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.

Madison Community Hospital (NPI 1588644058)

Field	Value
Entity Type	Organization
Organization	Madison Community Hospital
Address	323 Sw 10th St
City	Madison
State	SD
ZIP	57042
Taxonomy	Critical Access Hospital
NPI Enumerated	January 19, 2006

Payer Source	Total Paid
Medicaid	$1M
Medicare	$0

Medicaid: Complete Services Breakdown

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…	16,410	$30	$443K
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…	4,690	$30	$140.7K
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.	2,030	$60	$123.9K
W0037	N/A	3,130	$20	$68.8K
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.	1,200	$50	$57.5K
0241U	N/A	290	$100	$30K
90460	In this procedure, the provider administers a single live attenuated vaccine through a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age.	1,980	$20	$29.7K
87651	The lab analyst performs a test for the bacteria Streptococcus, group A, using amplified nucleic acid probe technique. Strep A commonly causes acute pharyngitis, or strep throat.	500	$30	$14.1K
99392	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…	190	$60	$11.7K
U0001	Cdc 2019 novel coronavirus (2019-ncov) real-time rt-pcr diagnostic panel	390	$30	$10.9K

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

Madison Community Hospital — 2 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…	25	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…	33	260	860	$80	$222.6K
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.	19	60	680	$60	$205.7K
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…	30	40	1,100	$80	$181.3K
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	70	1,150	$50	$155.9K
99392	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…	31	50	410	$80	$127.2K
A0425	Ground mileage, per statute mile	54	60	680	$50	$106.2K
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,…	79	160	210	$120	$97.4K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	48	110	990	$20	$82.9K
90460	In this procedure, the provider administers a single live attenuated vaccine through a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age.	6	30	150	$40	$72.6K

Showing 1–10 of 50

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Yuyang Zhang	MD	Diagnostic Radiology Physician	$920.4K	$0
Neil Bansal	NJ	Neuroradiology Physician	$351.9K	$0
Travis Petree	ND	Diagnostic Radiology Physician	$275.7K	$0
Scott White	IL	Diagnostic Radiology Physician	$264.9K	$0
Sean Feinberg	IL	Diagnostic Radiology Physician	$243.7K	$0
Eric Woolley	SD	Foot & Ankle Surgery Podiatrist	$238.4K	$0
Andrew Ciccarelli	MA	Diagnostic Radiology Physician	$220.1K	$0
Matthew Casey	MN	Diagnostic Radiology Physician	$187.7K	$0
Jeffrey Hebert	NM	Diagnostic Radiology Physician	$174.7K	$0
Bryan Suchecki	MA	Diagnostic Radiology Physician	$165.8K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Every Citizen Counts Organization	SD	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$20.7M
Eyecare Center Of Madison Prof LLC	SD	Optometrist	$0	$244.1K
Inter-lakes Community Action Partnership	SD	Voluntary or Charitable Agency	$0	$192.5K
Sanford Medical Center	SD	Community/Retail Pharmacy	$119.8K	$290
Madison Central School District	SD	Local Education Agency (LEA)	$0	$87K
Kevin M. Donlin, D.m.d., P.C.	SD	General Practice Dentistry	$0	$82K
Jason Evans	SD	Neurology Chiropractor	$60.8K	$0
Madison Family Dental Prof LLC	SD	General Practice Dentistry	$0	$51.8K
Ben Liscano	SD	Family Medicine Physician	$42.7K	$0
Avera Home Medical Equipment, LLC	SD	Durable Medical Equipment & Medical Supplies	$0	$41.4K

Madison Community Hospital — Billing Profile & Reimbursement Data

Sign up for Madison Community Hospital — Billing Profile & Reimbursement Data policy alerts

Madison Community Hospital — Billing Profile & Reimbursement Data

Sign up for Madison Community Hospital — Billing Profile & Reimbursement Data policy alerts

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References