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. Joseph's Medical Center (NPI 1568415974)

Field	Value
Entity Type	Organization
Organization	St. Joseph's Medical Center
Address	523 N 3rd St
City	Brainerd
State	MN
ZIP	56401
Taxonomy	General Acute Care Hospital
NPI Enumerated	May 18, 2006

Payer Source	Total Paid
Medicaid	$41.5M
Medicare	$0

Key Findings

ST. JOSEPH'S MEDICAL CENTER has no Medicare billing on file and reports $41.5M in lifetime Medicaid revenue, making its documented payment footprint effectively single-payer (Medicaid) in this dataset. The absence of Medicare claims means analyses of Medicare-based clinical mix, payment rates, or national Medicare competitive standing are not possible from the available billing data.

Revenue is highly concentrated: the top three Medicaid codes — G0463 (47.6%), 99284 (13.6%), and 99285 (10.2%) — together account for 71.4% of the provider’s total Medicaid revenue. That concentration signals that changes in outpatient clinic or emergency department volumes, reimbursement policy, or coding practice for these specific services would disproportionately affect overall Medicaid receipts.

The code mix points to an operational emphasis on hospital outpatient clinic visits and emergency department care. G0463 shows 253.1K claims at $76 avg paid/claim generating $19.2M (47.6% of Medicaid revenue), while ED-level E/M codes 99284 (43.1K claims, $5.5M) and 99285 (23.1K claims, $4.1M) together represent substantial ED throughput and revenue-driving acute care activity.

On statewide competitive standing, G0463 ranks #5 of 81 providers (95th percentile), indicating St. Joseph’s is a major provider of hospital outpatient clinic visits in Minnesota. The ED codes 99284 and 99285 rank #13 of 206 (94th percentile) and #16 of 160 (91st percentile) respectively; these are high-percentile positions but are characterized in the source as "typical, unremarkable volume for this code," suggesting the provider’s high counts align with expected volumes for comparable hospitals rather than representing an exceptional specialization beyond peers.

Laboratory and specimen services are a notable ancillary strength: 36415 (venipuncture) reports 79.2K claims and ranks #7 of 564 (99th percentile, notably above typical state volume), 80053 (CMP) reports 22.5K claims and ranks #8 of 302 (98th percentile, labeled an extreme outlier), and 85025 (CBC) reports 29.9K claims and ranks #18 of 374 (95th percentile, notably above typical). These outsized lab volumes are consistent with heavy outpatient and ED activity and imply significant in-house lab throughput supporting clinical services.

The presence of care-management billing is material but not dominant: G9002 (coordinated care fee, maintenance rate) accounts for $3.7M (9.1% of Medicaid revenue) across 16.2K claims and ranks #6 of 20 providers in-state (74th percentile). This suggests the hospital operates care coordination or maintenance programs at meaningful scale regionally, though it is not among the very largest statewide performers on this code.

The provider has a demonstrable COVID-testing/collection footprint: U0003 (high-throughput SARS-CoV-2 testing) shows 15K claims and $1.2M revenue (3.0% of Medicaid revenue) and ranks #13 of 274 providers (96th percentile), while C9803 (SARS‑CoV‑2 specimen collection) reports 5.5K claims and $198.2K revenue (0.5%). These rankings indicate above-median activity in pandemic-era testing relative to in-state peers, aligning with the hospital’s overall outpatient and ED testing volume profile.

ST. JOSEPH'S NPI was enumerated on 2006-05-18 (~20 years ago), indicating an established operational history. Coupled with the concentrated Medicaid revenue base, the provider appears to be a long-standing community hospital with substantial outpatient/ED and lab operations, which creates exposure to Medicaid policy or regional demand shifts concentrated in its top codes.

Medicaid: Complete Services Breakdown

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

192 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
G0463	Hospital outpatient clinic visit for assessment and management of a patient	253,110	$80	$19.2M
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.	43,060	$130	$5.5M
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.	23,140	$180	$4.1M
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.	41,820	$90	$3.9M
G9002	Coordinated care fee, maintenance rate	16,180	$230	$3.7M
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…	15,000	$80	$1.2M
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	79,220	$10	$475.3K
80053	The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel.	22,530	$10	$292.8K
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.	4,780	$40	$200.6K
C9803	Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source	5,510	$40	$198.2K

Showing 1–10 of 192

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. Joseph's 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

192 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	5	80	6,550	$80	$4.4M
H2035	Alcohol and/or other drug treatment program, per hour	241	280	5,980	$120	$3M
G9002	Coordinated care fee, maintenance rate	6	20	6,640	$150	$2.4M
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.	16	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.	13	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.	12	220	1,730	$120	$1.3M
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	42	120	400	$60	$685.8K
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…	41	50	310	$130	$678K
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…	86	110	1,880	$50	$564.6K
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.	47	100	510	$40	$560.8K

Showing 1–10 of 192

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
St Joseph's Medical Center	MN	General Practice Physician	$0	$7.3M
Duncan Dickson	MN	Radiation Oncology Physician	$391.3K	$0
Sumi Patel	MN	Rheumatology Physician	$364.5K	$0
Mevan Wijetunga	ND	Clinical Cardiac Electrophysiology Physician	$311K	$0
Deepak Reddy	MI	Emergency Medicine Physician	$75.8K	$169.6K
Kim Ogle	WI	Internal Medicine Physician	$211.8K	$0
Sharath Subramanian	MN	Cardiovascular Disease Physician	$209.9K	$0
Jodi Michaels	MN	Urology Physician	$203.1K	$0
Kari Messner	MN	Diagnostic Radiology Physician	$174.9K	$0
Sergey Shkurovich	MN	Diagnostic Radiology Physician	$162.1K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mille Lacs Band Of Ojibwe Indians	MN	Substance Abuse Rehabilitation Facility	$0	$17.5M
Minnesota Teen Challenge, Inc	MN	Substance Abuse Rehabilitation Facility	$0	$14.4M
Valhalla Place Brainerd LLC	MN	Methadone Clinic	$195.5K	$8.8M
Edgewood Brainerd Senior Living LLC	MN	Assisted Living Facility	$0	$8.7M
Prs Transportation Services, Inc.	MN	Non-emergency Medical Transport (VAN)	$0	$6.9M
Minnesota Specialty Health Systems-brainerd	MN	Mental Illness Community Based Residential Treatment Facility	$0	$6.2M
Independent School Dist 181 Crow Wing County	MN	Local Education Agency (LEA)	$0	$5.2M
Nathan Hilton	MN	Radiation Oncology Physician	$1.2M	$0
David Sabir	MN	Ophthalmology Physician	$274.9K	$0
Tyler Dunphy	MN	Internal Medicine Physician	$144.3K	$0

St. Joseph's Medical Center — Billing Profile & Reimbursement Data

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St. Joseph's Medical Center — 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