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.

St Vincent Hospital (NPI 1578587150)

Field	Value
Entity Type	Organization
Organization	St Vincent Hospital
Address	455 Saint Michaels Dr
City	Santa Fe
State	NM
ZIP	87505
Taxonomy	General Acute Care Hospital
NPI Enumerated	July 27, 2006

Payer Source	Total Paid
Medicaid	$46.5M
Medicare	$0

Key Findings

ST VINCENT HOSPITAL is effectively a single‑payer Medicaid facility in the available data: there is no Medicare billing on file while total Medicaid revenue is $46.5M, indicating Medicaid is the sole recorded federal payer driving measurable claims and payments for this provider. This concentration means any analysis of its service mix and financial risk should focus on Medicaid reimbursement patterns and statewide positioning.

Revenue is concentrated in a small set of outpatient and ED services: the precomputed top 3 Medicaid codes by revenue account for 44.8% of the provider's total Medicaid revenue, signaling a heavy dependence on a few high-volume service lines for nearly half of Medicaid receipts. That level of concentration implies vulnerability to reimbursement or utilization shifts in those specific codes.

Emergency services and hospital outpatient evaluation dominate the top revenue drivers: 99284 ($5.5M, 16.6%), 99283 ($4.8M, 14.3%), and G0463 ($4.6M, 13.9%) are the largest revenue contributors, showing the facility handles large volumes of ED visits with moderate and lower complexity plus high-volume outpatient clinic assessment. This code mix indicates the hospital operates as a significant regional emergency and outpatient care access point for Medicaid enrollees.

Competitive standing by code shows a mix of strong and typical volumes: G0463 ranks #4 of 38 providers in-state (92nd percentile) indicating a leading role in hospital outpatient assessment, while 99283 (84th percentile) and 99284 (73rd percentile) reflect solid but not dominant ED volumes relative to peers. Several other high-volume codes such as 97110 (96th percentile), 80053 (94th percentile), and 36415 (98th percentile) are notably above typical state volume, suggesting the hospital is a major local provider for PT, lab panels, and phlebotomy services.

Service-line breadth extends beyond ED care into infusion, imaging, and surgery: notable Medicaid revenue comes from oncology/infusion codes (96413, 96365, 96375), imaging (74177, 70450, 71045), cardiac testing (93005, 93306), and implantable device supply (C1713). This spread implies the hospital supports inpatient/ambulatory procedural care and ancillary diagnostics in addition to emergency and outpatient clinic services.

Several specific codes are statistical outliers or notably above typical state volume, indicating operational strengths: 0241U ranks #2 of 29 (96th percentile) and 97110 ranks #14 of 292 (96th percentile) — both labeled notably above typical — while 36415 is #5 of 252 (98th percentile) and 80053 is #7 of 97 (94th percentile). These high percentiles point to unusually large throughput in certain diagnostic, therapy, and specimen-collection services for the state.

The hospital has long operational tenure based on NPI enumeration: registered in 2006-07-27 (~20 years ago), which supports interpretation of these utilization patterns as established practice lines rather than recent programmatic shifts. That tenure may reflect stable referral relationships and service capacity in the Santa Fe market.

Although many codes show typical statewide ranks (60s–80s percentiles) for ED, imaging, and infusion, there are no Medicare comparators to assess national competitiveness; the absence of Medicare billing on file means competitive assessments must rely solely on Medicaid benchmarks and statewide ranks rather than national Medicare peer comparisons.

Medicaid: Complete Services Breakdown

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

446 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	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.	27,970	$200	$5.5M
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.	33,840	$140	$4.8M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	69,970	$70	$4.6M
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.	10,650	$250	$2.7M
0241U	N/A	9,690	$140	$1.3M
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…	25,480	$40	$1.1M
96413	Chemotherapy is a therapeutic procedure used for the treatment of cancer via the use of chemical agents. These chemical agents (drugs) work on the cancerous cells of the body to destroy them. These…	4,470	$240	$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.	4,250	$240	$1M
G0378	Hospital observation service, per hour	5,040	$200	$982.8K
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…	19,580	$50	$979K

Showing 1–10 of 446

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

St Vincent Hospital — 3 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

446 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.	21	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.	26	70	6,920	$210	$3.5M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	4	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.	14	80	10,650	$130	$2.4M
J0585	Injection, onabotulinumtoxina, 1 unit	14	20	810	$520	$1.6M
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.	18	60	3,070	$210	$1.4M
76820	The provider performs Doppler ultrasonography for fetal surveillance to determine the velocity of blood flow through the umbilical artery. This test determines the timing of labor induction and when…	15	20	2,780	$90	$1.3M
G0378	Hospital observation service, per hour	5	40	1,000	$400	$1M
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.	19	60	2,820	$110	$799.5K
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…	8	50	7,300	$60	$737.6K

Showing 1–10 of 446

Related Providers

Other providers that share a Tax Identification Number (TIN) with St Vincent Hospital, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mercy Health System Corporation	WI	Multi-Specialty Clinic/Center	$0	$13.2M
St. Vincent Hospital	NM	Pediatrics Physician	$0	$4.7M
St. Vincent Hospital	NM	Pediatrics Physician	$0	$4.4M
St. Vincent Hospital	NM	Urgent Care Clinic/Center	$0	$3.2M
St. Vincent Hospital	NM	Hospitalist Physician	$0	$2M
Robert Ali	NM	Hematology & Oncology Physician	$634.6K	$0
David Snyder	NM	Hematology & Oncology Physician	$286.8K	$0
John Garcia	NM	Orthopaedic Surgery Physician	$262.2K	$0
Michael Hoskins	NM	Clinical Cardiac Electrophysiology Physician	$254.2K	$0
Michael Bestawros	NM	Clinical Cardiac Electrophysiology Physician	$251.8K	$0

Nearby Providers

Other providers in the same ZIP code as St Vincent Hospital, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
New Mexico Treatment Services LLC	NM	Community/Behavioral Health Agency	$291.6K	$35.3M
Professional Home Health Care De Santa Fe Y Los Alamos	NM	Home Health Agency	$0	$32.5M
State Of New Mexico	NM	Public Health or Welfare Agency	$0	$15.9M
Whole Child Dental, LLC	NM	Pediatric Dentistry	$0	$13.6M
Presbyterian Medical Services	NM	Federally Qualified Health Center (FQHC)	$0	$13.3M
Santa Fe Indian Hospital	NM	Federal Public Health Clinic/Center	$0	$12.5M
Noesis Integrative Health Inc	NM	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$12.3M
Healthfront PC	NM	Emergency Medicine Physician	$0	$8.9M
Hero Dental Of Santa Fe PC	NM	General Practice Dentistry	$0	$8.3M
The Life Link	NM	Community/Behavioral Health Agency	$0	$8.1M

St Vincent Hospital — Billing Profile & Reimbursement Data

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St Vincent Hospital — 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