NM	Ophthalmology Physician	$132.2K	$0
Sierra Blanca Pharmacy LLC	NM	Community/Retail Pharmacy	$116.8K	$0

Presbyterian Healthcare Services — 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